Orthohealing

Isagani Leal MD, MPH visits Orthohealing Center from Philippines to observe Platelet Rich Plasma Procedures

dosampson — Mon, 08 Mar 2010 23:09:13 +0000

We were thrilled to have Dr Isagani Leal visit from Manilla, Philippines. Dr Leal completed his residency training in Tel Aviv, Israel and specializes in non-surgical orthopaedics utilizing musculoskeletal ultrasound. Of great interest, Dr Leal is the first Dr that I am aware of who utilizes ultrasound guided acupuncture known as “Intramuscular stimulation.” Developed by Dr Chan Gun, this practice emphasizes that tendon injuries are a result of shortened & contracted muscles. For example if someone has achilles tendon pain, the shortened muscles of the calf & tibialis posterior must be relaxed. Dr Leal palpates the shortened muscle and marks a spot that reproduces pain in the patient. Afterwards Dr Leal uses ultrasound to look into the muscle & inserts an acupuncture like needle into the muscle belly & illicits a “twitch.” The patient perceives a brief pulse known as “Qi (chi)” The needle is left in for 3 minutes then removed & heat is provided with ultrasound. According to Dr Leal patients need 2 treatments one wk apart & may have tremendous relief.

I must admit the idea is interesting having an acupuncture background myself. However this theory may influence us to consider injecting not only the tendon that is damaged but simultaneously relaxing the affected muscle. This phenomenon may also explain why some tendon injuries don’t respond appropriately when treated.

We may have learned more from Dr Leal than he from us! Many thanks to our kind patients who allowed Dr Leal to observe various procedures for the week! We hope to collaborate with Dr Leal in PRP research together.

Dr Sampson

The Orthohealing Center Supports Team USA Olympic Athletes in Vancouver 2010!

dosampson — Mon, 22 Feb 2010 04:21:10 +0000

In an effort to get our valued readers closer to the Olympic games, The Orthohealing Center has teamed up with the Team USA News . Please link to have access to the latest info and receive exclusive updates throughout the games. These athletes have dedicated their lives to this very moment & could use your support! We have treated many Olympic athletes & wish them well in the 2010 games!

The Orthohealing Center

Orthopaedic Surgeon Alan Lazar MD visits Orthohealing Center to observe platelet rich plasma procedures

dosampson — Mon, 22 Feb 2010 03:51:44 +0000

We were thrilled to have Dr Alan Lazar an orthopaedic surgeon from Plantation Florida visit our LA center recently. Dr Lazar specializes in minimally invasive arthroscopy and uses PRP in the operating room to facilitate recovery naturally. Also he has been injecting PRP in many patients. Most interestingly, Dr Lazar is one of few doctors pioneering adult fat stem cell injections to potentially regenerate cartilage & reduce pain from osteoarthritis. Various doctors are combining adult stem cells with PRP to get maximum results. Best of luck to Dr Lazar and many thanks to our patients allowing him to observe PRP ultrasound guided procedures. The Orthohealing Center

Orthohealing Center Supports One for all Charity

dosampson — Fri, 05 Feb 2010 00:03:02 +0000

Congratulations to our beloved medical assistant Mari Morales for her dedicated commitment to community service. Mari created a non profit organization “One for All” that benefits children in the Inglewood community. Twice annually children attend the event & bring their report card from school. If they get A’s & B’s they qualify for a special gift. This Christmas they each received a toy. Mari has been able to do this year after year with little financial support and we are more than happy to support her goodwill. The next event will be in June. Anyone interested in helping children in an under served local community in Los Angeles, can view the web site for a donation:

http://www.ofakids.org/

The Orthohealing Center

First US Approved Stem Cell Clinical Trial for ALS

dosampson — Wed, 03 Feb 2010 02:29:39 +0000

ALS or Lou Gehrig’s disease is a devastating disease that affects the neuromuscular system resulting in muscle weakness with eventual difficulty swallowing and breathing. For patients suffering with this condition many of the trreatments are palliative to improve function like rehabilitation. Some of my patients in the recent past have seeked stem cell based therapies in foreign countries like Costa Rica. One patient received Bone Marrow Stem Cells along with Menstural cells which were injected into his spine. These patients termed “pioneer patients” are driving change & are increasing awareness by describing their experiences. Unfortunately his treatment was not successful. However perhaps it won’t be long before Americans won’t have to travel abroad for these procedures.

According to CNNthe first US FDA approved trial (Neuralstem) utilizing 8 week fetal tissue for stem cells is taking place. The researchers are very noble in their efforts & the patients are very brave. However these patients have little options to reverse the effects of their disease.

New JAMA article on Achilles Tendon injury promotes dialogue on PRP

dosampson — Wed, 03 Feb 2010 02:05:20 +0000

In a recent article in the Journal of American Medicine (JAMA), a group from the Netherlands studies PRP VS saline injections under ultrasound guidance. The patients were studied for 6 months as a preliminary report. The study showed that both groups equally improved beyond baseline. The researchers concluded that the injection was no more than a placebo effect and that the eccentric exercises that both groups performed may have caused the benefits.

