Adding Regenerative medicine to your practice.
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my own knee results were similar after 1 year post meniscectomy. It just felt tighter, stronger, more stable.
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that needle is a harpoon......and the pic's sterile technique is much better than mine lol
April400 for 400$ off
Registration is ONLY 1200
Hands on conference including aesthetics
A great lineup of speakers including Bert mandelbaum, the team doc for the US soccer team in the World Cup, Aaron Calodney, Arthur Deluigi Andrea Trescot, Jesus Medina, Matt Murphy, Rob Kinne
Registration is ONLY 1200
Hands on conference including aesthetics
A great lineup of speakers including Bert mandelbaum, the team doc for the US soccer team in the World Cup, Aaron Calodney, Arthur Deluigi Andrea Trescot, Jesus Medina, Matt Murphy, Rob Kinne
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do you do any regen in the spine drusso? And if where exactly. Also what results are you seeing
let me ask, you do agree that China has been stealing our intellectual property for some time now correct?
China views the US as their greatest threat to gaining world dominance. They're a communist country that rules with an iron fist. I think it's safe to assume that the CCP affects all aspects of the country including the scientific community. but you're right, America may not be much better in some ways
Again you should read "Red handed". I believe I posted this in another thread. it would definitely open your eyes but may go against some of your preconceived ideas
Amazon product ASIN 0063061147
Two year placebo effect.
J Clin Med. 2022 Dec 23;12(1):102. doi: 10.3390/jcm12010102.
Platelet-Rich Plasma Injections Decrease the Need for Any Surgical Procedure for Chronic Epicondylitis versus Conservative Treatment-A Comparative Study with Long-Term Follow-Up
Juho Aleksi Annaniemi 1 2, Jüri Pere 1, Salvatore Giordano 2
Affiliations
1Department of Surgery, Welfare District of Forssa, 30100 Forssa, Finland.
2Department of Plastic and General Surgery, Turku University Hospital, University of Turku, 20500 Turku, Finland.
PMID: 36614903 DOI: 10.3390/jcm12010102
Abstract
Background: Platelet-rich plasma (PRP) injections may alleviate symptoms of chronic medial or lateral epicondylitis.
Methods: We retrospectively analyzed a total of 55 patients with chronic ME or LE who had undergone at least 6 months of any conservative treatment before intervention. The patients were divided into two groups: the PRP group (n = 25), who received a single injection of autologous PRP to the medial or lateral epicondyle, and the PT group (n = 30), who continued with PT and pain medication. The primary outcome measures were pain and functional outcomes measured in terms of the following: Patient Related Tennis Elbow Evaluation (PRTEE), Visual Analogue Scale (VAS), and Disabilities of the Arm, Shoulder, and Hand (DASH), which were detected at preintervention, 6-, 12-, 24-, and 36-month follow-up. Secondary outcomes included complications and the need for any surgery at follow-up.
Results: Primary outcome measurements showed significantly better results favoring the PRP group (6-month PRTEE total 43.2 ± 19.2 vs. 62.8 ± 24.0, p < 0.001; 12-month PRTEE total 6.9 ± 15.0 vs. 28.1 ± 24.4, p < 0.001; 24-month PRTEE total 4.8 ± 9.8 vs. 12.7 ± 14.5, p = 0.029), and significantly better results in VAS and DASH sub-scores. The PRP group required significantly fewer surgical procedures (n = 0/0% vs. n = 6/20%, p = 0.027) at follow-up (mean 38.3 ± 12.3 months), and one case of prolonged pain after injection was detected.
Conclusions: Patients who underwent PRP injections for epicondylitis resulted in better pain and functional outcomes compared to physiotherapy, and this improvement lasted at least 24 months. They required fewer surgical procedures and achieved faster recovery than the PT group. We recommend PRP for chronic epicondylitis of the elbow before considering surgery when other treatments have failed.
Keywords: epicondylitis; injection therapy; lateral epicondylitis; nonoperative treatment; physical therapy; platelet-rich plasma; tennis elbow.
J Clin Med. 2022 Dec 23;12(1):102. doi: 10.3390/jcm12010102.
Platelet-Rich Plasma Injections Decrease the Need for Any Surgical Procedure for Chronic Epicondylitis versus Conservative Treatment-A Comparative Study with Long-Term Follow-Up
Juho Aleksi Annaniemi 1 2, Jüri Pere 1, Salvatore Giordano 2
Affiliations
1Department of Surgery, Welfare District of Forssa, 30100 Forssa, Finland.
