Platelet Rich Plasma for the Hip vs. CorticoSteroids. Graph showing them comparison over 104 weeks.

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We are currently involved in a Research Study on a special process of purifying bone marrow or BMA using a system designed by Emcyte Corporation. We are working with Bio Sciences Research Center at Harvard and offering a great opportunity for special pricing on treatment. Call our office for details.

Platelet Rich Plasma for the Spine vs. CorticoSteroids. Graph showing them comparison over 104 weeks.

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This Graph Below Shows how PRP can work over a long period of time. I believe that this might be a reflection of how people can begin gaining not only ligament and disc strength but also as they move forward their function returns and the muscles begin to get stronger. In our office we aim to get to the far end of this graph faster than two years out. Things like Honey Matrix, CRP, adding Adipose Stem Cells, Ozone, proper rehabilitation, exercise with oxygen therapy as well as Chiropractic considerations all ad an advantage to receiving PRP at Gecko Joint and Spine. The use of High Definition Ultrasound to visualize your injury and guide the injection of the the PRP make sure our doctors are treating the appropriate tissues. Our athletes as well as many other patients whom often travel from out of state report significant benefit as well as a rapid recovery from spine and joint injury. You will  be amazed at why some MD’s still use steroids with these results. Platelet Rich Plasma  of the Knee vs. CorticoSteroids of the hip. Graph showing them comparison over 104 weeks. We are in Sarasota Florida, Tampa, orlando, florida. We are a non surgical, non drug clinic that uses regenerative injections to rebuild cartilage in the hip for AVN and osteoarthritis of the hip.

For an Appointment or to speak with one of our office staff call or you can e-mail AskDrGecko@Gmail.com

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PRP & Stem Cell to the Hip and Pelvis.

By Dr. John Lieurance

I can’t tell you how many times we have preformed a diagnostic injection under ultrasound into the hip joint to see what pain and dis-function is coming from that joint. The hip joint also seems to be involved in many lower back trouble and by treating the hip joint with PRP along with treating the spine we get results where many fail. Let me first say I have had personal experience with the amazing benefits of Regenerative PRP and Bone Marrow Stem Cell injections with my lower back and pelvis problems and also neck injuries. 18 years ago I was injured and diagnosed with a disc herniation with sciatica by both my doctor and the orthopedic surgeon he sent me to. Amazingly the orthopedic surgeon didn’t even touch my back just based his recommendation on the MRI images. Trust me this is VERY common! I just assumed I would need surgery one day. Lucky for me I was introduced to a young innovative doctor who was doing prolotherapy. The first thing he did was palpate my spine and feel the ligaments. He found them tender and suggested we do a diagnostic injection. This diagnostic injection consisted of lidocaine. You see he told me all he would inject would be the iliolumbar ligament, not the nerve or disc. If the pain went away it would be diagnostic that the pain producing tissue would be localized if the pain was relieved.  He told me about how the ligaments in your body had referal patternes and that many “disc problems” where simply referal from ligaments. He also told me that the disc is supported by the ligaments and that the ligaments must be damaged if the disc is either injured or displaced. By strengthening the ligaments the disc can become stable and heal. So back to my story, when he injected my iliolumbar ligament the pain in both my back and running down my leg went away!  He then suggested that we inject a dextrose solution into the same area to stimulate it to heal. He told me that this area was too dense for the body to deliver oxygen and nutrients that act as building blocks to repair the damage and that these dense connective tissues are what usually cause pain and instability. This pain and instability is almost always what leads to arthritis and degenerative changes in the spine. This was my first experience with prolotherapy and it was soon after this experience that I hired my first MD to work side by side with in my Chiropractic Clinic almost 20 years ago today. This same reasoning works with the hip joint as well.  These area’s are then usually targeted with prolotherapy with dextrose or PRP.

