The Regenerative Spine and Joint Institute Approach

With the advent of new bio-cellular regenerative interventions (BRI), we are able to successfully treat patients with mild to advance hipone space  conditions without the need for surgical interventions. Our interventions are designed to repair, regenerate, restore tissue to its normal health and function.one space  Potentially avoiding recurrent episodes of pain, disability and further surgical interventions.

 

Hip Arthritis

What is Arthritis?

Osteoarthritis or OA is the most common form and is related excessive wear and tear of the joints, ultimately damaging the joint the cartilage (which is the smooth, firm material which covers the ends of the bones in the hip joint). It can be associated with aging, overuse or trauma. With time, the cartilage become stiff, less effective in absorbing loads and damage ensures, causing inflammation. The tendons and ligaments around the joints begin to stretch and the pain worsens. Ultimately the cartilage wears out and the bones start to rub against each other, creating spurs and deformity in the joints.

Hip OA, frequently affects patients over 50 years of age, female, commonly associated with smoking, obesity, poor nutrition, previous trauma, labral tears, occupational factors, repetitive motions (sports) and genetic predisposition.

Rheumatoid Arthritis:

Is the second most common form of arthritis and is considered an autoimmune disease. Your body’s own natural defense systems for fighting illness, attacks the you own tissues such as the joints (specifically the lining called synovium) and ultimately the cartilage and bone. This can lead to significant pain, swelling, deformity and joint damage. RA is a progressive disease that can affect multiple parts of your body.

What are the Symptoms?

Patients with hip arthritis usually complain of groin pain and buttocks pain, aggravated by weight bearing and activity. As the condition worsens, limitation of range of motion ensues and the patients developed a limp or gait abnormalities.

How is it diagnosed?

After a comprehensive history and physical examination, usually X rays are obtained to confirm the diagnosis. MRI can yield more specific information about the degree of cartilage loss and other pathologic conditions usually associated with hip OA such as labral tear, bursitis and cartilage defects.. Frequently a diagnostic hip injection with local anesthetic is utilized.

How is it treated?

At the RSJI we believe that conservative therapies should be utilized in every patient prior to more advanced regenerative interventions or surgical options. Most patients can be successfully treated with this approach.

  • Conservative Interventions
    • Rest in the acute stages
    • Activity modification with avoidance of triggering factors
    • Weight Loss
    • Physical Therapy, Bio-mechanical training
    • Nutritional supplements
    • Medications: NSAIDS (non-steroidal anti inflammatory drugs)
    • Correction of muscle imbalance, stretching, Laser therapy
    • Lifestyle changes

    Surgical Interventions
    Patients who do not respond to non-operative care or injection therapy, and have significant pain are considered surgical candidates.

    Total Joint Replacement, Resurfacing

    The Regenerative Spine and Joint Institute Approach

    With the advent of new Bio-cellular Regenerative Interventions (BRI), we are able to successfully treat patients with mild to advance degenerative joint disease without the need for surgical interventions. Our interventions are designed to repair, regenerate, restore tissue to it’s normal health and function.

    By repairing the cartilage and adjacent structures, further recurrent episodes of pain, osteoarthritis, disability and further surgical interventions may be avoided.

    Indications for Bio-Cellular Regenerative Interventions (BRI)

    • Moderate to severe pain
    • Failed conservative therapy
    • Unable to undergo conservative therapy
    • Adjunct to conservative therapy

    Why Bio-Cellular Regenerative Interventions (BRI)?

    • Our treatments are designed to repair tissue, not suppress symptoms like steroids
    • Not associated with significant side effects (unlike steroids)
    • Only natural substances and biologics are used
    • The interventions can be repeated with minimal risks
    • Can significantly speed up the recovery process from injury
    • We utilized your body’s own growth factors and cells (no risk to acquired communicable diseases)
    • The interventions are usually office based and cost effective
    • Can potentially avoid or significantly delay more invasive surgical options

    What are the different types of Bio-Cellular Regenerative Interventions (BRI)?

    After a comprehensive evaluation, your physician will discuss which intervention and treatment pathway is the most effective in treating your condition. The treatment plan is based on two major criteria’s: Bio Regenerative Index (which is a proprietary evaluation tool which can predict the body’s ability to heal) and the Degenerative Index (based on the severity of the damaged or degenerated tissue).

    There are two main types of therapies utilized to enhance your body’s ability to heal: Natural ( which consists of injections glucose, hormones, oxygen in high concentration, lubricants, plant derived anti-inflammatories) and Bio-Cellular (which consists of using your body’s own growth factors and stem cells).

