Alpine Spine & Orthopedics

Interventional Orthopedics

Regenerative Orthopedic Treatments for Complex Injuries and Conditions

Interventional Orthopedics involves using minimally-invasive image-guided procedures to inject a variety of specific medications and regenerative therapeutic agents at the exact site of injury to stimulate and accelerate the repair of tissues and joints. These medications can include a variety of cell signaling peptides, PRF, A2M, stem cells, viscosupplementation, and new arthritis medications, in addition to several anti-inflammatory agents, described in further detail below.

"Orthopedic surgeons are at an exciting crossroads in medicine, where biologic therapies are evolving and increasingly available. Time-tested interventions such as arthroplasty have shown good results and still have a major role to play, but newer regenerative approaches have the potential to effectively delay or reduce the requirement for such invasive procedures." --Aaron Krych and Mario Hevesi, Orthopedic Surgeons at the Mayo Clinic, International Orthopaedics, Feb 2021.

Orthopedic Injuries - the following conditions are commonly treated at our clinic. Also see additional information for the newest treatments of connective tissue injuries (tendon, ligament, meniscus, labrum, cartilage, etc.) as well as spine injuries, nerve injuries, joint injuries, arthritis, and other conditions with many treatments described on the PRF, A2M, peptides, spine, joint arthritis, stem cells, shockwave, and treatment pages.

Of note, some practitioners continue to use high-dose steroid injections as a shotgun approach for many orthopedic ailments even though these medications tend to cause atrophy of tendon, ligament, bone, cartilage, and skin due to downregulation of collagen synthesis, thus causing worsening or recurrence of some problems and deleterious feedback cycles. There are a few instances where corticosteroids should be used (primarily for actual inflammatory processes and rarely for repetitive degradative injuries, nerve entrapments, chronic inflammatory conditions, etc.) (1) (2) (3) (4) (5) (6) (7) (8). Rather than use injections of degradative medications, in most cases it is preferable to use a regenerative approach that actually stimulates tissue repair, including peptides, biologics, PRF, A2M, pentosan, hyaluronic acid, chondroitin, and shockwave therapy, which promote connective tissue rebuilding, repair, and protection rather than inhibit it as corticosteroids do. We suppress inflammatory processes as necessary and then kickstart regenerative phases that will optimize tissue repair and healing using image-guided injections with a cocktail of factors that are chosen specifically for your injury or condition.