We once had a retired MD come to see us for osteoarthitis of the hips. He had learned on the internet from Dr. Whitiker’s site about prolozone. He received 4 treatment and called his son who also was an MD. His son told him it must have been placebo. His response was that it couldn’t be placebo because I didn’t think it would work. In our office we almost always utilize ozone in our treatments at the same time as dextrose prolotherapy and PRP.  Prolozone is a form of non-surgical ligament and joint reconstruction and is a treatment for chronic pain. It is thought that the ozone gas, which is made of 3 oxygen molecules fused together, can activate stem cells, improve circulation, and stimulate healing. Ozone gas can reconstruct damaged or weakened connective tissue in and around joints. These substances are injected into the damaged connective tissue in and around a joint to rebuild the damaged areas. Using ozone in concert with other therapies such as PRP and stem cell treatments offer patients the advantage of improving circulation, oxygen and the activation of stem cells to improve tissue response and regeneration.

Minimally Invasive Oxygen-Ozone Therapy for Lumbar Disk Herniation. The Italian Study. Outcome with treatment of spinal disk herniations was successful in 70.2% of the patients treated with medical ozone. They believed that the ozone caused disk healing. They also felt the ozone improved local microcirculation and increasing the supply of oxygen. This effect has a positive effect on pain as the nerve roots are sensitive to hypoxia. Another reason for using medical ozone to treat disk herniation is its analgesic and anti-inflammatory effects which may counteract disk-induced pain. 

 

Conclusion: Ozone therapy is an option to treat lumbar disk herniations that has failed to respond to conservative management, before recourse to surgery or when surgery is not possible.

 

Below are some of our video’s of patients we have treated for spinal regenerative using some of these exciting new, non-surgical, treatment options.

Avascular Necrosis and the use of adult stem cells to repair the damage. Bone Marrow Stem Cells

Avascular Necrosis

Avascular necrosis (AVN) of the Hip is a painful condition where the blood supply to the hip bone (femoral head) causes the death of bone tissue, often leading to breaks and subsequent collapse of the bone. Frequently referred to as osteonecrosis, aseptic necrosis, or ischemic bone necrosis, AVN affects an estimated 10,000 to 20,000 new people each year in the United States. Avascular necrosis is progressive, and the timeline from diagnosis to collapse can range from several months to several years. Diagnosis is usually made by xray and MRI.
Unlike osteoarthritis, Avascular Necrosis of the Hip tends to affect a young population, from 30 to 50 years of age. Until very recently, the most common treatment of AVN of the femoral head has been total hip replacement, often a sub-optimal solution for patients under 50 years of age due to possible activity restrictions and the fact that a synthetic hip joint will wear out with time. Adult stem cell orthopaedic surgery offers young patients a viable, safe alternative to hip replacement surgery.
Causes of Avascular Necrosis of the Hip include:

Corticosteroids. People who take high doses of corticosteroids, such as prednisone, for short periods of time, or lower doses for long periods of time, are candidates for avascular necrosis.
Excessive alcohol intake. People who consume large amounts of alcohol on a daily basis may be more likely to experience avascular necrosis. The alcohol can cause fatty deposits to form in one’s blood vessels, restricting the flow of blood to the bones.
Sickle cell anemia. People suffering from sickle cell anemia are susceptible to AVN, as red blood cell sickle cells become obstructed, preventing blood flow. Deprived of blood’s important nutrients, including oxygen, tissues fail to survive and begin to break down (necrosis)
Lupus. Avascular necrosis can be caused by lupus itself or by high doses of corticosteroids used to treat the disease.
Cancer treatments, including chemotherapy and radiation.
Trauma such as fracture or dislocated joint, to the bone. The trauma can damage the blood vessels that deliver blood to the bone, leaving the bone without a source of oxygen and nutrients. As a result, the bone cells die, weakening the bone.

For two years, Dr. Chen has been performing breakthrough treatments to reduce the progression, and, in many cases, eliminate Avascular Necrosis of the Hip, utilizing a safe, innovative technique to grow new bone from the patient’s own stem cells procured from bone marrow. Involving the direct inoculation of autologous bone marrow stem cells, which reduces the risk of rejection, this treatment has been practiced by only a few doctors, including Dr. Chen, nationwide. The success rate is highest when the disease is diagnosed in its early stage.
In orthopaedics, adult stem cells are derived from a patient’s own body, not from fetal or embryonic sources.