    Natural Therapies (Usually indicated in early stages)

    • Prolotherapy (Creates tissue proliferation)
    • Ozone (Increases tissue oxygenation)
    • Traumeel (Homeopathic anti-inflammatory)
    • Viscous Supplementation (Increases joint lubrication)
    • Peptide Therapy (stimulates production of cartilage cells)

    Bio-Cellular Therapies (Usually indicated in moderate to advanced stages)
    PRP (Growth Factors obtained from your own blood)

    • PRP stands for platelet rich plasma, which is obtained by processing your blood and concentrating the platelets, which are cells which contain numerous chemical that help your body heal. These chemicals are called growth factors). For more information see Biocellular Regenerative Interventions.

    BMAC ( Mesenchymal Stem Cells concentrated from your own bone marrow)

    • BMAC stands for bone marrow concentrate aspirate, which is obtained from your bone marrow and contains not only platelets, but also infection and cancer fighting cells. More importantly, it contains a type of stem cell called mesenchymal stem cells. These cells are responsible for secreting growth factors that can significantly enhance the tissues ability to heal and regenerate. For more information see Biocellular Regenerative Interventions.

    ADSC (Mesenchymal Stem Cells concentrated from your own adipose tissue)

     

    • ADSC stands for adipose derived stromal cells, which is are from your own adipose tissues and contains different types of cells which helps your body heal. More importantly, it contains a type of stem cell called mesenchymal stem cells. These cells are responsible for secreting growth factors that can significantly enhance the tissues ability to heal and regenerate. The number of cells can be up to 500% more than in BMAC and they possess greater anti-inflammatory capabilities. For more information see Biocellular Regenerative Interventions.

    Allogeneic Amniotic Tissue Grafts (Growth Factors and Stem Cells from donor amniotic fluid)

    • Amniotic Grafts refers to tissues obtained from amniotic fluids obtained from donors (carefully screened with no communicable diseases). It contains collagen, growth factors and a small percentage of live amniotic stem cells. These cells are mesenchymal in origin and are more powerful than traditional adult mesenchymal cells. We utilized amniotic grafts in patients that cannot donate their own cells or are unwilling to undergo the graft extraction procedure. For more information see Biocellular Regenerative Interventions.

    Scaffolds(fibrin from your own blood and adipose tissue)

    • Scaffolds are biologic tissues used to assist in the repair process when combined with growth factors and stem cells. It helps provide a 3D environment for the cells to be protected, proliferate and arrange themselves according to the tissue in which they are transplanted. More importantly, it acts as a slow release systems for growth factors. It is an essential component in tissue engineering techniques. Scaffolds come from fibrin (obtained from your own blood), lipo-aspirte (from your own adipose tissues) and Hyaluronic Acid (naturally manufactured tissue filers).For more information see Biocellular Regenerative Interventions.


    (These interventions are not designed as stand alone therapies and in order to achieve maximum tissue repair and regeneration may have to be repeated. It is important to continue to exercise proper ergonomics, bio-mechanics, avoidance of triggering factors, continue physical, chiropractic and massage therapy (as needed), and abide by a sound Regenerative Lifestyle. (

Labral Tears

What is a labral tear?

Labral tears: The labrum is a ring like cartilage located in the outer rim of the hip socket. It helps the stability and cushioning of the hip joint. This condition is common in athletes who participate in soccer, football, ballet , hockey and golf. Many labral tears are asymptomatic. Mechanism of injury is usually traumatic (car accidents or contact sports), Femoral-Acetabular impingement (structural hip abnormality), repetitive motion, OA and age related.

What are the symptoms?

Most patient experience groin or hip pain, stiffness, decreased range of motion, clicking or locking sensation and decrease athletic performance.
Pain is also associated with getting up from chairs, sitting, climbing stairs, putting on your shoes and driving.

How is it diagnosed?

A comprehensive history and physical is essential evaluation patient with hip problems. Frequently other test such as X rays, MRI, CT Scan are utilized to assess for multiple structural abnormalities. Frequently a hip arthrogram (injection x ray contrast in the hip joint) can assist in making the diagnosis of a labral tear. Injection of local anesthetics in the hip joint helps confirm the hip as the pain generator.

How is it treated?

At the RSJI we believe that conservative therapies should be utilized in every patient prior to more advanced regenerative interventions or surgical options. Most patients can be successfully treated with this approach.