• Spine injuries, pathologies, and pain of the neck and low back (cervical thoracic and lumbar spine). strained ligaments, herniated discs, & spinal facet joints.
• Herniated discs, annular and radial tears of disc, strained ligaments, & spinal facet joints.
• Vertebral fractures, pars defect fractures, spondylosis, sponylolisthesis, and spinal stenosis.
• Arthritis and other arthropathies of the spine, facets, knees, hips, sacroiliac (SI) joints, ankles, shoulders, elbows, toes, thumbs, hands, wrists, fingers, neck, back, atlanto-axial, atlanto-occipital, and temporomandibular joints.
• Forearm lateral epicondyle pathologies (tennis elbow).
• Forearm medial epicondyle pathologies (golfer's elbow).
• Rotator cuff tears, adhesive capsulitis (frozen shoulder), & many other shoulder pathologies.
• Strains, sprains, ruptures, or tears of tendons, ligaments, labrum, meniscus, & pulleys.
• Labral tears, meniscus tears, and dislocations of hip, shoulder, knee, etc.
• Osteoarthritis, joint pain, joint instability, synovitis & effusions.
• Hip pathologies, including labrum, ligament, & cartilage injuries.
• Sacroiliac (SI joint), piriformis, gemelli, obturator, greater trochanteric, & deep gluteal syndromes.
• Hip & Femoroacetabular impingement syndromes (Femoral-Acetabular Impingement = FAI) & ankle impingement syndromes.
• Knee pathologies, including ligament, cartilage, & meniscus injuries.
• Regenerative patching of intraosseous non-union fractures, avascular necrosis, Osgood-Schlatter, Legg-Calve-Perthes, and other bone injuries and defects.
• Cartilage fracture, chondral fissure, chondral defects, cartilage delamination, & subchondral contusion injuries.
• Iliotibial IT band friction syndrome and bursitis at the hip, knee, elbow, & shoulder.
• Hamstring tears of muscle and tendon (hip origin & knee insertion).
• Hip flexor and femoral quadriceps pathologies (proximal & distal).
• Pathologies of biceps femoris, semitendinosus, & semimembranosus.
• Impingement syndromes of shoulder & hip (FAI-S).
• Injuries of the hip, thigh, knee, ankle, foot, and toe in runners and other competitive athletes.
• Patellar tendinosis & plica syndrome.
• Gastrocnemius/soleus pathologies.
• Peroneus/tibialis posterior or anterior pathologies.
• Medial tibial stress syndrome (shin splints & stress fractures).
• Achilles tendinosis & achillodynia.
• Plantar fasciitis.
• Turf toe, capsuloligamentous tears, & Morton's neuroma.
• Tendonitis, enthesitis, tendinopathies, tenosynovitis, & tears.
• Pulley ruptures, volar plate avulsions, checkrein ligament strains, lumbrical tears, jersey finger, stener lesion, & related injuries.
• Ganglion cysts, Dupuytren's contractures, Heberden's nodes, Bouchard nodes, tophi, synovial cysts, & fibromatosis.
• Osteophytes, enthesophytes, bone spurs, & calcific tendinosis.
• Rotator Cuff, SASD, Scapulothoracic, Gluteal, Ischial, Olecranon, & Prepatellar Bursitis
• Joint effusions & cysts.
• Muscle tears, strains, trigger points & myofascial syndromes.
• Osteoporosis (zoledronic acid infusions, bisphosphonate therapy, and parathryoid hormone analogs like teriparatide and abaloparatide)
• Radicular nerve root pain, thoracic outlet syndrome, neuropathy, nerve entrapment or impingement, & nerve tunnel syndromes.
• Regional nerve blocks and releases of spine, head, neck, hip, knee, shoulder, elbow, ribs, arm, ankle, etc.
• Nerve compression and nerve entrapment injections of carpal tunnel (median nerve), cubital tunnel and guyon's canal (ulnar nerve), radial nerve, suprascapular nerve, occipital nerves, sciatic nerve (sciatica, piriformis syndrome, ischiofemoral ischial tunnel, etc), tarsal tunnel (tibial nerve), fibular nerve, superficial and deep peroneal nerve, meralgia paresthetica (lateral femoral cutaneous nerve), femoral nerve, nerve plexus, regional blocks, stellate ganglion, sphenopalatine pterygopalatine ganglion, discogenic nerve root compressions, etc.

-----

ASOI © 2021 All Rights Reserved

*Disclaimer: We seek to always provide the highest-quality evidence-based care to our patients customized for their specific conditions, injuries, and diagnoses, which may include FDA-approved therapies as well as additional investigational, alternative, or regenerative therapies. We always discuss potential risks and benefits of all these options. The information presented here is for informational use and cites the ongoing cutting-edge research and medical advancements on these relevant topics. There are many treatments, interventions, and protocols routinely practiced in medicine and surgery which the FDA has not studied nor formally approved yet which have demonstrated overwhelming evidence of efficacy and clinical benefit, while many standard treatments and common surgeries can actually have high rates of failure and complication. The FDA does not regulate the practice of medicine but rather regulates medical marketing of devices and drugs. The FDA does not conduct clinical trials or attempt to discover new treatments, but rather requires companies or other entities to fund marketing approvals. Breakthrough technologies typically require years to decades of research work to optimize the technology and collect enough data to prove efficacy and superiority, which in some cases can optionally be submitted to the FDA if there is sufficient financial backing to market a specific product or drug. Thus the FDA has not yet studied, evaluated, or formally approved many regenerative therapies currently practiced by many of the top physicians and surgeons in the United States and around the world. Some therapies, products, or interventions may still be considered investigational or "off-label" even with substantial evidence of efficacy, and many different applications of regenerative therapies continue to be researched by our institute and other top institutions around the world. The rapid evolution and advancement of medicine demands that physicians continually update their knowledge and practice techniques to adapt to future improvements and advancing technologies. These statements have not been evaluated by the FDA, and the treatments and products presented here are for informational purposes and not guaranteed to diagnose, treat, cure, or prevent any specific disease or condition. All injuries and conditions should be formally evaluated by a knowledgeable medical professional whereby standard treatments and additional therapeutic interventions may be considered with the diagnosis and treatment plan.