Total Hip Replacement: Many times Patients are more optimistic than even their surgeons!

“Surgeons and patients often do not agree on what to expect from total hip replacement. More disabled patients expect better outcomes than their surgeons.”

Jourdan C, Poiraudeau S, Descamps S, Nizard R, Hamadouche M, Anract P, Boisgard S, Galvin M, Ravaud P. Comparison of patient and surgeon expectations of total hip arthroplasty. PLoS One. 2012;7(1):e30195. Epub 2012 Jan 17.

Increasing Dangers
in Hip Replacement Surgery
A recent New York Times Article reported on the increasing number of complaints of failed hip replacements. In the first half of 2011 more than 5,000 people contacted the Food and Drug Administration (FDA) regarding adverse effects of metal-on-metal hip replacements.

Watch this video on Cartilage regeneration!

 

Treatment of a hip capsular injury in a professional soccer player with platelet-rich plasma and bone marrow aspirate concentrate therapy

Treatment of a hip capsular injury in a professional soccer player with platelet-rich plasma and bone marrow aspirate concentrate therapy
Kevin J. Campbell, Robert E. Boykin, Coen A. Wijdicks, J. Erik Giphart, Robert F. LaPrade and Marc J. Philippon

 

Abstract

This report presents a 27-year-old male professional soccer player who developed heterotopic ossification of his hip capsule and gluteus minimus tendon after an arthroscopic hip procedure. After removal of the heterotopic bone, the patient had a symptomatic deficiency of his hip capsule and gluteus minimus tendon. A series of orthobiologic treatments with platelet-rich plasma and bone marrow aspirate concentrate improved the patient’s pain and strength as well as the morphologic appearance of the hip capsule and gluteus minimus tendon on magnetic resonance imaging. A series of motion analyses demonstrated significant improvement in his stance-leg ground reaction force and hip abduction, as well as linear foot velocity at ball strike and maximum hip flexion following ball strike in his kicking leg. Level of evidence IV.

One-Step Cartilage Repair with Bone Marrow Aspirate Concentrated Cells and Collagen Matrix in Full-Thickness Knee Cartilage Lesions. Hip

One-Step Cartilage Repair with Bone Marrow Aspirate Concentrated Cells and Collagen Matrix in Full-Thickness Knee Cartilage Lesions

Comment: The following article is regarding knee regeneration, however hip regeneration is very similar the only difference is the injection location. We treat many hips with these methods.

Yours in Health,

Wellington Chen, MD.

Results at 2-Year Follow-up

  1. Alberto Gobbi1⇓
  2. Georgios Karnatzikos1
  3. Celeste Scotti2
  4. Vivek Mahajan1
  5. Laura Mazzucco3
  6. Brunella Grigolo4

  1. 1Orthopaedic Arthroscopic Surgery International, Bioresearch Foundation, Milan, Italy

  2. 2Residency Program in Orthopaedics and Traumatology, University of Milan, Milan, Italy

  3. 3Centro Trasfusionale e Laboratorio Biotecnologie, Ospedale SS Antonioe Biagio, Alessandria, Italy

  4. 4Laboratorio di Immunoreumatologia e Rigenerazione Tissutale, Istituto Ortopedico Rizzoli , Bologna, Italy
  1. Alberto Gobbi, MD, Orthopaedic Arthroscopic Surgery International, Via Amadeo 24, 20133, Milan, Italy Email: gobbi@cartilagedoctor.it

