Case Study: Amniotic Fluid/Membrane Suspension for Osteoarthritis

A 58 year old male patient presented to the office with long-standing left lateral joint line pain. He injured his left knee playing football in high school and underwent a partial meniscectomy at that time. He subsequently had a second arthroscopy in his 30s. He remained very active and was doing well until the last 6 years, when his pain increased markedly. He had several corticosteroid injections, which provided temporary relief. He maintained a home exercise program and optimized his weight. Eventually, his pain and swelling increased to the point of markedly limiting his activity: he was unable to run or even jog and had difficulty with his volunteer activity of “search and rescue”. His symptoms were proportional to activity, but he had full range of motion and no other associated symptoms.

Note the lateral joint space narrowing consistent with osteoarthritis.

His radiographs revealed marked left lateral joint space narrowing, malalignment, and was consistent with osteoarthritic changes. He is a candidate for partial or total knee replacement, but he wanted to delay joint replacement as long as possible. We discussed the available non-operative treatment options including unloader bracing, viscosupplementation, repeat corticosteroid injection, and Ortho-Biologic options ranging from Platelet Rich Plasma to various Stem Cell options. He elected to proceed with ReNu®, an amniotic fluid and membrane stem cell injection.

He had no problems with the knee injection. As is typical for biologic injections, the positive effects slowly began around 6 weeks after the injection. He noted progressive decrease in pain and swelling. After 3 months his pain had diminished markedly and he was able to increase cycling and began running for the first time in years. He had not pain at rest and rated his max pain 2 out of 10 with minimal or no swelling.  He was happy to be able to return to training for his “search and rescue” team.

After 12 months he continued to be happy with his knee. He remains quite active and has less swelling than prior to injection.  For those interested in actual patient reported data (PRO), it is listed below.