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Old 05-30-2019, 04:01 PM
 
10,322 posts, read 6,797,252 times
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https://www.ortho.wustl.edu/content/...njections.aspx


Quote:
At this point, most insurance companies consider PRP injections experimental, as large research trials demonstrating the benefit, or lack thereof, have not been published.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2609914/


Quote:
Currently there is a paucity of critical scientific data regarding the beneficial effects of platelet rich plasma in clinical procedures. There have been animal and human studies both purporting and refuting its adjunctive positive effect. In theory, PRP has many beneficial effects such as autologous supply of growth factors and improved wound healing. In addition it is relatively inexpensive and readily available. However, from the current available literature it is clear that there is great variability in study design, clinical and radiographic parameters that were measured, and clinical outcome. Many studies claiming a positive beneficial effect suffer from a poor study design. Many have no controls or a limited sample size. In general, conclusions advocating for an adjunctive effect are not supported by the study design. Therefore, the use of this material cannot be supported at present, and further controlled, prospective clinical trials are urgently needed.



OP, please rely on your surgeon
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Old 05-30-2019, 04:27 PM
 
Location: Southern California
26,130 posts, read 9,504,307 times
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Quote:
Originally Posted by mike1003 View Post
Wonder why so many ortho surgeons have now gone to these Regenerative therapies? It's true, look it up.
Many are now offering this option.
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Old 05-30-2019, 10:16 PM
 
348 posts, read 177,025 times
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Definitely get a second opinion. A sports medicine doctor is usually just an orthopedist who does shoulders and knees. There really is nothing special about the title per se.

If the MRI is negative, then what would one fix by surgery? I have never heard of an "exploratory" knee surgery (and I worked as a physician assistant in orthopedics for 2.5 years in the past.)
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Old 05-30-2019, 11:01 PM
 
Location: Texas
4,176 posts, read 3,548,740 times
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Originally Posted by townshend View Post
Definitely get a second opinion. A sports medicine doctor is usually just an orthopedist who does shoulders and knees. There really is nothing special about the title per se.
Most of the time now when I hear someone say Sports Medicine doctor, they are referring to family practice/general practitioner who has done a fellowship in Sports Medicine. I know a lot of Ortho practices will have some in the group to handle nonoperative issues and refer to surgeons when necessary. My head usually goes to what you describe above, an Orthopedic surgeon who is fellowship trained in Sports and does lots of knees and shoulders.
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Old 05-30-2019, 11:09 PM
 
Location: Southern California
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I've seen two sports med MD's for my knee issue..one teaches at UCLA and is not a surgeon and not a family practice MD, but he was into some holistic remedies when I saw him about 20 yrs ago and the other one also not family med or surgery but did the Prolo work and other work like draining the knee and maybe cortisone but not sure thinking back to that one.
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Old 05-31-2019, 11:04 AM
 
348 posts, read 177,025 times
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Originally Posted by Texas Ag 93 View Post
Most of the time now when I hear someone say Sports Medicine doctor, they are referring to family practice/general practitioner who has done a fellowship in Sports Medicine. I know a lot of Ortho practices will have some in the group to handle nonoperative issues and refer to surgeons when necessary. My head usually goes to what you describe above, an Orthopedic surgeon who is fellowship trained in Sports and does lots of knees and shoulders.
I'm not sure how others use the term Sports Medicine, but I have never heard it used of a family practitioner/general practitioner. Family practice/general practitioners, as far as I know, do not train in surgery during their residencies. They are trained to do office procedures, but training for the OR is completely different.

A fellowship in sports medicine would include all types of surgeries; I don't see how a family practitioner could do that unless, of course, he was double board certified in family practice and orthopedics.

Here is the clinic I once worked at, back in the 2000s: https://www.posmc.com/physicians/

POSMC - Plano Orthopedic and Sports Medicine Center.

Notice that not a single physician mention is a family practice or general practitioner. Also notice the use of the term sports medicine to describe the orthopedists' specialties.

Three doctors (Sutker, Troop, and Barber) are specifically described by the phrase "Shoulder, Knee and Sports Medicine" and a newer doctor (McGarry) also covers sports medicine but also has the phrase "general orthopedics" added to his bio.

The non-surgeons in orthopedist practices are usually physical medicine and rehabilitative types, or perhaps an anesthesiologist who specializes in pain management injections. In the group I mentioned, Dr. Dauber is a cool dude, doing physical medicine. He did both an EMG and NCV on me as part of a work up before the "hand surgeon" performed a left ulnar nerve transposition.

Of course, other non-surgery individuals can be associated with an orthopedic practice: particularly physical therapists.

In short, sports medicine is generally used in an orthopedic context, and its practitioners focus mainly on knee and shoulder care.

Sorry for the long post -- just trying to clarify how I see it.
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Old 05-31-2019, 11:47 AM
 
4,866 posts, read 2,097,360 times
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Quote:
Originally Posted by townshend View Post
I'm not sure how others use the term Sports Medicine, but I have never heard it used of a family practitioner/general practitioner. Family practice/general practitioners, as far as I know, do not train in surgery during their residencies. They are trained to do office procedures, but training for the OR is completely different.

