Cost Effective Alternatives to Supartz or Chicken Fat Injections
As of April 1, 2018, Blue Cross and Blue Shield of Michigan will no longer cover any hyaluronic acid injections for arthritis. This includes injections better known as Supartz, Synvisc, Effflexa or sometimes referred to as roster comb and/or chicken fat injections. Medicare and Blue Cross products covering Medicare will still cover these injections. The rationale is not due to any adverse reactions or increasing cost of the injections, but rather due to a recommendation from the American Academy of Orthopedic Surgeons. Without insurance reimbursement, these treatments can cost up to $1600 which is a terrible burden for our patients. However, Advanced Orthopedic Specialists and Dr. Edward G. Loniewski have come up with some very cost effective treatment alternatives that are more effective, safer and less time consuming than the current hyaluronic injection series.
In summary, we have the following cost effective options:
• Platelet Rich Plasma (PRP) injections – This uses the healing growth factors of your own blood to relieve pain and restore function better than hyaluronic injections with just one treatment.
• Homeopathic Traumeel and Zeel Injections- Imported from Germany and clinically proven to reduce pain without any known side effects. Three injections given one week apart.
• Joint Builder Ultra- This special combination of oral hyaluronic acid, glucosamine, boswellia and MSM provide relief of pain.
• Multi-Waved Locked System (MLS) Laser- Medical grade dual laser therapy to reduce inflammation and pain without any injection or side effects.
Please contact our office at 810-299-8550 for the most current pricing.
This blog will focus on homeopathic injections as an alternative:
Homeopathic Injections- Samuel Hahnemann brought the idea that “like cures like” to the modern world in the early 1800’s and this was so popular by the late 1800’s that the University of Michigan opened its own homeopathic college in 1891. Homeopathy fell on hard times when many medical journals and standard medical organizations refused to recognize this form of medicine as legitimate theory.
However, this may change soon with the release of some recent studies by such institutions such as the Case Medical Center and the University of Miami. In addition, some basic science studies now show some significant positive biologic changes occurring with these preparations. The first study compared a homeopathic preparation called Zeel to two traditional arthritis medication called Celebrex (celcoxib) and Vioxx (refacoxib). Although there are some flaws in the design of the controls of this study and no use of a placebo, it did conclude that there was no statistical superiority of any of the medications in the treatment of mild to moderate arthritis of the knee. This meant that the homeopathic preparation performed just as effectively as two traditional medications The MOZArT study helped justify this concept by putting together a blinded and placebo controlled study conducted in the United States at Case Hospitals in Cleveland. Over 252 patients between the ages of 45-80 with moderate to severe osteoarthritis of their knee were enrolled to either receive 3 injections of Traumeel/ Zeel combination or a placebo of saline. They received one injection per week for 3 weeks. They completed pain and function scores as well as 50-foot walking test and a global physician assessment. Patients were accessed about every 2 weeks for 99 days. The homeopathic injection group with Traumeel and Zeel had statically significant improvements in all parameters.
Another interesting study evaluated the biochemical effect of Traumeel in vitro (in a test tube) on human T-Cells and gut epithelial cells. The researchers at The Center for Integrative Complementary Medicine in Jerusalem, Israel found that Traumeel had a profound effect on the pro-inflammatory production of Interleukin 1-beta (IL-1B), Tumor Necrosis Factor-alpha ( TNF-a) and Interleukin-8 ( IL-8). Traumeel reduced these toxic, inflammatory byproducts of cells by 50-70% in both active and resting cells and this effect had an inverse relationship to the concentration of the product thus proving the long-held concepts of homeopathy. In plain English this means that the homeopathic preparation dramatically reduced harmful biochemical markers which are important in the treatment of arthritis. These pro-inflammatory products especially Interleukin-1 beta are extremely important in joint homeostasis or the restoration of normal biochemical function of the knee. In addition, it appears that Traumeel has further effects on the activation of biochemical pathways which help with the repair of a damaged joint. Researchers at the University of Leipzig found that exposing chondrocytes (cartilage cells) to Traumeel caused an elevation of Transforming Growth Factor – Beta (TGF-B) as well as stimulating the basic function of cartilage cells while also reducing harmful chemicals called Matrix Metalleoproteinases (MMP-13). This study helped to solidify the previous study and it revealed that this homeopathic solution not only stimulated positive effects on cartilage cells, but also helped protect these cells.
Traumeel is a botanical mixture of approximately 14 biologic minerals and is designed for short term pain relief of inflammation caused by trauma, or arthritis. It can be used orally, topically or as an injection into a joint. Zeel is also a botanical mixture of 14 biologic minerals in differing dosing to provide longer term relief of pain caused by an arthritic joint and is proposed to slow down the degenerative process of arthritis. These preparations have been used by practitioners in Germany and Austria for over 30 years with excellent safety profiles.
A combination of just 2 cc of Traumeel and 2 cc of Zeel with 1-2 cc of standard local anesthetic can be injected into almost any arthritic joint with little need for any time off work or activities. Most patients notice changes beginning after the second injection and most notice relief for at least 3-6 months. The injections of Traumeel and Zeel do not interfere with other medications, nor cause any changes in blood sugars which is a problem with corticosteroid injections. The injections can be safely injected into tendons or ligaments without fear of rupture or destruction. The treatments can also be repeated without concerns about resistance or further damage to the joint surface.
Because these are botanical minerals and they are diluted beyond a traditional pharmaceutical product, the prices are naturally lower. This is much lower than platelet rich plasma or even hyaluronic injections. Because this natural botanical preparation does not produce harmful effects on cellular preparations, this can be safely used in patients receiving stem cell or PRP injections for faster pain relief while helping to restore the normal biochemical environment of an arthritic joint. Advanced Orthopedic Specialists is excited to offer this option to our patients as we continually strive to provide “state of the art care in a friendly environment.” If you are interested in scheduling an appointment with Dr. Edward Loniewski to discuss this natural and cost effective treatment, call 810-299-8550 as we are always happy to help.