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Weekly Education meeting 2020-06-22

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Weekly Education meeting 2020-06-22
Lots of questions and answers regarding regenerative medicine and hip pain.
-Can regenerative medicine help in hip arthritis?
-SI joint issues.
-How long does it take after treatment to see benefit?
-Treatment candidacy.
-Treating the contralateral side when you have arthritis on one side.
-Medications contraindications to treatment.

Weekly educational meeting for the team at Chicago Arthritis and Regenerative Medicine where we discuss the basics of what we do for arthritis, tendinitis, injuries, and back pain.

Okay Hello this is Siddharth Tambar from Chicago arthritis and Regenerative medicine. This is our weekly educational broadcast discussion that I have with my team. So we have a couple questions today. And these are questions that I get from, team members who are talking to patients in terms of what are they hearing, what are the concerns patients have.

So, a couple questions that came up. Number one is kind of an interesting one which is for the regenerative treatments, How well does it work if you have such bad hip arthritis that you need hip replacement? I think that was the question right Jackie? And it’s a great question because number one, there’s a, it’s worthwhile to understand that different locations, respond differently to treatment. So based on information that we have, from not only the Regenexx network registry but also from the overall literature, what we know is that hip patients will respond differently than knee patients. So someone that has like advanced knee arthritis can still respond quite well, someone who has advanced hip arthritis is less likely to respond well. What that means is that their chance of getting a good degree of pain relief and functional improvement is going to be harder than someone that has knee arthritis.

There’s probably a few reasons for that. Number one, knees are just built to handle a significant amount of damage and pain. So our classic knee patient that shows up will be someone that will come in saying, “I’ve had knee symptoms going on for like 10, 20 years”. Maybe they’ve had surgery, maybe they’ve had other injections and frequently they may not be ideal body weight and they have diabetes. And yet their response to treatment for what we do in terms of the regenerative medicine treatments is they’ll still on average get 60 to 65% improvement in pain or better like just knees can handle it.
Hips on the other hand, are a very different story. Our classic hip patient, is someone who’s actually in shape, is actually exercising, pretty regularly, and comes in saying “wow my hip has been hurting a lot progressively the last nine to 12 months”. And pretty quickly you find that they have very aggressive advanced arthritis. They’ve lost a range of motion. Biologically something else is going on. So an interesting study that came out a couple years ago, actually looked at hip arthritis patients and found that the ones that had more progressive arthritis, and worse outcomes, where folks that actually had significant dysfunction in the mesenchymal stem cells within the bone around the hip joint. So biologically there’s something different about hip patients compared to our knee patients.
So our typical hip patient, if they’re coming in with severe hip arthritis, where they’ve lost range of motion. They are going to be a very hard patient for us to treat. And frequently in that kind of case, I will recommend, if I’m convinced that their pain is coming from the hip joint, I’ll recommend that they actually go for hip replacement surgery. In the cases where patients in that scenario, want to avoid surgery and still want to try one of our regenerative treatments. Number one, I’d recommend bone marrow aspirate concentrate derived stem cells. Number two, they need to understand that their chance of getting a good average or better response let’s say 50% or better response in terms of treatment is going to be harder. That they may have a 30% chance of hitting that or better. They’re just a harder candidate.

Now with that said, there are different levels to hip arthritis or hip pain. A lot of times when people think of pain in one area, they’ll think of it as a x ray of what’s going on and say your pain is coming from that one arthritic joint, but in reality the human body works a bit differently than that. Meaning when you look at someone that has hip pain, there’s a series of different things that are causing problems that lead to pain and dysfunction, meaning it’s not just a joint. It can be the bone, which I’ll describe in a second, that can lead to hip pain. It can be ligaments, soft tissue structures, labrum. It can be a lot of other structures around the hip that are driving pain. The interesting thing is that it can be more than just hip pain though, it can be coming from the SI joint. The SI joint is essentially the joint between the pelvis and the hip that basically can cause pain in the back of the head in the buttock area, but it can also be pain, even in the lower back, that can then translate into pain in the hip.