  • Conservative Interventions
  • Rest in the acute stages
  • Activity modification with avoidance of triggering factors
  • Weight Loss
  • Physical Therapy, Bio-mechanical training
  • Nutritional supplements
  • Medications: NSAIDS (non-steroidal anti inflammatory drugs)
  • Correction of muscle imbalance, stretching, Laser therapy
  • Lifestyle changes
  • Surgical Interventions
  • Patients who do not respond to non-operative care or injection therapy, and have significant pain are considered surgical candidates.
  • Arthroscopic Labral Tear Repair

The Regenerative Spine and Joint Institute Approach

With the advent of new bio-cellular regenerative interventions (BRI), we are able to potentially treat patients with mild to advanced labral tears without the need for surgical interventions. Our interventions are designed to repair, regenerate, restore tissue to it’s normal health and function.

By repairing the cartilage and adjacent structures, further recurrent episodes of pain, osteoarthritis, disability and further surgical interventions may be avoided.

Indications for Bio-Cellular Regenerative Interventions (BRI)

  • Moderate to severe pain
  • Failed conservative therapy
  • Unable to undergo conservative therapy
  • Adjunct to conservative therapy

Why Bio-Cellular Regenerative Interventions (BRI)?

  • Our treatments are designed to repair tissue, not suppress symptoms like steroids
  • Not associated with significant side effects (unlike steroids)
  • Only natural substances and biologics are used
  • The interventions can be repeated with minimal risks
  • Can significantly speed up the recovery process from injury
  • We utilized your body’s own growth factors and cells (no risk to acquired communicable diseases)
  • The interventions are usually office based and cost effective
  • Can potentially avoid or significantly delay more invasive surgical options

What are the different types of Bio-Cellular Regenerative Interventions (BRI)?

After a comprehensive evaluation, your physician will discuss which intervention and treatment pathway is the most effective in treating your condition. The treatment plan is based on two major criteria’s: Bio Regenerative Index (which is a proprietary evaluation tool which can predict the body’s ability to heal) and the Degenerative Index (based on the severity of the damaged or degenerated tissue).

There are two main types of therapies utilized to enhance your body’s ability to heal: Natural ( which consists of injections glucose, hormones, oxygen in high concentration, lubricants, plant derived anti-inflammatories) and Bio-Cellular (which consists of using your body’s own growth factors and stem cells).

Natural Therapies (Usually indicated in early stages)

  • Prolotherapy (Creates tissue proliferation)
  • Ozone (Increases tissue oxygenation)
  • Traumeel (Homeopathic anti-inflammatory)
  • Viscous Supplementation (Increases joint lubrication)

Bio-Cellular Therapies (Usually indicated in moderate to advanced stages or patients in early stages who did not respond to natural therapies)

  • PRP (Growth Factors obtained from your own blood)
  • PRP stands for platelet rich plasma, which is obtained by processing your blood and concentrating the platelets, which are cells which contain numerous chemical that help your body heal. These chemicals are called growth factors). For more information see Biocellular Regenerative Interventions.
  • BMAC (Stem Cells concentrated from your own bone marrow)
  • BMAC stands for bone marrow concentrate aspirate, which is obtained from your bone marrow and contains not only platelets, but also infection and cancer fighting cells. More importantly, it contains a type of stem cell called mesenchymal stem cells. These cells are responsible for secreting growth factors that can significantly enhance the tissues ability to heal and regenerate. For more information see Biocellular Regenerative Interventions.
  • ADSVF (Stem Cells concentrated from your own adipose tissue)
  • ADSVF stands for adipose derived stromal vascular fraction, which is obtained from your own adipose tissues and contains different types of cells which helps your body heal. More importantly, it contains a type of stem cell called mesenchymal stem cells. These cells are responsible for secreting growth factors that can significantly enhance the tissues ability to heal and regenerate. The number of cells can be up to 500% more than in BMAC and they possess a greater anti-inflammatory capabilities. For more information see Biocellular Regenerative Interventions.
  • Amniotic Grafts(Growth Factors and Stem Cells from donor amniotic fluid)
  • Amniotic Grafts refers to tissues obtained from amniotic fluids obtained from donors (carefully screened with no communicable diseases). It contains collagen, growth factors and a small percentage of live amniotic stem cells. These cells are mesenchymal in origin and are more powerful than traditional adult mesenchymal cells. We utilized amniotic grafts in patients that cannot donate their own cells or are unwilling to undergo the graft extraction procedure. For more information see Biocellular Regenerative Interventions.
  • Scaffolds(fibrin from your own blood and adipose tissue)
  • Scaffold biologic tissues used to assist in the repair process when combined with growth factors and stem cells. It helps provide a 3D environment for the cells to be protected, proliferate and arranged themselves according to the tissue in which they are transplanted. More importantly, it acts as a slow release systems for growth factors. It is an essential component in tissue engineering techniques. Scaffolds come from fibrin (obtained from your own blood), lipoaspirte (from your own adipose tissues) and Hyaluronic Acid (naturally manufactured tissue filers).For more information see Biocellular Regenerative Interventions.