2Department of Plastic and General Surgery, Turku University Hospital, University of Turku, 20500 Turku, Finland.
PMID: 36614903 DOI: 10.3390/jcm12010102
Abstract
Background: Platelet-rich plasma (PRP) injections may alleviate symptoms of chronic medial or lateral epicondylitis.
Methods: We retrospectively analyzed a total of 55 patients with chronic ME or LE who had undergone at least 6 months of any conservative treatment before intervention. The patients were divided into two groups: the PRP group (n = 25), who received a single injection of autologous PRP to the medial or lateral epicondyle, and the PT group (n = 30), who continued with PT and pain medication. The primary outcome measures were pain and functional outcomes measured in terms of the following: Patient Related Tennis Elbow Evaluation (PRTEE), Visual Analogue Scale (VAS), and Disabilities of the Arm, Shoulder, and Hand (DASH), which were detected at preintervention, 6-, 12-, 24-, and 36-month follow-up. Secondary outcomes included complications and the need for any surgery at follow-up.
Results: Primary outcome measurements showed significantly better results favoring the PRP group (6-month PRTEE total 43.2 ± 19.2 vs. 62.8 ± 24.0, p < 0.001; 12-month PRTEE total 6.9 ± 15.0 vs. 28.1 ± 24.4, p < 0.001; 24-month PRTEE total 4.8 ± 9.8 vs. 12.7 ± 14.5, p = 0.029), and significantly better results in VAS and DASH sub-scores. The PRP group required significantly fewer surgical procedures (n = 0/0% vs. n = 6/20%, p = 0.027) at follow-up (mean 38.3 ± 12.3 months), and one case of prolonged pain after injection was detected.
Conclusions: Patients who underwent PRP injections for epicondylitis resulted in better pain and functional outcomes compared to physiotherapy, and this improvement lasted at least 24 months. They required fewer surgical procedures and achieved faster recovery than the PT group. We recommend PRP for chronic epicondylitis of the elbow before considering surgery when other treatments have failed.
Keywords: epicondylitis; injection therapy; lateral epicondylitis; nonoperative treatment; physical therapy; platelet-rich plasma; tennis elbow.
PT and Pain Medication. What medication. NSAIDs. Did they control for OTC NSAIDs? Anyone put steroids in there? Seems like the appropriate comparator? If the 6/30 had surgery, why did the 24/30 not need surgery? Were they better?
cons:
1. retrospective study.
2. not a blinded study. in truth, not really a study but a comparison of charts. highly suspect for bias.
3. over a 6 year period of time, they only found 55 cases?
4. interestingly, one of the exclusions is that they had to have already failed conservative therapy including some PT. so the PT group had failed conservative therapy and was studied as whether more conservative therapy would help.
5. PRP group was more predominantly male and older.
6. unfortunately:
pros:
1. one of the few studies that compared to standard of care PT.
2. statistically significant difference at 6 and 12 months all measures and half the measures at 24 month.
3. PRP group did have no surgeries vs the PT group, that had 6 out of 30.
so several studies show PRP is probably helpful, and are quotable.
this isnt one of them.
1. retrospective study.
2. not a blinded study. in truth, not really a study but a comparison of charts. highly suspect for bias.
3. over a 6 year period of time, they only found 55 cases?
4. interestingly, one of the exclusions is that they had to have already failed conservative therapy including some PT. so the PT group had failed conservative therapy and was studied as whether more conservative therapy would help.
5. PRP group was more predominantly male and older.
6. unfortunately:
pros:
1. one of the few studies that compared to standard of care PT.
2. statistically significant difference at 6 and 12 months all measures and half the measures at 24 month.
3. PRP group did have no surgeries vs the PT group, that had 6 out of 30.
so several studies show PRP is probably helpful, and are quotable.
this isnt one of them.
Do you think you could do an equally thorough and unbiased analysis of the original Pfizer and Moderna vaccine data?
If I were Intracept, I'd be pissed...
Medicina (Kaunas). 2023 Jan 5;59(1):112.
doi: 10.3390/medicina59010112.
Affiliations expand
Materials and Methods: PRP was administered intradiscally to two LBP patients with Modic type 1. PRP was obtained from the patients' anticoagulated blood. Primary endpoints were physical condition, laboratory data, and X-ray for safety evaluation. Secondary endpoints were pain scores using the visual analog scale (VAS), the Oswestry Disability Index (ODI), and the Roland-Morris Disability Questionnaire (RDQ) to evaluate PRP efficacy. The observation period was 24 weeks after the PRP injection. In addition, changes in Modic type 1 using MRI were evaluated.