Abstract

Objective: The purpose of our study was to determine the effectiveness of cartilage repair utilizing 1-step surgery with bone marrow aspirate concentrate (BMAC) and a collagen I/III matrix (Chondro-Gide, Geistlich, Wolhusen, Switzerland). Materials and Methods: We prospectively followed up for 2 years 15 patients (mean age, 48 years) who were operated for grade IV cartilage lesions of the knee. Six of the patients had multiple chondral lesions; the average size of the lesions was 9.2 cm2. All patients underwent a mini-arthrotomy and concomitant transplantation with BMAC covered with the collagen matrix. Coexisting pathologies were treated before or during the same surgery. X-rays and MRI were collected preoperatively and at 1 and 2 years’ follow-up. Visual analog scale (VAS), International Knee Documentation Committee (IKDC), Knee injury and Osteoarthritis Outcome Score (KOOS), Lysholm, Marx, SF-36 (physical/mental), and Tegner scores were collected preoperatively and at 6, 12, and 24 months’ follow-up. Four patients gave their consent for second-look arthroscopy and 3 of them for a concomitant biopsy. Results: Patients showed significant improvement in all scores at final follow-up (P < 0.005). Patients presenting single lesions and patients with small lesions showed higher improvement. MRI showed coverage of the lesion with hyaline-like tissue in all patients in accordance with clinical results. Hyaline-like histological findings were also reported for all the specimens analyzed. No adverse reactions or postoperative complications were noted. Conclusion: This study showed that 1-step surgery with BMAC and collagen I/III matrix could be a viable technique in the treatment of grade IV knee chondral lesions.

The following video explain’s PRP and shows how it can be of benefit to people suffering Hip tendonitis, arthritis, DJD, and other tendon, ligament or cartilage damage to the Hip. 

PRP is beneficial for tears in the hip rotator tendons, labrum tears, DJD of the hip joint or “bone on bone” of the hip.

I invite your to explore how these amazing therapies can help you return to the life you deserve. 

“where things grow back”

Call us for more information on how PRP works at 

(941) 330-8553 or e-mail me at

AskDoctorJL@Gmail.com

Yours in Health,

 

Wellington Chen,  M.D.

John Lieurance,  D.C.

2222 S. Tamiami Trail

Sarasota, FL 34239

“Rheumatology” Journal Evaluates PRP Platelet-Rich Plasma Injections for Hip Osteoarthritis

Nov 21, 2011. Posted by bcharchian.

40 patients affected by severe hip osteoarthritis were included in the study which was designed to assess the safety and symptomatic changes of PRP injections for hip arthritis. Each patient received three intra-articular injections of PRP, which were administered once a week.

Statistically significant reductions in pain scores were reported at 7 weeks and 6 months.  23 (57.5%) patients reported a clinically relevant reduction of pain (average of 45%, range 30–71%). More importantly, pain relief was shown to be sustained at 6 months with a parallel reduction of disability. Side effects were negligible and were limited to a sensation of heaviness in the injection site.

We look forward to more studies being published detailing the safety and efficacy of Platelet-Rich Plasma Injections for a wide array for joint, tendon, and ligament problems which have failed to respond to other treatments- setting the stage for a new era in regenerative medicine.

 

Hip Resurfacing, Hip Replacement, Prolotherapy, Prolozone & PRP in Sarasota, Florida.

Hip Resurfacing, Hip Replacement, Prolotherapy
John Lieurance, D.C.

There are a lot of options to treating your hip pain.

Hip resurfacing is not hip replacement. In hip resurfacing a metal ball replaces the bone “ball” portion at the top of the femur (thigh bone) that fits into the socket of the pelvis.

In hip replacement not only is the “ball” replaced, but the socket and a portion of the femur bone into the “greater trochanter.”

One of the main selling points for hip resurfacing is that it leaves more bone so a hip replacement can be performed later.

In our chronic pain clinic at Gecko Joint and Spine – we see this as one hip surgery setting up another. Surgery in my opinion, should always be the last option.

Is Hip Resurfacing really a less invasive technique?
According to surgeons, hip resurfacing is more difficult to perform and requires a larger incision than typical hip replacement. This increases the risk of complications.

For an athlete or worker who’s profession is physically demanding, this can mean a lot of down time.

Does hip resurfacing keep a younger patient active?
Another main selling feature for hip resurfacing as opposed to hip replacement is that studies have shown that it allows the patient to remain more active. The problem is, it is for a limited amount of time. Hip resurfacing has a life span of 15 years. After 15 years – it is hip replacement.

So if you are a young person of 45 who loves to play tennis or other demanding sports, at age 60 those days may be gone for good as your hip resurfacing needs replacement and there is just enough bone for a total hip replacement.