(These interventions are not designed as stand alone therapies and in order to achieve maximum tissue repair and regeneration may have to be repeated. It is important to continue to exercise proper ergonomics, bio-mechanics, avoidance of triggering factors, continue physical, chiropractic and massage therapy (as needed), and abide by a sound Regenerative Lifestyle. (

Hip Bursitis/Tendinosis

What is a bursa?

A bursa is a normally collapsed fluid sac located between a tendon its bony attachment, which sole function is to decrease friction between bone and tendons. There are around 150 bursas in the human body.

What is Hip Bursitis?

Bursitis is a term use to describe inflammation and swelling of the bursa(s) around the hip area. It can be inflamed on it’s own, or more frequently associated with tendinitis or tendon tears. On rare occasions, the hip bursa can become infected with bacteria. This condition is called septic bursitis. Although uncommon, the hip bursa can become inflamed by crystals that deposit as seen in gout or pseudo gout.

What is a tendon?

A tendon is the fibrous structure which connects muscles to the bony attachments. It provides support and flexibility for proper muscle and joint function. It has poor blood supply and is susceptible to the normal wear and tear.

Hip Tendonitis – is a condition where you experience pain, swelling and inflammation from damage or micro-tearing of one or more of the tendons in your hip. The tendons in your hip connect muscle to bone and when these tendons are injured they usually cause pain and tenderness at the front, side and back of your hip, and even into your buttocks as well. If you have hip tendonitis, you could be suffering from different kinds of tendonitis including iliotibial band (IT band) tendonitis, gluteus medius tendonitis, or hip flexor tendonitis (iliacus tendonitis or iliopsoas tendonitis).

Risks factors associated with bursitis are: diabetes, rheumatoid Arthritis, obesity, sedentary lifestyle, thyroid disorders, female, over 40 years old, osteoarthritis, leg inequality, degenerative joint disease, repetitive trauma, sports related.

What is Trochanteric Bursitis and Tendinosis?

Bursitis is frequently associated with repetitive motions (sports), trauma, tendon injury, infectious processes, degenerative joint disease, obesity, sedentary lifestyle and poor bio-mechanics. The trochanteric bursa is located under the surface of the gluteus medius and minimus, where they insert in the greater trochanter (lateral aspect of the hip).

What are the Symptoms?

The pain and tenderness is usually located in the lateral aspect of the outer hip. Aggravated by excessive walking, exercise, stair climbing. Inability of sleep on the painful side.

Patients frequently notice pain in the outer hip with stair climbing or descending and tenderness of the hip when lying on the affected side at night. The doctor can localize the tender areas to the location of the bursa of the hip. Occasionally, X-ray of the hips are used to rule out other conditions of the bone and joints, such as arthritis. Sometimes X-ray testing can highlight areas of calcium deposits in an inflamed bursa. These areas of calcification indicate a past history of inflammation of the bursa.

What is Ischio-Gluteal Bursitis/Hamstring Tendinosis?

The hamstring tendon attaches to lower part of the pelvic bone called the ischial tuberosity. The symptoms of ischio-gluteal bursitis are identical to hamstring tendon inflammation (tears) and include pain and tenderness at the ischial tuberosity, pain when stretching the hamstring muscles. The pain is mainly felt in the buttock area and can radiate behind the thigh. Prolonged sitting can also aggravate the pain, as well as sprinting training sessions.

What is Iliopsoas Bursitis/Tendonitis?

The iliopsoas bursa is located between the bony rim of the hip and the iliopsoas tendon. Bursitis is usually associated with the usual risk factors, as well as repetitive motions in sports.

Tendinosis involves inflammation and irritation of your iliopsoas tendon and the area surrounding your tendon. Overuse and repetitive activities cause small micro-tears to the iliopsoas tendon tissue.

How is is Bursitis/Tendinosis diagnosed?

The diagnosis of bursitis/tendinosis of the hip is usually based on clinical evaluation. Hip bursitis is diagnosed upon reviewing the history of the location of the hip pain and specific areas of tenderness of the outside of the hip. This can be further confirmed when a local injection of anesthetic relieves the pain. Diagnostic Ultrasonography has become the gold standard in diagnosing and treating patients with bursitis and tendinosis. On rare occasions, the hip bursa can become infected with bacteria. This condition is called septic bursitis. Although uncommon, the hip bursa can become inflamed by crystals that deposit there from gout or pseudogout.

Diagnostic tests such as X rays, CT Scan and Hip MRI are usually performed in order to fully evaluate other causes of hip pathology which may be associated with bursitis and tendinosis.

