Arthritis in your hand or thumb or wrist? Don’t forget about platelet rich plasma! There are many treatment modalities….medications, bracing, therapy, steroid shots……but only PRP is truly based on using your body’s own healing and anti-inflammatory systems. Here is a 1 minute video showing a recent in office injection….he had an injection 1 year ago and got 80% pain reduction and back to all his activities! (after steroid shots were not working). Results vary of course BUT with PRP the biggest risk is that it doesn’t work….no GI problems, no surgery, no uncomfortable braces, no steroid risk.
Bone marrow derived stem cells for cartilage repair worked in horses 8 years ago…isn’t time we started treating people with state of the art equine care?? In a 2010 article published in the Journal of Bone And Joint Surgery, the authors compared micro fracture of a 15mm chondral lesion in the trochlea with micro fracture plus bone marrow aspirate concentrate injection. Outcomes at 8 months showed that all scoring systems AND histology AND MRI analysis all showed that both the amount of cartilage AND the type 2 collagen content was significantly better in the BMAC treated group.
I like to try to have a thoughtful personalized approach to treating meniscal pathology rather than a less sophisticated approach of “treat them all the same”. After 25 years of surgical experience to use to help interpret often contradictory published papers, I think the best approach is to separate out the acute from the degenerative tears, stable from the unstable tears, and finally to appreciate the vascular anatomy of the tear location. The picture presented is of a patient who had an acute onset of knee pain over the medial joint line and who failed to get better with a month of directed physical therapy.
What about exosomes as an “off the shelf” orthobiologic therapy?
Today I received 4 email inquiries about exosomes.
How much human outcomes data there is on the efficacy of exosomes in orthopedics? …not much at all. Exosomes are produced locally in response to the specific environment…ie. if a joint is inflammed, the exosomes being produced may have an anti-inflammatory nature overall.
We just completed another successful training course…our 25th in 9 years…and now have trained well over 1000 clinicians on MSK ultrasound. Our next Course in January 24-26, 2019 at the Cosmopolitan Hotel in Las Vegas. www.orthosono.com
I recently received a “Cease and Desist” letter from the attorneys for Zimmer because I used the term “subchondroplasty” in a lecture presentation and on Dallas PRP and Stem Cell’s web site . Zimmer has a trademark on the term “subchondroplasty” which they market as a specific procedure where bone cement is put into a bone lesion…it is not a regenerative medicine procedure and obviously a non-anatomic procedure.
Sadly,not true. At least not the way it is presented to people at seminars as a sales tactic to separate people from their hard earned money. A simple 5 degree xray tilt will make an xray change to look as if new cartilage has grown….that is what these clinics and people are showing potential patients who are interested in regenerative medicine procedures….and these clinics usually compound the deceit by telling patients they can get living stem cells from amniotic fluid or umbilical cord blood.
Our patient wanted to share her story…..she is only 4 months after her in office bone marrow derived stem cell procedure that took 1 hour. She is 2 months after a PRP injection we did into the same knee to give her a better result. Now? 90%+ better and doing things without pain that she had not been able to do for years. In her words.
Here is a case study using PRP to help a NCAA college football player with a quadriceps muscle disruption. The procedure is done in the office in about 30min. Hopefully it gets him back in the game faster!
Block an artery to decrease knee arthritis pain?? I am just not convinced that a patient with knee arthritis should be advised to have their geniculate artery clotted (embolized) in an interventional radiology suite…with an expected 6 months of partial pain relief. This write up discusses a very small pilot study with no statistical significance….but my question is whether we should even be pursuing this idea when we have an alternative that is autologous, safe, and can be done at a lower cost in the doctor’s office, and lasts 9-12 months…….PRP!