So I’ll give a couple examples to that. So my mother, I recall my mother limping, when I was looking, when I was doing college, when I was interviewing for colleges. I remember at Brown University which is located I think in Rhode Island, Providence, Rhode Island. That is very hilly and that she was limping, as we were going from one building to the other is the first time that I noticed that maybe she had something wrong with her gait. I kind of forgotten about for about 20 years. And in my late 30s, I realized she was having more hip pain. On her imaging, you’ll see that she’s got some hip arthritis, but on her examination you realize that her pain is not necessarily coming from the hip joint. It’s actually coming from SI joint. So, when you talk to her, she’ll tell you, “oh yeah, I’ve had that pain in my hip since you were born.” And so what you realize is that the normal kind of experience of pregnancy was that her si joints got loosened up in order to accommodate the womb. And she’s basically had pain from her SI joint those translated into her hip for literally decades. So our approach in her case was we ended up doing PRP treatment into her, into her SI joint, SI ligaments. And the cover our bases, we treated some of those other tissues as well the hip joint in the lower back but it’s is really the SI joint, and she had a really good response to treatment to the point where her hip pain was significantly better, where she’s able to walk significantly more exercise regularly on a daily basis, she can do five K’s. And my mother is about 74, she’s 74 currently or 73 could becoming 74. And essentially, I’ll still treat her basically every two years for the last couple years, and that sort of keeps her tuned up for the next couple of years where she can keep on exercising. So someone that’s got hip pain, could be really coming from SI area. You can tell that based on partly examination, partly on description of pain, and some even imaging.

The thing about imaging is that imaging can sometimes lead you down the wrong path. Have another patient, I’m actually seeing him today for his left hip pain, but I recently saw him several years ago for right hip pain. What’s interesting was his right hip showed a lot of damage on his imaging at that time. And he actually had a hip replacement and he still had hip pain. So at that time before he saw me he actually saw an interventional pain doctor that did a diagnostic injection. where they injected numbing medication into his SI joint, and he had resolution of his hip pain. So again we treated that with PRP, and he did well for a few years. I’ll find out how he’s doing right now, today. But an example of where imaging doesn’t always lead to things, right when imaging can sometimes be tricky.

The last example, I saw a lady recently over telehealth, tele Med. where she was describing hip pain again. She’s in her late 70s. She came to me, because she’s a friend of family in California. So I had a relatively limited examination that I could do for, do you with her, but she’s got an X ray of her hip that shows very mild arthritis, and on her examination from what she could do over zoom, a zoom call you could tell that she can move her hip. She’s still a good range of motion but she would have discomfort in her hip, suggested that there is something going on in the hip joint that could be a problem. So what’s curious is her physicians where she was she lives in Palo Alto had tried an injection to the epidural space. She’s had multiple injections over the last 20 years, steroid injections into the epidural space in her lower back, which have given her pain relief in the lower back. They also then recently tried a injection into her lateral hip, the outside part of her hip because they thought could this be bursitis, and she didn’t get any benefit from that either. So for me I was, I was talking to her saying look your examine is suggesting one thing, your x rays don’t fit that you’ve had some other treatments there’s something that we’re missing here. so we ended up getting a hip MRI. And so her hip MRI ends up showing that she’s got some damage in the actual bone. She’s got some early stage of avascular necrosis. That’s relevant because the bone is what actually feeds the joint. So she’s got pain in her hip, because she’s got avascular, developing avascular necrosis an early stage of that. Realistically, she probably developed that because of all the steroid injections shes had over decades. And so, you know, it’s like she has hip pain that can be treated still non surgically because she doesn’t have bad hip arthritis yet. But if he doesn’t get treated that damage to the bone will eventually lead to bad hip arthritis. And so the right way to treat that is percutaneously, meaning with a needle based method, you kind of put the needle into the hip bone decompress it, and then you inject your own bone marrow derived stem cells that’ll actually help her out. If she does that, she’ll probably get done in California from from a colleague. But it’s another example where there’s layers of this, when somebody says “hey I’ve got hip pain that requires surgery.” Well, you need to look through those different kind of layers. And so you can still come to a smart decision, but realize that there’s sort of what we know about hip arthritis, and there’s really how you approach it to kind of sometimes get at what’s really causing pain. Does that make sense?

