Our treatment philosophy is that the simplest treatment that works and returns our patients to normal activity is always best.
Often major surgery is not needed to treat knee conditions. We have extensive experience with biologic treatments and can recommend the ones that are most likely to be effective for a particular knee condition. We are leaders in non-surgical treatment and offer the most advanced therapies.
Biologic Non Surgical Treatments
PRP and PRF
Platelet rich plasma (PRP) and Advanced Platelet Rich Fibrin (A-PRP) are products that are derived from the patient's own blood.
20 to 60 milliliters of blood are placed in a device that will separate the different components. The layer containing platelets or platelets and white blood cells is separated and placed in a seringe. It can then be injected wherever it is needed.
PRP and A-PRF uses in the knee include:
Pes Anserine bursitis
Quadriceps tendon injuries
Patella Tendon injuries
Mild Knee osteoarthrits
Lipogems is unique process that allows us to get healing cells from your own fat using an ingenious patented device. Following a quick a relatively painless harvest the fat is processed to obtain clusters of healing cells. These cells are injected under ultrasound guidance into any tissue or joint that is injured. We are experienced in treating knees with arthritis, meniscus tears and ligament injuries.
Fat contains a high percentage of stem cells which are undifferentiated cells that may regenerate and multiply forming tissue when necessary. Conventional stem cell treatments isolate these stem cells and inject them into areas that require healing or repair. Many stem cells however die in the process due to lack of a supportive environment. LIPOGEMS uses a special device that preserves the fat environment which contains cells such as pericytes and cytokines that support and direct the activity of stem cells. During the process, the adipose tissue is fragmented to release cells and certain residues that promote inflammation are removed. No enzymes are used at all and a sterile saline solution helps minimize damage to the cellular products.
For the procedure, your doctor first selects a site for fat extraction. The area is injected with a mixture of anesthetic and saline. After the area is sufficiently anesthetized, about 50-120 cc of fat is extracted depending on how much is needed. There is no visible change in appearance at the donor site. The fat is then processed in the LIPOGEMS device which takes about 20 minutes. It is then drawn into syringes and injected into areas that require healing and regeneration. The entire procedure takes about 90 minutes.
Advantages of Lipogems:
Multiple joints can be injected on the same day
Fast procedure done in the office without general anesthesia
Sterile process as the cells are never in contact with air and stay inside the system until they are delivered.
Quick acting - most patients start to improve within 4-6 weeks and the improvement continues for many months
Effective for knee arthritis. In my experience Lipogems is more effective than viscosupplementation or PRP
BONE MARROW ASPIRATE CONCENTRATE
Bone Marrow Concentrate (BMC) Therapy, also known as Bone Marrow Aspirate Concentrate (BMAC) Therapy, is a promising cutting-edge regenerative therapy to help accelerate healing in moderate to severe osteoarthritis and tendon injuries.
BMC therapy is a promising non-surgical regenerative treatment used to treat various orthopedic injuries, including moderate to severe osteoarthritis and tendon injures. BMC is a concentrate of regenerative stem cells obtained from a patient's own bone marrow. The physician removes a small amount of the patient's bone marrow and spins it in a centrifuge in order to generate a powerful concentrate that is injected into the injured area. In the past, these types of cells were often very difficult and expensive to obtain from the body. With recent medical advancements, the cells can be easily obtained and the procedure can be done with minimal discomfort by a simple office procedure.
Unlike other cells of the body, bone marrow cells are "undifferentiated", which means they have the ability to replicate themselves into a variety of tissue types. When injury occurs, the usual number of regenerative cells needed for tissue regeneration is often inadequate. With BMC, the concentrate of regenerative cells provides a more robust healing of the damaged tissue and aids in growth and repair by accelerating the body's natural healing mechanism. While the full benefits of BMC are still unknown, it has been shown to reduce swelling, relieve pain, and enhance healing of articular cartilage and bone.
Conditions that can be treated:
Meniscus Tears (Medial, Lateral),
Tendon Injuries (Patellar Tendonitis, Quad Tendon),
Ligament sprains or tears (MCL, LCL, ACL)
Tenex procedure is a minimally invasive method to identify and remove pain generated from scar tissue in tendons of the knee which can occur due to various musculoskeletal conditions arising from overuse and other injuries.
The procedure is performed under local anaesthesia to numb the affected area. The micro tip of the TX1 tissue removal system, the size of a tooth pick, is inserted into the affected area under ultrasound guidance. The tip releases ultrasonic energy which breaks and emulsifies the scar tissue which is then aspirated. It takes about 15 minutes and the tiny opening is covered with an adhesive bandage with no sutures required.
You will be able to return to normal activities in approximately a month after the procedure.
Conditions treated are:
Patella Tendonitis (Jumper's Knee)