FREQUENTLY ASKED QUESTIONS
What is a Sports Medicine Physician?
A sports medicine physician has received special training in the care of orthopedic and medical problems of athletes. Patients need not be gifted or competitive athletes to qualify to see a sports medicine physician. The 35 year-old tennis Mom, 50 year-old trying to do his first 5K and the 70 year-old golfer are all athletes than can benefit from a sports medicine doc.
What are platelet-rich plasma (PRP) injections?
These are regenerative injections utilizing a patient’s own blood. Our platelets are very rich in our own natural growth factors. We draw blood from your arm and then place the syringe in a computerized centrifuge. This spins for 15-20 minutes and separates the red blood cells from the plasma which contains the platelets. Then, under ultrasound guidance, the PRP is injected back into your damaged tissue in order to promote healing. We continue to see promising results when using these for tennis & golfers' elbow, hip, shoulder and knee arthritis, meniscal tears, plantar fasciitis and hamstring, Achilles, rotator cuff & patellar tendonitis, just to name a few.
What is the Tenex Health TX procedure?
This is a minimally-invasive ultrasound-guided procedure performed to treat chronic tendon problems. A small handpiece is inserted under the skin after a tiny incision is made. That handpiece is then delivered to the area of soft tissue damage, and ultrasonic energy is used to aspirate (remove) the damaged portion. The actual procedure typically takes less than 5 minutes and only local anesthesia (lidocaine) is required. No stitches are required, only a steri-strip. Recovery is much more rapid than a typical open (long incision) procedure for these types of problems. At this time, the Tenex procedure is being used primarily for tennis & golfer's elbow, plantar fasciitis and chronic Achilles and patellar tendon problems. Success rates exceed 90%.
What is musculoskeletal (MSK) ultrasound?
MSK ultrasound uses the same technology used for years to look at the fetus of a pregnant women or a gallbladder to now look at tendons, ligaments, cysts and fluid collections in patients with orthopedic problems. It is painless, much less expensive than an MRI, does not expose the patient to any radiation and allows for immediate comparisons to the unaffected side. It has become a tremendously successful tool in injection guidance. Injections are performed in a much more accurate fashion, allowing for a greater benefit combined with a decreased risk.
What are amniotic membrane injections?
Amniotic membrane allograft injections, like PRP, are "regenerative" injections. This membrane comprises the innermost layer of the placenta, which covers the fetus when a woman is pregnant. The donated membrane has been isolated, purified and processed into a sterile powder or a frozen liquid form. This substance is very nutrient and growth factor rich, much like PRP. Under ultrasound-guidance, it is injected into an area of damage such as a tendon, fascia or joint. The goal of these injections is to reduce unhealthy inflammation, reduce scar tissue formation and promote the healing of microtears in soft tissue. They also may slow or halt the progression of joint degeneration. We have used amniotic membrane injections for over 7 years to successfully treat plantar fasciitis, tennis and golfer's elbow, Achilles, rotator cuff, high hamstring and patellar tendonitis as well as hand, knee and hip osteoarthritis.
What about stem cell treatments?
In the orthopedic world, stem cell treatments carry great promise for the treatment of arthritis and various chronic tendon problems. Stem cells are commonly derived from three sources: a patient’s own bone marrow, a patient’s own adipose/fat or from the umbilical cord of another individual. We are diligently studying and training on their use. However, at this point, there are not many high-quality studies that demonstrate a benefit, and we carefully discuss the cost-benefit and risk-benefit ratio of stem cell use with our patients. These are currently the most expensive type of regenerative/orthobiologic injection. Unfortunately, many medical providers with limited experience are injecting low-quality and very costly solutions into patients that are misrepresented as legitimate stem cell injections. Obtain your information from experienced medical doctors that have your best interest at heart.
I’m worried that if I come to an orthopedic doctor, then I will have to undergo surgery.
90% of problems seen in an orthopedic office do not require surgery. Dr. Holmes’ primary focus is on treating your problem in a non-surgical and minimally-invasive manner. He has no vested interest in performing unnecessary surgery on any patient. That being said, if he truly recommends surgery for your condition, then he can put you in the hands of a surgical colleague best equipped from a technical and bedside manner standpoint to treat you.