[Team] yes What’s the next question Jackie?
– [Jackie] How Long Does it take,
– Recovery after the procedure to see differences?

Right, so great question. So, when you look at, so the question was how long does it take after a regenerative treatment process to see a response. So, this is very different than let’s say a steroid injection or a numbing injection. Steroid injection you’ll get relief after like one or two days, it’ll last for weeks to a couple of months, and then it progressively wears off. It’s different than let’s say a platelet or bone marrow stem cell injection, where you’ll have more inflammation for the first few days and even stiffness for the first couple of weeks, and then progressively improvement that starting at that four to six week mark. That’ll then kind of progressively improve for the next three to six months. In PRP there’s data that shows you’ll get that improvement up to six months in some cases even up to 12 months. What I generally tell people as expect improvement at the four to six week mark let we reconnect at the at the eight week mark see where you are. And if at some point over the next several months you’re starting to plateau and you’re not at your goal, then let’s repeat treatment. However, if you’re still improving expect there to be a continued slow improvement. And the nice thing is, as that improvement occurs, you’re able to then start to do more physical activity, which then provides more support for the joint that’s been treated. And then, that adds on to treatment improvement as well.

Jackie you had one more question?
– [Jackie] Yes, can they still proceed with the procedure if they are anemic?
– Right, so the question is about anemia. So, if you’re anemic it depends on how anemic they are, realistically so if you are, the guidelines that we have are if you are mildly to moderately anemic we reduce the amount of bone marrow that we’ll draw out or the amount of blood that will draw out from a safety standpoint. So part of it depends on, you know why are they anemic? Meaning if somebody is anemic because they have let’s say, leukemia or lymphoma, well that’s not really the kind of person that you necessarily want to treat with these kind of treatments, you’d prefer that they actually get their underlying condition treated first, before they proceed with treatment. On the other hand if they’re anemic because let’s say, they’re B12 deficient. Okay, well you just reduce the amount of blood or marrow that you take out, you should obviously be trying to treat the anemia as well. Mainly because from an overall health standpoint you want to improve that also. If they’re anemic because they’re on meds. Maybe it would make sense for them to actually do something to manage your meds first before they actually proceed with treatment. But at the time, obviously you kind of adjust the amount of blood or marrow that you take out. Does that make sense?
– [Jackie] Yes

To me the big thing is, why, right, like are they anemic because there’s something actively going on. That should be addressed before they actually proceed with treatment. You know reality is if somebody is anemic because they’re severely B12 deficient, if you corrected that they may just feel better on their own, right, they may not actually need to proceed with treatment. So sometimes understanding the Why goes a long way to, you know before you make a decision. Other questions.

– [Member 1] When someone comes to you with hip arthritis in the right hip, how often do you notice the other hip have damage, and do you ever recommend treatment, what kind of treatment?

There’s so many layers to that. So the question is when someone comes with hip arthritis on one side, how often do you see problems on the other side. And would you prophylactically treat that. That’s an interesting question because if you’re getting if you if you have someone that has severe arthritis in one hip, That may just need to be treated separately surgically anyway, Right? But then you sort of put attention to the other side where you’re saying well look something’s developing over there, maybe it would still make sense to treat that after the other hip has been treated. I think that’s one way to think of it. The other way to think of it is if somebody has let’s say mild to moderate hip arthritis that can still succeed from our treatments. Should you also be thinking about the other hip, you should certainly be thinking about it from a physical therapy, posture related standpoint, weight reduction standpoint. I think if you’re treating one hip with let’s say bone marrow derived cells, if they’re other hip is milder, they may benefit from just platelets. Alternatively, understand that they may have pain on the other side, not because of the hip joint but maybe from the lower back. So, if their lower back or SI areas is problematic, perhaps treating that at the same time would actually help the other side as well. So again it depends on why the other side is problematic, what stage is it, and is there something else going on the lower back that needs to be addressed.
– Thank you