Results: This study assessed two LBP patients with Modic type 1. There were no adverse events in physical condition, laboratory data, or lumbar X-rays after injection. Follow-up MRI showed a decrease of high signal intensity on T2WI compared to before PRP administration. The pain scores tended to improve after the injection.
Conclusions: PRP injection into the intervertebral disc of LBP patients with Modic type 1 might be safe and effective. This analysis will be continued as a prospective study to establish the efficacy.
Keywords: Modic type 1; low back pain; platelet-rich plasma; regenerative medicine.
Medicina (Kaunas). 2023 Jan 5;59(1):112.
doi: 10.3390/medicina59010112.
Autologous Platelet-Rich Plasma Administration on the Intervertebral Disc in Low Back Pain Patients with Modic Type 1 Change: Report of Two Cases
Soya Kawabata 1, Kurenai Hachiya 1, Sota Nagai 1, Hiroki Takeda 2, Mohd Zaim Mohd Rashid 2, Daiki Ikeda 1, Yusuke Kawano 1, Shinjiro Kaneko 2, Yoshiharu Ohno 3 4, Nobuyuki Fujita 1Affiliations expand
- PMID: 36676735
- DOI: 10.3390/medicina59010112
Abstract
Background and Objectives: Modic type 1 is known to be associated with lower back pain (LBP), but at present, a treatment has not been fully established. Meanwhile, platelet-rich plasma (PRP) has been used for tissue regeneration and repair in the clinical setting. There is no clinical PRP injection trial for the intervertebral disc of LBP patients with Modic type 1. Thus, this study aimed to verify PRP injection safety and efficacy in LBP patients with Modic type 1. As a preliminary experiment, two LBP cases with Modic type 1 are presented.Materials and Methods: PRP was administered intradiscally to two LBP patients with Modic type 1. PRP was obtained from the patients' anticoagulated blood. Primary endpoints were physical condition, laboratory data, and X-ray for safety evaluation. Secondary endpoints were pain scores using the visual analog scale (VAS), the Oswestry Disability Index (ODI), and the Roland-Morris Disability Questionnaire (RDQ) to evaluate PRP efficacy. The observation period was 24 weeks after the PRP injection. In addition, changes in Modic type 1 using MRI were evaluated.
Results: This study assessed two LBP patients with Modic type 1. There were no adverse events in physical condition, laboratory data, or lumbar X-rays after injection. Follow-up MRI showed a decrease of high signal intensity on T2WI compared to before PRP administration. The pain scores tended to improve after the injection.
Conclusions: PRP injection into the intervertebral disc of LBP patients with Modic type 1 might be safe and effective. This analysis will be continued as a prospective study to establish the efficacy.
Keywords: Modic type 1; low back pain; platelet-rich plasma; regenerative medicine.
2 cases. Didn’t do a third as they knew diskitis was coming.
Last edited:
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this has been done, multiple times.
like steve said - 2 case reports.
i guess one could consider it a start from which to base a full RCT. compare PRP to intracept, sham injection and standard of care.
Jason Dragoo is Denver now.
Jason L. Dragoo, M.D. | Jason L. Dragoo, M.D., Board Certified Orthopaedic Surgeon, Sports Medicine Specialist, Denver, CO
Jason L. Dragoo, M.D. | Jason L. Dragoo, M.D., Board Certified Orthopaedic Surgeon, Sports Medicine Specialist, Denver, CO
www.jasondragoomd.com
So my 21 y/o brother is killing it after I did his Prp a couple weeks ago on a reconstructed knee. But I didn’t mention my father did not respond to prp(prev chemo and xrt) on moderate OA of his knees. So today I did a stem cell procedure on both his knees.
I treated my own when I thought I needed surgery. Extruded, non extrduded, reducing, and if you go after the root are all factors
What was your experience treating your own menisci?
it was great. i had 3-4 weeks of mechanical locking clicking, difficulty ambulating. got MRI found complex longitudinal tear. US showed edema in the mensicus and was extruded, with a MCL edema etc spoke to two ortho about "clean out" even though I knew the studies
decided to hail mary during a live course I was teaching to put LR PRP directly into the cleft. HURT a lot. no lidocaine.
