Dr Ralph Rogers’ CV is impressive to say the least: a leading Harley Street consultant, former First Team Doctor to Chelsea Football Club, currently Medical Advisor to the NBA and founder of the Rogers Regenerative Medical Group. In short, when it comes to joints from necks to back to knees, he’s the person you want to see. Happily, he is also a clinician at Living Room Health. In the following interview, find out why, when it comes to your knees, there are approaches other than invasive knee surgery.
If someone comes to you with osteoarthritis of the knee what would you recommend?
It depends on many factors, one of the most important being age. If you’re in your 30s and have early osteoarthritis, you might not want to jump straight into invasive surgery. Surgeons used to do a thing called a ‘wash out’, they would open up the joint and wash it out but that simply doesn’t work. You would also be too young for something like a knee replacement. However, you’re still in pain so this is where someone like me comes in. I can help with what is called orthobiologics, which can include the use of Platelet Rich Plasma (PRP), n-stride, Lipogems and more. This combined with a comprehensive rehabilitation programme can produce really good results in terms of pain relief and function.
Does this involve surgery?
No, we deliver orthobiologics via injection so it’s minimally invasive. We sometimes take blood and process it to get all the molecules we need, including growth factors such as exosomes, and all these other wonderful cells that we’re able to inject into the joint to create what we call a regenerative microenvironment. Alternatively, we can take something like your fat. We know that fat has the most mesenchymal stem cells and we know from Arnold Kaplan’s work from 1991 that this cell does not create cartilage but it creates what we call a regenerative micro-environment. These cells also bind to pain receptors to reduce pain and help with function. Reduction of pain is what it’s all about. People don’t come to me because they’ve lost cartilage, they come to me because they’re in pain so my objective is to get you out of pain and increase your function to the time where either something new has come up or you have a knee replacement if there is nothing else we can do for you.
Is surgery always a bad idea?
It really depends on your age. If you’re still relatively young it is much better to try minimally invasive treatments instead of surgery. Once you cut into the body you create scar tissue which can be just as bad as the injury itself. This is one of the reasons why there is a movement in healthcare towards regenerative treatment.
The statistic that no one likes to talk about is that up to 34% of knee replacements don’t work and often it’s not the surgeon’s fault. Even if the surgeon has done a great job and can see the knee working well, the patient may still be in pain. And if they are still in pain then I would say the surgery has failed. On top of this, these knee replacements will only last around 15 years. So if you have one in your 30s you’ll need another one in your 50s and so on.
I’m not against knee surgery but I think it needs to be done at the right time and with the right person. And while nothing is guaranteed, there is about an 85-87% success rate with orthobiologics. That doesn’t mean completely pain free, but if I can get someone from, say, 7 out 10 on the pain scale down to a 3 then I consider it successful treatment.
If you are suffering from joint pain then you can speak to one of our consultants by completing our contact form.