  • Local anesthetic/steroid injection (bursitis only).
  • Injection of steroids in tendon not indicated

How is it treated?

At the RSJI we believe that conservative therapies should be utilized in every patient prior to more advanced regenerative interventions or surgical options. Most patients can be successfully treated with this approach.

  • Conservative Interventions
  • Rest in the acute stages
  • Activity modification with avoidance of triggering factors
  • Weight Loss (if needed)
  • Physical Therapy, Bio-mechanical training
  • Nutritional supplements
  • Medications: NSAIDS (non-steroidal anti inflammatory drugs)
  • Correction of muscle imbalance, stretching, Laser therapy
  • Proper footwear and orthotics (if indicated)
  • Lifestyle changes
  • Local anesthetic/steroid injection (bursitis only). injection of steroids in tendons is not indicated.

Surgical Interventions

Patients who do not respond to non-operative care or injection therapy, and have significant pain are considered surgical candidates.

  • Bursectomy/Debridment
  • Tenotomy

The Regenerative Spine and Joint Institute Approach

With the advent of new bio-cellular regenerative interventions (BRI), we are able to successfully treat patients with mild to advanced hip bursitis and tendinosis without the need for surgical interventions. Our interventions are designed to repair, regenerate, restore tissue to it’s normal health and function.

By repairing the cartilage and adjacent structures, further recurrent episodes of pain, osteoarthritis, disability and further surgical interventions may be avoided.

Indications for Bio-Cellular Regenerative Interventions (BRI)

  • Moderate to severe pain
  • Failed conservative therapy
  • Unable to undergo conservative therapy
  • Adjunct to conservative therapy

Why Bio-Cellular Regenerative Interventions (BRI)?

  • Our treatments are designed to repair tissue, not suppress symptoms like steroids
  • Not associated with significant side effects (unlike steroids)
  • Only natural substances and biologics are used
  • The interventions can be repeated with minimal risks
  • Can significantly speed up the recovery process from injury
  • We utilized your body’s own growth factors and cells (no risk to acquired communicable diseases)
  • The interventions are usually office based and cost effective
  • Can potentially avoid or significantly delay more invasive surgical options

What are the different types of Bio-Cellular Regenerative Interventions (BRI)?

After a comprehensive evaluation, your physician will discuss which intervention and treatment pathway is the most effective in treating your condition. The treatment plan is based on two major criteria’s: Bio Regenerative Index (which is a proprietary evaluation tool which can predict the body’s ability to heal) and the Degenerative Index (based on the severity of the damaged or degenerated tissue).

There are two main types of therapies utilized to enhance your body’s ability to heal: Natural ( which consists of injections glucose, hormones, oxygen in high concentration, lubricants, plant derived anti-inflammatories) and Bio-Cellular (which consists of using your body’s own growth factors and stem cells).

Bursa and Tendon Injections

Natural Therapies (Usually indicated in early stages)

  • Prolotherapy (Creates tissue proliferation)
  • Ozone (Increases tissue oxygenation)
  • Traumeel (Homeopathic anti-inflammatory)
  • Viscous Supplementation (Increases joint lubrication)

Bio-Cellular Therapies (Usually indicated in moderate to advanced stages or patients in early stages who did not respond to natural therapies)

  • PRP (Growth Factors obtained from your own blood)
  • PRP stands for platelet rich plasma, which is obtained by processing your blood and concentrating the platelets, which are cells which contain numerous chemical that help your body heal. These chemicals are called growth factors). For more information see Biocellular Regenerative Interventions.
  • BMAC (Stem Cells concentrated from your own bone marrow)
  • BMAC stands for bone marrow concentrate aspirate, which is obtained from your bone marrow and contains not only platelets, but also infection and cancer fighting cells. More importantly, it contains a type of stem cell called mesenchymal stem cells. These cells are responsible for secreting growth factors that can significantly enhance the tissues ability to heal and regenerate. For more information see Biocellular Regenerative Interventions.
  • ADSVF (Stem Cells concentrated from your own adipose tissue)
  • ADSVF stands for adipose derived stromal vascular fraction, which is obtained from your own adipose tissues and contains different types of cells which helps your body heal. More importantly, it contains a type of stem cell called mesenchymal stem cells. These cells are responsible for secreting growth factors that can significantly enhance the tissues ability to heal and regenerate. The number of cells can be up to 500% more than in BMAC and they possess a greater anti-inflammatory capabilities. For more information see Biocellular Regenerative Interventions.
  • Amniotic Grafts(Growth Factors and Stem Cells from donor amniotic fluid)
  • Amniotic Grafts refers to tissues obtained from amniotic fluids obtained from donors (carefully screened with no communicable diseases). It contains collagen, growth factors and a small percentage of live amniotic stem cells. These cells are mesenchymal in origin and are more powerful than traditional adult mesenchymal cells. We utilized amniotic grafts in patients that cannot donate their own cells or are unwilling to undergo the graft extraction procedure. For more information see Biocellular Regenerative Interventions.
  • Scaffolds(fibrin from your own blood and adipose tissue)
  • Scaffold Scaffold biologic tissues used to assist in the repair process when combined with growth factors and stem cells. It helps provide a 3D environment for the cells to be protected, proliferate and arranged themselves according to the tissue in which they are transplanted. More importantly, it acts as a slow release systems for growth factors. It is an essential component in tissue engineering techniques. Scaffolds come from fibrin (obtained from your own blood), lipoaspirte (from your own adipose tissues) and Hyaluronic Acid (naturally manufactured tissue filers).For more information see Biocellular Regenerative Interventions.