-Lilia.
-[Lilia] what make a candidate not a good candidate for treatment?
Yeah. So what makes somebody a bad candidate for treatment. I think of a few different things. Number one is obviously what’s the severity of the pathology, but again, understand, an advanced arthritic knee can still respond well to pain relief. Advanced hip arthritis, not as much so part of it depends on which area, what degree of pathology. Number two is what about their otherwise overall health. You take someone that’s like a bad diabetic, who is poorly controlled that’s got bad metabolic syndrome, that kind of person is a challenging candidate for any treatment that humans can do, right, just because they are overall, just not a healthy person. On the other hand if you take someone that’s a diabetic, but they’ve actually put in the work the effort. Maybe they’re on meds, but really good diet, they’re exercising they’re doing everything they can. That’s kind of someone who’s put in a lot of effort, where maybe they’re controlling things where maybe they’re actually an okay candidate still that despite that other diagnosis they’ve done so much to help themselves out where they can still benefit. Then I think the other thing that I think of is what other meds they on. Are they on meds that can actually be challenging in terms of response to treatment. Because there are some meds that can actually do that. And then, to me, the the other kind of thing is what is also their expectations for treatment. When I talk to patients, if they’re fixated on let’s say, improving an imaging finding and not as much pain relief and functional improvement, You know, like maybe they’ve got the wrong expectations for treatment. That they may be a good candidate based on some of the other objective medical factors. Maybe they’ve got the wrong expectations and so having that conversation is important. So it’s going vary from person to person based on pathology, or their medical issues, maybe medications, and then also their expectations like from a professional standpoint, it’s sort of sussing out all those details to align our expectations and what we can achieve.

– [Member 2] Can you me an example of medications?
Yeah it’s an interesting one because the Regenexx lab in Colorado has really looked at what medications are harmful for mesenchymal stem cells in the lab setting. there’s so many different meds, like it’s it’s most meds, realistically. Your body’s not used to being exposed to that, it’s not evolutionary been developed for that. So, it’s tricky because if you can get people to limit certain non essential meds, then they should try to limit that. Let’s say anti inflammatory meds for pain. Okay, let’s try to limit that. Some blood pressure meds, maybe they can do stuff like that but it’s a little bit hard, right. The one that’s most relevant to me that I see are patients that have autoimmune issues, who may be on steroids, some other immunosuppressants. And what I try to guide them is, can you minimize the steroids as much as possible. But if you need that other medication to maintain your overall immune health, then I think you stay on that. It’s tricky. In my own experience, even when patients are on those meds, in theory you can tell them that maybe that’s not ideal for your treatment, but in my experience, they still do fine, in terms of treatment, but in theory that might be something that could be a limiting factor to treatment. But in reality, if they stopped those meds, if their overall condition is then active, that makes them a much harder medical candidate at that point. So, my personal take is, if someone’s got an overall medical issue that’s still active, optimize that in whatever way you can, ideally if you could do that non medication wise, which is diet and exercise or supplements. but in those people that still need meds, if that keeps them optimized and the best at their health, then that’s the best they can be in terms of a candidate. And just stopping those meds is not a smart thing you need to just take that into consideration that that may limit the effectiveness, but at least those meds have optimized your ability to live. What else.

So good questions you guys came prepared. Thank you.
-[Member] Thank you.
Yeah. Okay, good. Well, thank you very much everyone, and until next week, look forward to talking then. Be well and live well. Bye bye.


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Listen to the Regenerative Medicine Report podcast:
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***For evaluation and treatment at Chicago Arthritis and Regenerative Medicine:
Determine if you are a Regenerative Medicine treatment candidate:

Candidate Form

Contact us for more information or to schedule an appointment:
https://www.chicagoarthritis.com/contact-us/

MEDICAL ADVICE DISCLAIMER: All content in this message/video/audio broadcast and description including: infor­ma­tion, opinions, con­tent, ref­er­ences and links is for infor­ma­tional pur­poses only. The Author does not pro­vide any med­ical advice on the Site. Access­ing, viewing, read­ing or oth­er­wise using this content does NOT cre­ate a physician-patient rela­tion­ship between you and it’s author. Pro­vid­ing per­sonal or med­ical infor­ma­tion to the Principal author does not cre­ate a physician-patient rela­tion­ship between you and the Principal author or authors. Noth­ing con­tained in this video or it’s description is intended to estab­lish a physician-patient rela­tion­ship, to replace the ser­vices of a trained physi­cian or health care pro­fes­sional, or oth­er­wise to be a sub­sti­tute for pro­fes­sional med­ical advice, diag­no­sis, or treatment. You should con­sult a licensed physi­cian or appropriately-credentialed health care worker in your com­munity in all mat­ters relat­ing to your health.