What are the options?
In our clinic we try to keep the patient away from surgery because once something is removed, it cannot be restored. Such as the bone removed in hip resurfacing.

We look at the problem of the hip in another way. The reason a hip procedure is needed is because there is a bone-on-bone situation causing pain and possibly impingement of soft tissue. The reason the bone on bone situation occurred was because the connective tissue in the pelvis region, the ligaments, tendons, and cartilage have shrunk, been torn, or have become weakened through “laxity.” In other words they are stretched out.

Strengthening and restoring the connective tissue, naturally, is in my opinion, the best first option.

Rejuvenating the hip
In our pain clinic we use Prolotherapy, prolozone, and PRP to revitalize weakened and damaged connective tissue. With these injections the Prolotherapy doctor hopes to mimic a new injury by causing a minor irritation at the connective sites where tendons attach to muscles, ligaments attach to bone, and also where cartilage has flatten.

The irritation caused by the Prolotherapy injection causes a controlled inflammation. In this inflammatory response the body brings the immune cells necessary to rebuild the collagen matrix-the protein blocks that soft tissue is made from.

Strengthened ligaments and tendons help hold the hip joint in its proper place cause less grinding and bone on bone. Restored collagen can help rebuild the cartilage between the pelvis and thigh bone – cushioning and relieving the bone on bone situtation.

Why remove tissue when it can be restored?

CBS News medical correspondent Dr. Jon LaPook explains that the term PRP

PRP therapy a viable joint treatment?

 

PRP Therapy

CBS News
Original Post
December 6, 2011


PRP therapy may be a way of fixing a muscle, tendon, or joint-related injury without surgery — and it’s really catching on.

The thing is, there’s no firm evidence that this experimental treatment actually works.

CBS News medical correspondent Dr. Jon LaPook explains that the term PRP stands for “platelet-rich plasma” therapy. Platelets are a part of your blood that’s responsible for clotting and healing.

“It’s that healing power that first attracted professional athletes to it about five years ago,” LaPook said. “Now, ordinary folks are requesting the treatment, and some swear by it.”

After enduring years of chronic foot pain, Linda Leonard is thrilled to be back on horseback. While riding 15 years ago, her horse stumbled, prompting her to jump off. Leonard landed hard, shattering her ankle.

Leonard said of her injury, “The angle, weight, momentum, just blew (my ankle) apart into 40 places. And I thought. ‘I’m in real trouble.’ And I had to crawl out on my elbows, and I was laying on the side of the road.”

After multiple surgeries, arthritis set in.

“People who live with pain every day — it’s exhausting,” Leonard said. “It got to a point where I thought, ‘Is this going to be my life? This is not even the essence of me; it’s not me.”‘

Leonard spent years searching for relief. Then, in 2009, she heard about an experimental, non-surgical solution that claims to stimulate powerful healing. Leonard sought out Steven Sampson, an osteopath who offers PRP.

“What we do is we isolate the body’s natural healing properties, called platelets,” Sampson, of the Orthohealing Center, said. “We’ve learned that platelets release growth factors that stimulate repair.”

The procedure is simple. A small amount of the patient’s blood is spun in a centrifuge to separate and concentrate the platelets. Then they’re injected into the injury. The cost varies from about $500 to $2,000, but is rarely covered by insurance because it’s still experimental.

Sampson said, “We’ve had success from head to toe, from neck, back, hip, knee.”

But thus far, studies have not produced convincing evidence that PRP is a magic bullet for tendon and muscle injuries.

Dr. Peter McCann, chairman of orthopedic surgery at Beth Israel Medical Center in New York City, said, “The PRP is equivalent to cortisone injections. There are a few studies that show slight improvement, but it’s really not improvement that patients would appreciate.”

That didn’t stop former National Basketball Association star Maurice Taylor from trying it. He claims it eliminated pain in both of his knees.

“I’m very surprised because it’s a quick treatment,” Taylor said. “I’m surprised that a treatment that takes so little time has such big results.”

McCann, who is also editor in chief of The American Journal of Orthopedics, says further studies are warranted

“The jury’s still out,” McCann said. “We need more studies to figure out if we can select out those patients who could really benefit because it does have great potential.”