(These interventions are not designed as stand alone therapies and in order to achieve maximum tissue repair and regeneration may have to be repeated. It is important to continue to exercise proper ergonomics, bio-mechanics, avoidance of triggering factors, continue physical, chiropractic and massage therapy (as needed), and abide by a sound Regenerative Lifestyle. (

Hip Osteonecrosis or Avascular Bone Necrosis (ABN)

What is Osteonecrosis?

Osteonecrosis of the hip, also called avascular necrosis, is a condition that is present when the blood supply to the femoral head is disrupted. Your femoral head is located at the top of your thigh bone (femur) and forms part of your hip joint. Due to the poor blood supply, the bone starts to die, becomes weakened, predisposing to collapse and arthritis. The condition occurs in stages, with unpredictable duration.

Conditions associated with osteonecrosis includes: alcohol abuse, gout, Caisson disease (decompression sickness), renal osteodystrophy (kidney disease), sickle cell anemia, steroid use (corticosteriods), and trauma.

What are the Symptoms of AVN?

Patients with hip arthritis usually complain of groin pain and buttocks pain, aggravated by weight bearing and activity. As the condition worsens, limitation of range of motion ensues and the patients developed a limp or gait abnormalities. The pain at rest ensues.

How is Osteonecrosis diagnosed?

A complete history and physical examination is essential along with clinical suspicion. Initially X Rays may be normal and ultimately will show partial collapse and arthritic changes. MRI allows for more accurate diagnosis and evaluate the stage of degeneration. The contralateral hip should also be evaluated by MRI.

What is the treatment for Osteonecrosis?

At the RSJI we believe that conservative therapies should be utilized in every patient prior to more advanced regenerative interventions or surgical options. Most patients can be successfully treated with this approach.

  • Conservative
  • Rest in the acute stages
  • Activity modification with avoidance of triggering factors
  • Weight Loss
  • Physical Therapy, Bio-mechanical training
  • Nutritional supplements
  • Medications: NSAIDS (non-steroidal anti inflammatory drugs)
  • Correction of muscle imbalance, stretching, Laser therapy
  • Lifestyle changes
  • Ambulation Assistive Devices (if necessary)

Surgical

 

  • Early Stages (femoral head is well preserve and there are minor degenerative joint changes).
  •  

     

  • Core DecompressionConsist of removing some of the dead bone in the femoral head and injecting the area with a bone graft.
  •  

     

  • Advanced stages (partial or completed collapse of the femoral head).
  •  

     

  • Total Hip Arthroplasty (Replacement).
  •  

    The Regenerative Spine and Joint Institute Approach

    With the advent of new bio-cellular regenerative interventions (BRI), we are able to successfully treat some patients with early stages of hip ostenonecrosis (AVN).

    Indications for Bio-Cellular Regenerative Interventions (BRI)

        • Early stage AVN (no femoral head collapse)
        • Moderate to severe pain
        • Failed conservative therapy
        • Unable to undergo conservative therapy

    Why Bio-Cellular Regenerative Interventions (BRI)?

    Because the traditional non-surgical treatments are designed to suppress symptoms, can be associated with significant medications side effects and do not have to capability to repair the underlying damaged tissue.

    Why Bio-Cellular Regenerative Interventions (BRI)?

        • Our treatments are designed to repair tissue (not suppress symptoms like steroids or other pain medications)
        • Not associated with significant side effects (unlike steroids)
        • Only natural substances and biologics are used
        • The interventions can be repeated with minimal risks
        • Can significantly speed up the recovery process from injury
        • We utilized your body’s own growth factors and cells (no risk to acquired communicable diseases)
        • The interventions are usually office based and cost effective
        • Can potentially avoid or significantly delay more invasive surgical options

    Minimally Invasive Core Decompression (MICD) and injection of BMAC (Bone Marrow Concentrate Aspirate) and Scaffolds. For more information see Bio-cellular Regenerative Interventions.