***About this video***
In this video Siddharth Tambar MD from Chicago Arthritis and Regenerative Medicine discusses regenerative medicine treatment options for the hip, and related issues.

Regenerative Medicine approach to Hip pain- PRP treatment.

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Regenerative Medicine approach to Hip pain- PRP treatment.

Treating hip pain can require nuance and thoroughness. If you’d like to learn more, send us a message.

So I had a really interesting hip case, hip pain patient this past week, that I think, has a lot of interesting things, that we can all learn from. And I think for patients to understand, how we handle musculoskeletal issues, when it comes to wear and tear arthritis. There are some subtleties that are important to understand.

So when it comes to wear and tear arthritis, it’s so important to understand, that it is very rarely just one structure that’s the problem, it’s a whole unit that’s problematic. Meaning when somebody comes in with hip pain, you can’t just think that, the hip joint that’s a problem. You have to ask, are there any soft tissue issues, ligaments, tendons? Is there any other adjacent joint, like the SI joint, or anything nerve related, from the lower back that could be related.

So in this particular case, and I actually made a TikTok video of this, and I put it up on all of our social sites, and I got a lot of interesting kind of feedback from that. It was a woman who has some chronic lower back issues, and has some more recent onset right hip pain. And upon examination, imaging, discussion, we sort of figured out that, her pain was maybe slightly coming from the hip joint, but more predominantly from the soft tissue structures, meaning tendons around the hip, and then also from the lower back and the SI joint.

So she had failed multiple other conservative processes, and treatments. So we ended up proceeding with platelet rich plasma, and were able to help her out because we ended up using a very high concentration of platelet rich plasma into the hip joint and the SI joint. We also ended up injecting a lower concentration of platelet rich plasma into the hip tendons and ligaments. And then lastly, also injecting platelet growth factors, into the epidural space, to treat some of the nerve related pain.

I’m very confident that’s going to give her a great result, in large part because we properly pinpointed, where her issue was. Which is that it’s not just coming from the hip joint, but from all those other structures. Number two, because we took a comprehensive approach, which means that instead of just treating, that one structure that might be involved, we treated the whole functional unit. Which meant treating not only the joint, adjacent joints, nerves, soft tissue. And because of that, she’ll likely do better longer term as well. And lastly, because using like really high level ultrasound and X ray guidance, able to make sure we’re really directly, and exactly hitting the right things, which will go a long way to getting her to feel better longer term as well.

The other aspect in her case, was she actually had a similar kind of pain, couple years ago for the left side, and did dramatically well when we had the same kind of approach to treatment. So I’m very confident she’ll actually do well there as well. But big takeaways are, if you do have some kind of joint issue, it’s never good enough to just say, hey my problem is just this one thing. You really have to think two, three orders deeper, to really get out what’s really driving things, to get a better result.

***For more educational content:
Sign up for our email newsletter:
https://www.chicagoarthritis.com/newsletter/
See our blog:
https://www.chicagoarthritis.com/blog/
Listen to the Regenerative Medicine Report podcast:
https://www.chicagoarthritis.com/regenerative-medicine-report/

***For evaluation and treatment at Chicago Arthritis and Regenerative Medicine:
Determine if you are a Regenerative Medicine treatment candidate:
https://www.chicagoarthritis.com/regenexx-candidate-form/
Contact us for more information or to schedule an appointment:
https://www.chicagoarthritis.com/contact-us/

MEDICAL ADVICE DISCLAIMER: All content in this message/video/audio broadcast and description including: infor­ma­tion, opinions, con­tent, ref­er­ences and links is for infor­ma­tional pur­poses only. The Author does not pro­vide any med­ical advice on the Site. Access­ing, viewing, read­ing or oth­er­wise using this content does NOT cre­ate a physician-patient rela­tion­ship between you and it’s author. Pro­vid­ing per­sonal or med­ical infor­ma­tion to the Principal author does not cre­ate a physician-patient rela­tion­ship between you and the Principal author or authors. Noth­ing con­tained in this video or it’s description is intended to estab­lish a physician-patient rela­tion­ship, to replace the ser­vices of a trained physi­cian or health care pro­fes­sional, or oth­er­wise to be a sub­sti­tute for pro­fes­sional med­ical advice, diag­no­sis, or treatment. You should con­sult a licensed physi­cian or appropriately-credentialed health care worker in your com­munity in all mat­ters relat­ing to your health.
***About this video***
In this video Siddharth Tambar MD from Chicago Arthritis and Regenerative Medicine discusses Regenerative Medicine approach to Hip pain- PRP treatment.