A fellowship in sports medicine would include all types of surgeries; I don't see how a family practitioner could do that unless, of course, he was double board certified in family practice and orthopedics.

Here is the clinic I once worked at, back in the 2000s: https://www.posmc.com/physicians/

POSMC - Plano Orthopedic and Sports Medicine Center.

Notice that not a single physician mention is a family practice or general practitioner. Also notice the use of the term sports medicine to describe the orthopedists' specialties.

Three doctors (Sutker, Troop, and Barber) are specifically described by the phrase "Shoulder, Knee and Sports Medicine" and a newer doctor (McGarry) also covers sports medicine but also has the phrase "general orthopedics" added to his bio.

The non-surgeons in orthopedist practices are usually physical medicine and rehabilitative types, or perhaps an anesthesiologist who specializes in pain management injections. In the group I mentioned, Dr. Dauber is a cool dude, doing physical medicine. He did both an EMG and NCV on me as part of a work up before the "hand surgeon" performed a left ulnar nerve transposition.

Of course, other non-surgery individuals can be associated with an orthopedic practice: particularly physical therapists.

In short, sports medicine is generally used in an orthopedic context, and its practitioners focus mainly on knee and shoulder care.

Sorry for the long post -- just trying to clarify how I see it.
Internists/family practitioners can do a fellowship for sports medicine and get certified on the non-surgical aspects of sports medicine. Not everyone is looking to have surgery.

https://www.amssm.org/Fellowships.html - here is information on training for sports medicine.
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Old 05-31-2019, 12:13 PM
 
Location: Texas
4,176 posts, read 3,548,740 times
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Quote:
Originally Posted by townshend View Post
I'm not sure how others use the term Sports Medicine, but I have never heard it used of a family practitioner/general practitioner. Family practice/general practitioners, as far as I know, do not train in surgery during their residencies. They are trained to do office procedures, but training for the OR is completely different.

The non-surgeons in orthopedist practices are usually physical medicine and rehabilitative types, or perhaps an anesthesiologist who specializes in pain management injections. In the group I mentioned, Dr. Dauber is a cool dude, doing physical medicine. He did both an EMG and NCV on me as part of a work up before the "hand surgeon" performed a left ulnar nerve transposition.
Correct, the Sports Medicine Doctors I mentioned are not surgeons, they are strictly nonoperative. They do some injections. They are Board Certified in Family Practice or some other primary care specialty. Incidentally, I think there are still a fair number of patients who incorrectly believe they are Orthopedic Surgeons, but they are not. They are more like those described in RamenAddict's post below. They are beneficial to have in a multi specialty Ortho practice from a patient's point of view because they are usually more accessible than a surgeon, and can handle most nonoperative issues. They are beneficial from the surgeon's point of view as partners because they can function as gatekeepers.

I always thought of PM&R (a term which seems to be interchangeable with physiatrist) as its own specialty with specific residency training and its own Board certification etc. The ones I interacted with worked in Rehab Hospitals with patients across the spectrum of not just Ortho rehab, but stroke, TBI etc. I can see, however, where they might fall under the umbrella of Sports Medicine if they work within an Ortho practice as you describe above.

Quote:
Originally Posted by RamenAddict View Post
Internists/family practitioners can do a fellowship for sports medicine and get certified on the non-surgical aspects of sports medicine. Not everyone is looking to have surgery.

https://www.amssm.org/Fellowships.html - here is information on training for sports medicine.
Maybe bluedevilz can chime in on how he sees these specialty terms used most often. He's the one who would know best.

Last edited by Texas Ag 93; 05-31-2019 at 12:48 PM..
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Old 05-31-2019, 01:44 PM
 
Location: Bella Vista, Ark
73,684 posts, read 86,117,409 times
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Originally Posted by Surfertx View Post
I already went to my PCP and saw a orthopedic specialist. Honestly I didn't have much confidence with the ortho doctor I picked. He didn't seem to fully understand the pain I'm experiencing (sport injury) and prescribed a knee brace then micro surgery. So I'm not sure what should be my next step. Should I visit a sport medicine doctor and get a second opinion? I rather not get surgery as the MRI on the knee doesn't show any tears.

when in doubt get a second opinion. I am certainly not in favor of always getting second opinions but you seem so uncertain.
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Old 05-31-2019, 01:47 PM
 
Location: Bella Vista, Ark
73,684 posts, read 86,117,409 times
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Quote:
Originally Posted by mike1003 View Post
As stated above, 2nd opinion with Sports Ortho specializing in knees is your best bet. You are lucky to be in Houston (ask around to find best knee specialist)


Don't go the experimental route with fads like PRP, stem cell or prolo (sugar water) unless your Ortho has a long and successful record with experimental cures that are not covered by insurance
totally agree. At least see what the second doctor has to say.
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