Taylor said, “I was off the court and away from training for two days, then the third day, I was playing basketball.”

Taylor now plays for a team in China, and Leonard remains free of crippling pain.

“Maybe it won’t work on everybody, but it worked on me,” Leonard said. “It’s given me my life back.”

PRP has not yet been approved by the Food and Drug Administration, LaPook added on “The Early Show.” The agency told CBS News that licensed medical practitioners can use it, but they cannot claim the treatment will actually correct any problem.

“Patients are coming in and asking for it, right?” LaPook said. “It’s the classic clash between belief and evidence-based medicine. Last year, the International Olympic Committee commissioned a report saying, ‘Let’s look at the entire world literature and see (whether it works).’ They found that it was safe so far, although there are no long-term studies, but in terms of it being effective, the jury is still out.”

The results, LaPook said, are anecdotal up to now. “You know who was not in today’s piece?” LaPook asked. “My friend, Richard, who had an injection in each Achilles tendon for $2,500 each, and it totally didn’t work.”

” … I think there’s a very important study that people need to go back to,” LaPook continued. “About 10 years ago, everybody knew that, if you had arthritis of the knee, you do an arthroscopy, you clean things out, you smooth things out and you get better. So people said, ‘I get better with this.’ Well, so they said, ‘Let’s do a brave study,’ and it was brave, 180 people, they divided them into three groups. One had the actual arthroscopy and they washed it out. Another had the debris cleaning procedures. The other had a placebo — they did a couple of cuts and they did nothing. There was no difference between the three groups. And interestingly enough, all three groups got better. So what is the contribution of the placebo effect? Placebo is very powerful. And until you do these controlled studies, you know, you really don’t know for sure.”

When asked how this all plays out, LaPook said, “I think it goes to informed patient consent, informed decision-making, which is that the doctor says in the privacy of that office, what really goes on when you look at that patient in the eye, are you saying, ‘I’m telling you, this works. In my hand, it works.’ But are you saying the honest truth, which is, look, the jury is still out.”

Effective New Treatment for Osteonecrosis of the Femoral Head.

Osteonecrosis of the femoral head (ONFH) means death of the bone of the head of the femur, the rounded end of the upper leg bone that fits into the acetabulum or cup of the pelvis. While generally thought of as a problem associated with aging, ONFH can occur at any age as a result of trauma or disease. In the past, the treatment for advanced ONFH was frequently “wait until it’s bad enough to replace the hip joint.” Early treatment was an attempt to manage pain while slowing the progression of bone destruction. Recent medical innovations have created more effective orthopedic options, which result in decreased pain, require a shorter recuperation period, and are less expensive. Stem cell tissue from the patient’s body is at the center of new treatment for osteonecrosis of the femoral head.
Osteonecrosis or bone death occurs frequently when normal circulation of the blood is impaired. Bone loses its natural shape as tissue dies. Pain and physiological and mechanical malfunction follow. While all factors are not yet understood, trauma such as dislocated bone fracture and diseases that compromise blood flow are often precursors to osteonecrosis of the femoral head. Arthritis, lupus, decompression sickness, and diabetes, for example, can result in ONFM, as well as certain genetic conditions such as Sickle cell disease and Legge- Calve-Perthes. Additional factors are radiation therapy, transplant surgery, steroid use, and alcohol abuse.
Gecko Joint and Spine has combined the implantation of the patient’s stem cell tissue with other innovative treatment options to provide a uniquely effective and safe method of treatment. Prolozone is injected into the body, along with human growth hormone and platelet rich plasma, stimulate repair and regrowth of bone tissue. Over-the-counter supplements also provide key nutrients to support recovery. The exact course of treatment is dependent upon the stage of ONFH. As an orthopedic practice, IRMO is committed to continuing research in treatment of osteonecrosis. Hyperbaric therapy, for example, has been in clinical use since the 1960s and recent research reveals potential to improve treatment of ONFH. We utilize EWOT or exercise with oxygen.  Hip replacement is no longer the only option for patients suffering with the pain and loss of mobility associated with osteonecrosis.