    Minimally Invasive Core Decompression (MICD) and injection of ADSVF (Adipose Derived Stromal Vascular Fraction) and Scaffolds. For more information see Bio-cellular Regenerative Interventions.

    Intra-articular Injection of BMAC, ADSVF and Scaffolds. For more information see Bio-cellular Regenerative Interventions.


    These interventions are not designed as stand alone therapies and in order to achieve maximum tissue repair and regeneration, they may have to be repeated.
    It is important to continue to exercise proper ergonomics, bio-mechanics, avoidance of triggering factors, continued physical, occupational, chiropractic and massage therapy as needed, and abide by a sound Regenerative Lifestyle.

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  • What is a Strain?

    A muscle strain or a (pulled muscle) is a stretching injury resulting in muscle fiber tears. Symptoms varies according to the severity of the strain. A grading system describe the strain by the degree of tissue damage and symptoms.

    Grade 1 strains involve minor tearing of muscle fibers with only minimal or no loss in strength. Pain is usually mild to moderate with no defect noted in the muscle.
    Grade 2 strains involve more severe disruption to the muscle fibers with significant pain and loss of strength. A tissue defect may be present.
    Grade 3 strains are a result of complete tearing of the muscle with associated severe pain and complete loss of strength. A significant tissue defect is present during physical examination.

    A muscle strain occurs most commonly when a muscle is stretched whilst it is contracting. This type of contraction is termed ‘eccentric contraction’. It is usually present in running(sprinters, long distance), jumping (basketball), contact (football, soccer, rugby)and kicking sports. Improper warm up is frequently associated with muscle strains.

    What are the Symptoms of a Hip Strain?

    Symptoms varie according to the location of the specific muscle(s) group involved. Pain is usually located in the inner groin area for adductor strains, anterior hip area for the hip flexors group (psoas), lateral hip area for the gluteus and the posterior hip/thigh area for the hamstrings. Weakness is frequently present along with swelling and ultimately a gait dysfunction can result.

    How is Hip Strain Diagnosed?

    The majority of the muscle strains can be diagnosed with a comprehensive history and physical examination. Localized pain, tissue swelling along with reproduction of pain with provocative maneuvers is usually successful in arriving a proper diagnosis. Diagnostic ultrasonograpy has improved the diagnostic capabilities to a higher level. In cases where other pathology is suspected, X rays and MRI are sometimes indicated.

    How is Hip Strain Treated?

    At the RSJI we believe that conservative therapies should be utilized in every patient prior to more advanced regenerative interventions or surgical options. Most patients can be successfully treated with this approach.

    • Conservative
    • Activity modification and rest as needed
    • Rest in the acute stages (short duration)
    • Activity modification with avoidance of triggering factors
    • Weight Loss
    • Physical Therapy, Bio-mechanical training
    • Nutritional supplements
    • Medications: NSAIDS (non-steroidal anti inflammatory drugs)
    • Correction of muscle imbalance, stretching, laser therapy
    • Lifestyle changes
    • Ambulation Assistive Devices (if necessary)

    The Regenerative Spine and Joint Institute Approach

    With the advent of new bio-cellular regenerative interventions (BRI), we are able to successfully treat patients with mild to advanced hip strain without the need for surgical interventions. Our interventions are designed to repair, regenerate, restore tissue to it’s normal health and function.

    By repairing the muscle and adjacent structures, further recurrent episodes of pain, disability and further surgical interventions may be avoided. Early return to athletic activities can be achieved in the majority of patients.

    Indications for Bio-Cellular Regenerative Interventions (BRI)

    • Moderate to severe pain
    • Failed conservative therapy
    • Unable to undergo conservative therapy
    • Adjunct to conservative therapy

    Why Bio-Cellular Regenerative Interventions (BRI)?

    • Our treatments are designed to repair tissue, not suppress symptoms like steroids
    • Not associated with significant side effects (unlike steroids)
    • Only natural substances and biologics are used
    • The interventions can be repeated with minimal risks
    • Can significantly speed up the recovery process from injury
    • We utilized your body’s own growth factors and cells (no risk to acquired communicable diseases)
    • The interventions are usually office based and cost effective
    • Can potentially avoid or significantly delay more invasive surgical options

    What are the different types of Bio-Cellular Regenerative Interventions (BRI)?

    After a comprehensive evaluation, your physician will discuss which intervention and treatment pathway is the most effective in treating your condition. The treatment plan is based on two major criteria’s: Bio Regenerative Index (which is a proprietary evaluation tool which can predict the body’s ability to heal) and the Degenerative Index (based on the severity of the damaged or degenerated tissue).