It’s great that more & more evidence is emerging on PRP therapy. This study was a single center randomized blinded trial however it did have some limitations.

Here are my thoughts.

My published review article is referenced in the JAMA article. While the authors of this study should be commended by adding to a topic in need of controlled trials; there are some limitations to be mindful of before drawing indefinite conclusions.

First, there was no gel matrix added which may have limited the duration of time the PRP was in the tendon. The injection graft was activated by direct contact with the tendon upon injection without an agonist. I currently use a PRP that utilizes a gel matrix by utilizing autologous thrombin combined with calcium chloride.

Secondly there were no laboratory platelet counts performed to determine what PRP levels were achieved. There are numerous platelet separation devices available with varying concentrations of platelets & leukocytes & having definitive counts would have been insightful.

The authors unfortunately did not have a third control group to isolate the effects of an eccentric exercise program. It is unreasonable to assume that the eccentric exercises alone accounted for the substantial clinical improvement of VISA-A & satisfaction surveys in both groups. Moreover there is no discussion on the theory that the ultrasound guided needle procedure in both groups may have created microtrauma that could initiate healing.

Also there is no long term f/u beyond 6 months. Follow up in 12 months may indicate a difference between the two control groups. Also there is no follow up imaging to determine if there is structural healing occurring.

The article provides good follow up data on a single injection, however for chronic Achilles tendinosis, a series of injections may be required.

It’s terrific that more & more studies are emerging to better define how PRP is best indicated. In my experience chronic Achilles tendinosis is a very challenging condition with limited treatment options. This study suggests that needling of the injured tendon under ultrasound guidance combined with an eccentric exercise program was effective initially for 6 months. However long term follow up data & imaging is necessary to clarify interpretations. As with any treatment there will be pro & con articles. In the end we’ll continue better understand this treatment which is in no way a panacea.

Dr Steven Sampson

Dr Sanjay Gupta & Anderson Cooper Discuss Platelet Rich Plasma Therapy in Tiger Woods & Athletes

dosampson — Thu, 17 Dec 2009 21:17:10 +0000

With the recent news that Tiger Woods received PRP therapy to accelerate his knee recovery from surgery, there has been lots of media exposure for PRP. Here is a video from ">CNN last night.

Tiger Woods Received Platelet Rich Plasma Injection after Knee Surgery

dosampson — Wed, 16 Dec 2009 21:30:39 +0000

Recently there was news regarding Tiger Woods receiving Platelet Rich Plasma Injections for his knee to accelerate recovery. This brought even more attention to this treatment. A good article that clarifies some info is:

http://www.huffingtonpost.com/johnny-benjamin/tiger-woods-dr-galea-goss_b_393880.html

Dr Betul Turan of Turkey Visits the Orthohealing Center to Observe Platelet Rich Plasma Procedures

dosampson — Mon, 14 Dec 2009 01:29:01 +0000

Last week after our visit from Japanese Orthopaedic Surgeon Dr Sobajima, we were honored to have Dr Betul Turan of Turkey visit us. Dr Turan is a Physiatrist who specializes in non-surgical orthopaedics. Her husband is an Orthopaedic surgeon who specializes in cartilage regeneration & repair. Together they are creating a state of the art Regenerative Medicine clinic in Orthopaedics. Dr Turan observed numerous cases including platelet rich plasma injections utilizing ultrasound guidance. In 2009 we had numerous Dr’s from across the world including Canada, Australia, Korea, Japan, Turkey and others observe procedures for training.

Dr Satoshi Sobajima of Japan visits The Orthohealing Center to observe Platelet Rich Plasma Procedures

dosampson — Mon, 14 Dec 2009 01:00:57 +0000

We were thrilled to have Satoshi Sobajima MD, an orthopaedic surgeon from Osaka Japan visit last week. Dr Sobajima spent time at the University of Pittsburg doing progressive research in regenerative medicine. Using stem cells, gene therapy, & PRP Dr Sobajima studied regeneration of intervertebral discs of the spine in animal models. Currently Dr Sobajima is looking at PRP & stem cells to regenerate cortical bone in Rabbit Femurs. This research could potentially influence surgical protocol around the world as we look for more cost effective, safer, and natural based alternatives. Dr Sobajima will be presenting his data at the Regenerative Medicine conference in Hiroshima in March 2010. Dr Steven Sampson will also be discussing his knee arthritis study and PRP experiences in Japan.

Dr Sobajima was particularily interested in utilizing ultrasound guidance for his non surgical management of orthopaedic issues. We welcome Dr’s from around the world to visit here to observe our work & to collaborate on research projects in the future.