#281 Knee Replacement Alternatives: Why 82% of ”Bone on Bone” Knees Avoided Surgery for 15 Years | Marc Pietropaoli @Victory in Motion

What if the knee your doctor wants to replace could be repaired instead?

In a 15-year study, 82% of arthritic knees treated with the patient's own bone marrow never needed a knee replacement. Orthopedic surgeon Dr. Marc Pietropaoli stopped doing knee replacements in 2020, and he explains why most knee arthritis pain comes from the bone under the cartilage and what actually repairs it.

Meet our guest

Dr. Marc Pietropaoli is a sports medicine fellowship-trained orthopedic surgeon who trained under Dr. James Andrews and specializes in regenerative medicine. He founded Victory In Motion, home of Knee Repair, NOT Knee Replacement, and wrote the #1 Amazon best seller Repair NOT Replace. He was the first surgeon in the world to perform an FDA-approved BEAR ACL repair outside of clinical trials. Today his team combines bone marrow concentrate, properly dosed PRP, laser therapy, and whole-body rehab, with the goal of ending the need for knee replacements by 2043.

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Key takeaways

• Cartilage has no nerves, so most arthritis pain comes from stress fractures in the bone under it.
• A bone marrow lesion in one bone around the knee makes a replacement 9 times more likely, and 13 times more likely in more than one spot.
• 82% of knees treated with bone marrow concentrate avoided replacement over about 15 years.
• Many "stem cell" shots contain no live cells, and many PRP treatments are underdosed.
• Cortisone knee injections are linked to needing a replacement sooner.
• Studies suggest 25% to 30% of joint replacements are unnecessary.
• ACL prevention training can cut the risk of an ACL tear by 50% to 75%.

Episode highlights

0:00 Why we still fix knees with 1960s technology

1:40 The operating room question that started it all

14:23 Why knee pain starts in the bone

16:10 The 15-year study: 82% of knees avoided replacement

21:26 Why some stem cell & PRP treatments fail (dose matters)

34:11 Told you're bone on bone? Ask to see your X-rays

39:41 Preventing knee damage: ACL injuries & BEAR surgery

Links

• Watch it on YouTube: https://youtu.be/ehAmqJS0aoE 
• Full episode show notes: https://outliyr.com/281

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