You deserve to stay as active as you want and we won't let a sports injury or arthritis or low back pain slow you down!
At Texas Orthobiologics we specialize in orthopedic surgery AND the latest evidence based non-surgical regenerative medicine options....all in the same office led by a board certified orthopedic surgeon.
*Looking for 22+ Regenerative Medicine Lectures that cover lots of topics? I have a playlist for you!
The Texas Orthobiologics youtube.com channel has lots of free information on regenerative medicine AND MSK ultrasound including lectures given at various orthopedic surgery, sports medicine, and regenerative medicine years.
My only ask? Please "like and subscribe" to the channel if you find any useful pearls!
Platelet Rich Plasma (PRP) is a regenerative medicine or orthobiologic injection that is made from a patient's own blood in the office.
There is a lot of ongoing research to determine what conditions PRP works best for and also to determine the best dose of this biologic "drug".
The good news is that we have enough research published to use PRP to help patients with many hand and wrist conditions like carpal tunnel syndrome and De Quervain's tenosynovitis. Previously, the main non surgical injection for these conditions was a steroid shot....which worked sometimes but also had other effects on the soft tissues that we would rather avoid! All of these injections are done in the office under ultrasound guidance so we can precisely place the injection.
15-20 years ago most new patients came from other clinician referrals and other patient referrals.
With the rise of the internet and doctor review sites.....along with the increasing cost of insurance and rising deductibles...things have been changing over the last 15 years.
Now, most common referral source listed by our new patients at Texas Orthobiologics is the insurance company website (searching for local in network docs) and then online patient review sites (to see who is highly ranked) like doctor.com, healthgrades.com, vitals.com, usnews.com, trustpilot.com, google.com, and even yelp(ugh!).
So, like it or not, we have to care about reviews if we want to take care of patients..'
This brief presentation shows how we can use ultrasound in the office to diagnose a meniscus tear and avoid the time and expense of a MRI scan. It is faster and cheaper for the patient and allows us to have a diagnosis and treatment plan at the very 1st office visit! No fighting with insurance companies for pre-authorization either! Not every tear and not all knee pathology can be seen with ultrasound so there is still a need for MRI scans....but when we can use ultrasound....everybody loves it!
...still haven't gotten then message about exosomes being an unapproved drug in the USA yet?
Patients, avoid any clinic or doctor who tells you they can legally do exosome treatments in the USA right now. Unless they are part of a FDA approved study ....odds are they are not telling you the truth....ask for their FDA documentation and drug approval letter(s).
Doctors, if you are in a gambling mood and look good in an orange prison jumpsuit....and are looking to stock your shelves....here is one outfit STILL selling exosomes as recently as yesterday.
*MFAT (microfat) injection for knee osteoarthritis? Yes....the clinical evidence is only growing!*
The best part? This is a way to use adipose tissue in the USA that is compliant with the FDA regulations.
This RCT published 9/5/2024 in Arthroscopy divided knee osteoarthritis patients into a MFAT group, a steroid group, and a normal saline group.
75 patients total followed for one year. The MFAT group was significantly better than the other groups at every time point and out to one year.
The steroid group had max benefit at 2 weeks which quickly returned to baseline.
The two most prominent companies with adipose solutions in the USA right now are Lipogems and JointTechLabs.
*Can you do an intra-osseous orthobiologic injection with just an 18g needle?*
Of course you can. Location matters....here is a video documented 18g injection into the greater tuberosity right after a rotator cuff repair....no power needed, takes 2.54 seconds! And...no 11g hole in the bone.....don't do that.
You can use the same technique for the femoral condyles and tibial plateaus, especially if there are small cortical breaks visualized on ultrasound...aim for those! Pro tip" If you are putting in 10cc volume....getting the needle perfectly in the center of a bone marrow lesion is not critical to clinical success...10cc spreads pretty quickly throughout the space....promis
Regenerative Medicine Clinics should know the dose of any drugs they give to patients....including platelet rich plasma! At Texas Orthobiologics we test every dose
*2024 FDA Untitled Letters and what it means for Orthobiologics*
In 2024, there have been 5 Untitled Letters sent out for regulatory noncompliance with biologics. Untitled letters typically give the company or person a chance to correct the variance before any further FDA regulatory action and clearly show the current FDA regulatory stances on various orthobiologics.