Hip Pain treatment- PRP

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Hip arthritis is painful. PRP injection done with precise imaging guidance can help with hip pain.

***For more educational content:
Sign up for our email newsletter:

Subscribe to our Newsletter

See our blog:

Chicago Arthritis Blog

Listen to the Regenerative Medicine Report podcast:
https://www.chicagoarthritis.com/regenerative-medicine-report/

***For evaluation and treatment at Chicago Arthritis and Regenerative Medicine:
Determine if you are a Regenerative Medicine treatment candidate:

Candidate Form

Contact us for more information or to schedule an appointment:
https://www.chicagoarthritis.com/contact-us/

MEDICAL ADVICE DISCLAIMER: All content in this message/video/audio broadcast and description including: infor­ma­tion, opinions, con­tent, ref­er­ences and links is for infor­ma­tional pur­poses only. The Author does not pro­vide any med­ical advice on the Site. Access­ing, viewing, read­ing or oth­er­wise using this content does NOT cre­ate a physician-patient rela­tion­ship between you and it’s author. Pro­vid­ing per­sonal or med­ical infor­ma­tion to the Principal author does not cre­ate a physician-patient rela­tion­ship between you and the Principal author or authors. Noth­ing con­tained in this video or it’s description is intended to estab­lish a physician-patient rela­tion­ship, to replace the ser­vices of a trained physi­cian or health care pro­fes­sional, or oth­er­wise to be a sub­sti­tute for pro­fes­sional med­ical advice, diag­no­sis, or treatment. You should con­sult a licensed physi­cian or appropriately-credentialed health care worker in your com­munity in all mat­ters relat­ing to your health.

***About this video***
In this video Siddharth Tambar MD from Chicago Arthritis and Regenerative Medicine discusses hip pain, hip arthritis, hip pain treatment, hip arthritis treatment, hip pain prp treatment, hip arthritis prp treatment, regenerative medicine.

