Paul Whitson was diagnosed with bone on bone cartilage wear in his knee, and in 2017 this former high school science teacher looked at some of the scientific evidence and decided to come here for PRP Stem Cell Joint Repair:

At 1:46 into the above video, he says of his initial knee evaluation here that “for the first time, somebody mentioned that maybe my pain wasn’t coming from the bone on bone, that there was collateral damage to ligaments and tendons. Most of this occurred as a result of an arthroscopic surgery that occurred earlier, 20 some years earlier, where some of my meniscus was removed, which created instability in the knee and accellerated wear and tear.” I said right after that this was “a brilliant, succinct statement”. Listen to your science teacher, kids!

Surgeons seem to focus on cartilage loss as their key justification for joint replacement. Like anything else in a knee, cartilage is important. The term “bone on bone” is thrown around a bit too loosely, as some situations only involve small areas where the cartilage is worn down to bone. At those sites where cartilage is actually, truly fully worn down to bone, our methods cannot grow new cartilage. At those sites where cartilage is not actually fully worn down to bone, our methods grow new veneer-like layers of cartilage more slowly than we’d like. Unlike meniscus, which is reinforced fibrocartilage, the softer joint cartilage spoken of in the “bone on bone” description is our most difficult substance to grow in a joint. However, there is so much more to improve and repair in a knee or other joint – ligaments, tendons, fascia, fibrocartilage, etc. Each case of “bone on bone” must be carefully evaluated, for in many cases, like Paul Whitson’s, repair of other parts in a joint may be able to eliminate pain and enable increased activity, leading to strengthening of surrounding muscle.

Last year Paul was diagnosed with bone on bone cartilage wear in his shoulder, and the last newsletter tells the story of how he got rid of the pain in that shoulder.

Joint replacement was recommended for Paul’s bone on bone knee and his bone on bone shoulder. Joint replacement did not turn out to be needed in either joint. However, joint replacement can be a correct call for some joints in some patients, though the above stories show that it also may not be necessary. Read here and here about the inadequately appreciated risks of joint replacement.

It is Autumn. Here is another version of Autumn Leaves by Paul Desmond:

We had snow unusually early this year, early in September. On that morning, I looked out of my home window and saw leaves of our apricot tree somehow unusually bright and luminescent from their unexpected collision with early snow. The first two photos are from that September morning. The others are from this morning in late November.

Dr. Jonas Skardis