The study found that more than 4.5 million Americans are now living with a minimum of one TKR. This accounts for nearly 5% of the population over age 50 making it more pervasive than heart failure and rheumatoid arthritis. This prevalence is higher in women than in men and 10% of those who reach 80 or older are living with a TKR.

The co-director of the Orthopedics and Arthritis Center for Outcomes Research at Brigham and Women’s Hospital, Boston, MA agreed that rate at which knee replacement is growing is truly alarming. As the prevalence of the specific surgery explodes, we may see a comparable growth in the number of revisions and complications. For patients who are young, there will be an even higher possibility of the need for revisions later in life.

It’s important to offer more treatments in order to delay this surgery in younger patients including PRP, bone marrow aspirate, viscosupplementation, bracing, and more. We are developing new treatments to help the nearly 5 million Americans living with a joint prosthetic like neural prolotherapy. This study confirms the epidemic we anticipated, but fortunately new treatments are on the horizon.

Arenas conducted a workout in the Los Angeles area Sunday that was attended by Lakers officials.  He could become a well-timed addition for a Lakers team badly in need of scoring help and guard depth.

The Orthohealing Center is proud to be a world  leader in the field of regenerative medicine, offering Platelet Rich Plasma (PRP) injections for a wide array of injuries to both elite athletes and people with pain that just won’t go away.

We’re thrilled to announce that Dr. Sampson has been selected to lecture amongst world leaders in regenerative procedures at the Biobridge “Generation Regeneration” annual symposium in Venice, Italy, Sept 24, 2012. Dr Sampson addressed doctors at the Biobridge Regenerative Symposium in the past at the historic Main Assembly Hall at the United Nations of Geneva (UNOG) Switzerland.

This fall’s meeting will bring together world leaders on the cutting edge of medicine including − Orthopaedics & Maxillofacial Surgery, Sport Medicine & Infiltrations, Plastic Surgery & Cosmetic Medicine, Wound Healing & Ophtalmology.

A sample of thirty-six patients was randomized into two study groups and prospectively evaluated. This sample involved 16 males and 20 females who were diagnosed with severe chronic plantar fasciitis and were non responsive to the traditional non-operative treatments such as rest, cam walker immobilization, heel lifts, night splinting, PT, local modalities, and NSAIDS. Before starting the treatment all of the patients had MRI and ultrasound studies which were consistent with plantar fasciitis. The first group was treated with a single 40 mg methylprednisolone ultrasound-guided injection of at the site of the injury. The second group was treated with a single un-buffered autologous PRP ultrasound-guided injection at the site of the injury. For the two weeks of the study the patients were immobilized fully weight bearing in a cam walker. Then they were started on home exercises after which they were allowed to return to their regular activities as their pain would permit without the extra support.

The study was judged based on The American Orthopedic Foot and Ankle Score (AOFAS) which is designed to evaluate the healing process of ankle and foot surgery. The first group originally had the OAFAS score of 52, which increased to 81 after three months, then decreased to 74 after 6 months and further decreased to 58 after 12 months. The second group had original score of 37 which then increased to .95 after 3 months and remained at 94 after 6 and after 12 months following the treatment.

These finding suggests that platelet rich plasma injection is a better and longer-lasting treatment than cortisone injection when treating severe chronic plantar fasciitis.

Recently we hosted 18 Physicians from 6 countries to enhance our understanding & skill set with regenerative orthopedic procedures including Neural Prolotherapy & Platelet Rich Plasma (PRP).  After learning about Dr Lyftgoft’s breakthrough; that simple injections of sterile water (saline) and Dextrose (sugar) beneath the skin surface can provide immediate pain relief, we made arrangements to build a seminar at the Orthohealing Center around this new therapy.

Neural prolotherapy is based on the premise that hundreds of nerves exist just beneath the skin and play a key role in regulating pain & healing. When these small nerves get constricted from trauma they increase pressure & dump chemicals called peptides (substance P & CGRP). This leads to pain and inflammation along with swelling of tissue, loss of type I collagen (tendon degeneration), and limited blood flow. These chemicals also have a proven effect on the brain causing depression & exhaustion. Furthermore the release of these peptides trigger an immune response which leads to cartilage deterioration & osteoarthritis. More & more research has pointed to the immune system as a key player in arthritis. Now we believe that by regulating these nerves just beneath the skin, we can regulate the immune system to potentially heal injuries.

Why Dextrose? Dextrose has been shown to directly block the key regulator of pain & Inflammation: the TRPV-1 or Capsaicin Receptor. Dextrose blocks the increase of sodium & calcium that shuts of the leaking nerves and inflammatory peptides. Within seconds appropriate patients find immediate relief without any anesthetic or cortisone. Often we will have patients “test drive” their pain & see if they can reproduce it in the office. They will transfer from sit to stand on a chair to test their knee or grab objects for their tennis elbow etc.