Inflammation, Pain, and Musculoskeletal Health

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Inflammation, Pain, and Musculoskeletal Health
Inflammation is complicated. But it definitely has a role in musculoskeletal health, pathology, and pain.
Hello, this is Siddharth Tambar from Chicago arthritis and regenerative medicine. On this video today I am talking about a fundamental issue when it comes to your musculoskeletal health and that is inflammation. First and foremost it’s important to understand the difference between acute and chronic inflammation. Acute inflammation would be when you’ve sprained an ankle, acutely injured your shoulder or knee, and it feels very inflamed, hot, warm, maybe a little bit swollen as well. That is generally the body’s normal way of trying to recover from an injury. Meaning you have an acute injury, trauma, your body brings in platelets, red blood cells, growth factors to help try to heal that kind of injury. In most circumstances that’s a good process. Occasionally too much acute inflammation can be problematic, but normally that is the normal process of trying to recover from an acute trauma. On the other hand, there’s chronic inflammation.
Chronic inflammation is a problem. And the reason why is because it’s your body’s way of trying to function and recover but is not doing so appropriately, and will actually prevent a normal healing process and normal function. So when it comes to chronic inflammation, it’s important to understand the difference between systemic or total body inflammation, versus local chronic inflammation. So systemic inflammation or total body inflammation is a problem because it can cause a number of issues including inflammation in the joints, damage in the joints, and sort of permanent damage and persistent functional problems. It can also make you more prone to metabolic syndrome as well as cardiovascular disease. Chronic inflammation is on a systemic level is a big problem and leads to a lot of pathology and pain and dysfunction long term. There’s then chronic inflammation at a local level meaning at a one joint, one tendon level. You could see that as persistent inflammation within a knee that is chronically swollen, or a tendon that is chronically strained or inflamed as well. That leads to not only persistent pain, instability, dysfunction, but also damaged in some cases as well. You can have that chronic inflammation if you have a joint or tendon that is chronically unstable or if you have some other process systemically that is causing that inflammation in that joint.
So chronic inflammation is a problem. Ways that you can control that include trying to be as clean and healthy when it comes to an anti-inflammatory diet. That can mean different things to different people, but as a general rule it, to me, at least it means more of a plant-based diet, reduced refined sugars. Each person probably has some degree of susceptibility to inflammation based on their diet and that can vary from person to person. Working with an expert, proper nutritionist can help you in that regard.
There are certain supplements that can also help with chronic inflammation- omega-3 and turmeric have benefit as well that’s been shown to help not only osteoarthritis, and rheumatoid arthritis in some cases. And can be as useful as chronic Anti-inflammatory medications as well. In some cases if there’s significant chronic inflammation, medications are necessary to help control those kind of conditions. Those medications work by modulating your immune system to prevent that chronic inflammation. And then lastly in some cases regenerative medicine treatments, orthobiologic treatments, can be helpful as well either because the actual treatment itself has an anti-inflammatory effect or because if you have an instability issue by improving instability, you can reduce the chronic inflammation with that joint as well.
Inflammation has some good parts if it’s acute but is a problem if it’s chronic. It’s something that can be treated and evaluated. It’s important to recognize, it’s important to treat it. And if it’s a component of your pain and inflammation and dysfunction, it’s something that should be checked out. Have a good day. Be well, and bye-bye.
***For more educational content:
Sign up for our email newsletter:
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https://www.chicagoarthritis.com/blog/
Listen to the Regenerative Medicine Report podcast:
https://www.chicagoarthritis.com/regenerative-medicine-report/

***For evaluation and treatment at Chicago Arthritis and Regenerative Medicine:
Determine if you are a Regenerative Medicine treatment candidate:
https://www.chicagoarthritis.com/regenexx-candidate-form/
Contact us for more information or to schedule an appointment:
https://www.chicagoarthritis.com/contact-us/

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***About this video***
In this video Siddharth Tambar MD from Chicago Arthritis and Regenerative Medicine discusses inflammation, pain, arthritis, tendinitis, and injuries.

MRI & Hip Labral Tears

MRI and Hip Labral Tears

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We have a patient being treated with platelet-rich plasma. He has asked something interesting that is worthwhile discussing. He has MRIs for both hips that show some very mild arthritis, and they also incidentally show other things that are likely part of his degenerative process.

In one hip, the MRI mentions fraying of the labrum. In the other hip, the MRI mentions a small tear in the labrum.

The patient asked a really reasonable question: “What’s the difference, and is that even relevant?”

What’s interesting is, in somebody that has arthritis, that labral change is just part of that degenerative process. Understanding that goes a long way to not overreacting to it, despite what that MRI finding is.

Number two: Is there really that much of a difference between a small tear and a fraying tear, or fraying of a soft tissue segment in someone who already has osteoarthritis? And the answer is likely not.

We really looked at this individual clinically during his treatment. We looked at all the different layers of tissue, from the skin all the way down to the joint in his case, and even dynamically had him flex and internally, externally rotate the hip. And we noticed that there’s no impingement here. It’s not a labral issue.

But when you look at the different layers of tissue that are involved, you have muscles, tendons, ligaments, the labrum, the joint, and all of these are what’s causing his degenerative process in the hip.

For an individual like this, when he looks at his MRI report really carefully, he gets thrown off because there’s an emphasis on something like a labral tear versus labral fraying. When we look at it under ultrasound, and we realize the layers of tissue that are involved to lead to that slow and progressive degenerative issue going on in his hip.

He doesn’t need to overreact to this MRI, and it’s helpful in his case to realize that there is a layered process of what’s going on here, and that he doesn’t need to overreact and get overly concerned to what the MRI imaging report has, and in his case, he’ll likely do well.

He’s still at an early stage of his condition, and hopefully we can keep him functioning at a very high level, with a very low-intense, low-risk, nonsurgical process.