    There are two main types of therapies utilized to enhance your body’s ability to heal:
    Natural ( which consists of injections glucose, hormones, oxygen in high concentration, lubricants, plant derived anti-inflammatories) and Bio-Cellular (which consists of using your body’s own growth factors and stem cells).

    For more information see: Bio-Cellular Regenerative Therapies.

Femoroacetabular Impingement (FAI)

What is FAI?

It is a condition that occurs when the bones of the ball and the socket of the hip joint, rub abnormally creating injury of the smooth cartilage the lines the joint. It can also affect the ligaments, which gives the hip ball stability. Eventually these structures will be damaged, osteoarthritis and cartilage defects will occur.

There are 2 types of FAI.

CAM: The bone abnormality is in the femoral head (ball)

PINCER: The bone abnormality is located in the acetabulum (socket)

What are the symptoms of FAI?

The symptoms from FAI usually develop slowly and can be present during the teenage years. Early on, the symptoms are intermittent and the in later stages seem to be present al the time  and similar in nature to Hip OA. The pain is aggravated by sport activities, exercise, driving, climbing stairs, tying your shoes, getting up from chairs and bending your knees.

How is FAI diagnosed?

After a comprehensive history and physical examination in patient with hip pain, different conditions that can cause or are associated with FAI must be evaluated. X rays are utilized to evaluate the shape of the hip bones and presence of osteoarthritis or other lesions (AVN). MRI and CT Scans are helpful in evaluating for cartilage defects and damage, labral tears and ligament tears. Diagnostic hip injections with local anesthetic identifies the hip as a pain generator in cases with unusual presentations.

How is FAI treated?

At the RSJI we believe that conservative therapies should be utilized in every patient prior to more advanced regenerative interventions or surgical options. Most patients can be successfully treated with this approach.

Consevative

  • Rest in the acute stages (short term)
  • Activity modification
  • Weight Loss (if necessary)
  • Physical Therapy, Bio-mechanical training
  • Nutritional supplements
  • Medications: NSAIDS (non-steroidal anti inflammatory drugs)
  • Correction of muscle imbalance, stretching, Laser therapy
  • Lifestyle changes
  • Ambulation Assistive Devices (if necessary)

Surgical

Depending on the causes, structures injured or stage of degeneration, arthroscopic interventions can be performed for the following conditions:

Ligamentum Teres tears (connects the socket to the ball of the hip), Labral Tears (shock absorbing cartilage in the socket), Pincer (shaving of bone spurs from the socket) and CAM (removing bone bumps from the ball).

The Regenerative Spine and Joint Institute (SJRI) Approach

With the advent of new bio-cellular regenerative interventions (BRI), we are able to successfully treat patients with mild to advance degenerative diseases without the need for surgical interventions. Our interventions are designed to repair, regenerate and restore tissue to its normal health and function.

By repairing the cartilage, ligaments and decreasing inflammation we can prevent further recurrent episodes of pain, osteoarthritis, disability and further surgical interventions.

(At the SJRI, we believe that Bio-cellular Regenerative Interventions (BRI) whenever possible,  should be utilized prior to undergoing any advanced surgical interventions.)

Indications for Bio-Cellular Regenerative Interventions (BRI)

  • Moderate to severe pain
  • Failed conservative therapy
  • Unable to undergo conservative therapy
  • Adjunct to conservative therapy

Why Bio-Cellular Regenerative Interventions (BRI)?

  • Our treatments are designed to repair tissue, not suppress symptoms like steroids
  • Not associated with significant side effects (unlike steroids)
  • Only natural substances and biologics are used
  • The interventions can be repeated with minimal risks
  • Can significantly speed up the recovery process from injury
  • We utilized your body’s own growth factors and cells (no risk to acquired communicable diseases)
  • The interventions are usually office based and cost effective
  • Can potentially avoid or significantly delay more invasive surgical options

What are the different types of Bio-Cellular Regenerative Interventions (BRI)?

After a comprehensive evaluation, your physician will discuss which intervention and treatment pathway is the most effective in treating your condition.  The treatment plan is based on two major criteria’s: Bio Regenerative Index  (which is a proprietary evaluation tool which can predict the body’s ability to heal) and the Degenerative Index (based on the severity of the damaged or degenerated tissue).

There are two main types of therapies utilized to enhance your body’s ability to heal: Natural ( which consists of injections glucose, hormones, oxygen in high concentration, lubricants, plant derived anti-inflammatories) and Bio-Cellular (which consists of using your body’s own growth factors and  stem cells).

For more information see: Bio-Cellular Regenerative Therapies.