7-10 days later was 70%, 15-20 days 95% better. about 1 month out was like nothing happened. i scanned it with US and it got better and better and was great for about 2 years until i reinjured it. once a meniscus is extruded the root is typically affected. if its extruded and non reducing back into the joint space under dynamic evaluation, injection is unlikely to help. some folks will inject where the root is at deep in the joint. it's a big of injection based on known relative anatomy... but if any structure is 100% torn, no amount of regen injectate is going to fix it
now my meniscus is mostly extruded. i cant inject the root myself. i have arthritic changes in the medial femoral condyle and deep knee bending causes a lot of grief
Yes 60 pure intra articular close to femoral head with fluoro
You can see the anterior labels tears really well with US. Inject LR prp minimal AC into the cleft and let them sit for 15 min. It’s not cement but it’ll fibrin up a bit. Often there is a cyst from the labrum you can aspirate with US guidance. Same thing seen on mri
Inject LP into the joint capsule. Consider subchomdral bmc
I second that. I went to the ARMI (Advanced Regenerative Medicine Institute) conference in Aug of 2022 in Nashville, TN and it was good. Very much hands on, lots of evidence-based materials, great conference all around. Came back home, have done a few PRPs on the knees - those patients report remarkable improvement that is actually getting better as the time passes (instead of the usual 2-3 weeks after Kenalog knee injection). Take it for what it's worth, just anecdotal evidence but I was a great non-believer before.
It looks like there is a course later this week. Will this course teach me enough to get started with PRP? I mainly want to learn about processing the blood, figuring out different kits / equipment required etc. Thanks!
That's exactly what they do. You will have your own processing station, will play with cow blood/ plasma samples. There will be industry sponsored stations (centrifuges, systems for sale).
Also they conduct a live patient station (centrifuge his own blood), then they do the PRP injection with US guidance. Very good conference overall, 1.5 days over the weekend. I might go there again in a few years, just to bounce ideas w/ other providers, pick their brains, network.
Also they conduct a live patient station (centrifuge his own blood), then they do the PRP injection with US guidance. Very good conference overall, 1.5 days over the weekend. I might go there again in a few years, just to bounce ideas w/ other providers, pick their brains, network.
Thank you gentlemen! Just registered and booked flights. I'm excited. If there is a SDN meet up, holla!
See you there. Hope you’ll make it for Friday as well
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Where are things at for regenerative treatments for the shoulder? Most of the the googling I did looks like stem cells for RTC, but I am curious about PRP or other options, and also outside of RTC but also GH OA. Thanks
PRP alone first for sure.....adipose+BMAC seems to do much better than BMAC alone if PRP isnt enough....at least for me.
I did PRP on my 50 y/o step-mom's shoulder tendinitis and partial tear and she is markedly improved. So much so that the entire other side of my family wants to be seen.
and SAFE
and no systemic hormonal effects, no catabolic effects, no atrophy of muscles, no neuritis... and repeatable without concerns about dosing
Looks like I won’t make it for the Friday session. Will have to return for that one with better planning. Had to reschedule Friday and Monday clinic at the last minute 😅
Do you use ultrasound guidance to target the soft tissues specifically? Fluoroscopy if you’re treating GH OA / knee OA etc?
Like...Damn man seriously? You do marrow AND adipose?
Pt pays by driving you to the BMW dealership and tells you to pick out a nice one?
feb 25-26 in sunny california. just US, just procedures... let me know if you're interested!
i drive an F250 diesel......do you know why i do both?
yes for US unless im targeting interior knee ligaments
Thanks for all the replies. I am feeling like I might be a little old dog/new trick for ultrasound but am feeling more and more inclined to consider PRP for certain conditions and it looks like data is trending away from steroids for certain conditions. What of these procedures could be done with fluoro skills? Mostly joints I am assuming. Also how successful is PRP for SI issues...I feel like it may be a good option for some of my patients.
PRP is fashionable. Literature is sparse and poorly done studies are 99:1 over crap to try and legitimize the treatment.
Heterogeneity regarding what PRP is and how it is made limits all of this to shots in the dark and everyone saying: "in my experience...."
For great markup and big profits.
unlike other things I think this one is here to stay...
FWIW, dextrose into the right place works really well too. no big sugar money. i bill 20552 200051 or 20553. pennies
gluten free dextrose
How often have you used PRP? Offer it for cheap at cost and see how many patients you can help that you couldn’t help before.
You might be surprised-
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I was doing PRP before it was fashionable.
I do PRP on request. Joints, bursa. Spin blood in office here. No kits.
I do this too but for cosmetic use. How much blood do you take? And after blood, how do you separate the platelets from the rest of the blood with no kits?
50cc.
Draw off using a Tuohy at buffy coat. Try to get more plasma and less red.
Only one spin? or do you double spin?