This outlook is a complete paradigm shift and will certainly change the way we look at pain. For so long patients have pointed to a spot (like the outside shoulder/deltoid or lower knee) & say “it hurts here.” We would explain to them there is nothing there & the pain is referred. Now we know there is something there & these nerves are critical to promote healing. When we examine patients we now look for these nerves which may be swollen. They can’t be seen on an MRI or x-ray but can be felt & follow a specific anatomical pattern.

We have been using this therapy successfully on many patients that have failed almost every treatment we have thrown their way. Neural prolotherapy or NPT is an exciting new therapy that we have just begun to explore its applications. We are also using this before PRP injections to promote healing from the outside in which also decreases pain from injections while limiting  lidocaine (anesthetic) usage which may hinder healing.

The interest in the field of embryonic research and therapy is fading. Embryonic stem cells have been found to have far less potential uses than originally anticipated. The alternative to embryonic stem cell research and therapy, which few people are aware of, is adult stem cell research. When the body experiences trauma like a stroke or a heart attack it draws on it’s own stem cells (adult stem cells) to repair the damage. Adult stem cell researchers at Mesoblast have released results that showed benefits of a clinical study showing the double-blind results of adult stem cells introduced to heart failure patients. Another argument for the use of adult stem cells over embryonic stem cells is that while embryonic stem cell research and therapy is costly and time consuming, adult stem cell usage is far more affordable and far more promising with less potential for adverse reactions.

Every month numerous studies are emerging in new applications of adult stem cells for difficult diseases. Most of all current research is focused on utilizing our own adult cells to stimulate healing vs embryonic. It is important to stay on top of the current opinion regarding regenerative medicine & this article provides some insight that we may more likely see implication of adult stem cells vs embryonic derived cells in the near future.

While platelet rich plasma (PRP) injections have long been providing patients with tendon, ligament, and joint pain much relief as an alternative to steroid injections, newer regenerative medicine techniques now include Bone Marrow Aspirate Concentrate, better known as “BMAC”.  Similar to PRP, BMAC utilizes the body’s own healing properties to deliver various growth factors and nucleated cells to an injured area. 

The combination of PRP, BMAC, and oral supplements gives new hope and offers non-surgical solutions for many common orthopedic problems including tennis elbow, rotator cuff injuries, meniscus tears, SI joint pain, facet mediated pain, and degenerative arthritis.

We are pleased to now offer BMAC at the Orthohealing Center with hopes of helping our patients add life to their years!

The study consisted of patients who have experienced chronic recalcitrant tendinopathy (chronic non healed tendon) which lasted over 3 months. They were treated with PRP injection and ultrasound-guided percutaneous tenotomy. The first part of the study involved forty one patients. They had to complete a survey gathering had to complete a survey that collected a wide variety of data including their pain level, hemoglobin and white blood cell concentrations, anthropomorphic data, PRP samples and more. The second part of the study involved 34 patients who had to return to the clinic after PRP injections and tenotomy.

The follow up continued for 14 months and showed “maximum benefits” from combining both therapies after 4 months. The results showed functional improvements of 68%, worst-pain improvements of 58%, and patient satisfaction and procedure recommendation to others was at 83%. Even though after the treatments none of the tendons have showed normal sonographic appearance, 84% did improve in echotexture and 82% had diminished intratendinous neovascularity.

It is still necessary to conduct larger studies to determine whether the two therapy combination is particularly beneficial to certain injuries or tendon types. This study however, did establish that the combination is safe and effective in helping people with ongoing tendinopathy.

You can learn more about the study by visiting www.orthosupersite.com.

We are seeing a revolution in technology that is being driven by patient to patient marketing. Dr Sampson and the Orthohealing Center were amongst the earliest in the country to integrate this cost effective “hands on” technology and train physicians from all around the world on this and other new treatments utilizing cutting edge technology.

Patients are seeking out further options, believing there must be more treatments medical professionals can offer. Furthermore, ”vision/action” patients are fueling new growth, as they require physical activity for sanity, balance and need to exercise to recover from injuries quickly. While the technology is utilized by elite professional athletes such as the NBA players, it is also available to the everyday patients who experience pain during daily activities such as transferring form a chair, standing, using stairs or sleeping on their side.

Sacroiliac (SI) joint pain afflicts millions of Americans every year, and is thought to be the main culprit in up to 30% of chronic back pain sufferers.  It continues to be widely underdiagnosed by many physicians in part because MRIs of the low back typically do not focus on this area and therefore show nothing abnormal.  Most patients with the condition feel hopeless when conventional treatments including physical therapy and steroid injections do not provide sustained relief.

As outlined in the Winter 2011 issue of Pain Pathways magazine, Radiofrequency (RF) Ablation offers new hope.  In this procedure, a probe is inserted near the area of the SI joint and its tip is heated – deadening the surrounding nerve tissue and offering substantial and more prolonged pain relief.   A similar procedure can be performed for nerves in the low back (medial branch nerves which innervate facet joints of the lumbar spine).

We have performed numerous RF ablations at the Orthohealing Center with exceptional results , and are excited to see word spread about this innovative procedure!