I don’t play tennis, how do I have “tennis elbow”?

Written by admin on January 7, 2013 – 8:52 am -

You don’t have to be Serena Williams or Roger Federer to be diagnosed with “tennis elbow”. You may be surprised to learn that most of my patients with this condition have never played tennis, even once! Tennis elbow, or lateral epicondylitis, is the progressive degeneration of the tendons that attach the forearm muscles to the outside of the elbow.

Originally presumed to be an inflammatory condition, “tendonitis,” it is now well accepted that true tendonitis is only rarely present. The term “tennis elbow” originates in the high prevalence of the malady in tennis players. Players experience pain when grasping the racquet with backhand strokes being most problematic, but any grasping activity, even non-athletic, may be associated with pain. Primarily an overuse injury, racquet sports athletes, as well as painters, carpenters, and mechanics, are prone to developing tennis elbow.

Symptoms of tennis elbow include pain localized on the outside of the elbow, weak grip strength, and pain with specific motions (picking up a gallon of milk, turning a door knob, or holding a cup of coffee).

There are surgical and non surgical treatment options for tennis elbow. Non surgical options include: oral or topical anti-inflammatory medication, braces designed to change the angle of action of the tendon, lessen pressure at its boney insertion and decrease pain, exercises to stretch and strengthen the muscles and steroid injections directly into the tendon. Initially, rest, particularly avoiding those motions that cause the most pain are ideal. Once symptoms subside, stretching and strengthening the elbow will help prevent further damage to the tendon. We have recently enjoyed success with a promising emerging technique, Platelet Rich Plasma (PRP), injections directly into the failing tendon. Surgical treatment is an outpatient procedure in which the surgeon removes the defective tendon. The recovery time from surgery is a few weeks before normal subsistence level activities can be performed painlessly and 10-12 weeks before sport and weight activities can be resumed.

Dr. Mark Galland is a Board Certified Orthopaedic Surgeon specializing in sports medicine, practicing in Wake Forest and North Raleigh. He serves as team physician and Orthopaedic consultant to the Carolina Mudcats, High-A Affiliate of the Cleveland Indians of Major League Baseball, as well as several area high schools and colleges. Dr. Galland can be reached at (919) 562-9410 or by visiting www.orthonc.com or www.drmarkgalland.com or you can follow him on twitter: @drmarkgalland.

Kate Anderson, ATC/LAT is a post-graduate fellow at GOSM, Galland Orthopaedic and Sports Medicine. Follow her on twitter @kattethegreatt.


Tags: , , , , ,
Posted in Elbow, Hand & Wrist, Platelet-Rich Plasma Therapy (PRP) | 1 Comment »

PRP May Be Superior Knee OA Treatment When Compared With Visco Supplementation

Written by admin on December 6, 2012 – 8:18 pm -

Comparison Between Hyaluronic Acid and Platelet-Rich Plasma, Intra-articular Infiltration in the Treatment of Gonarthrosis.

Cerza F, Carnì S, Carcangiu A, Di Vavo I, Schiavilla V, Pecora A, De Biasi G, Ciuffreda M.


Tags: , , ,
Posted in Joint Replacements, Knee, Platelet-Rich Plasma Therapy (PRP) | No Comments »

Dr. Mark Galland Releases Podcast On Platelet Rich Plasma Therapy

Written by admin on October 12, 2012 – 8:55 am -

Dr. Mark Galland, a physician at Orthopaedic Specialists of North Carolina, has announced the release of a podcast discussing platelet rich plasma therapy, a minimally invasive, non-operative method of treating common overuse in chronic musculoskeletal injuries. In the podcast, Galland discusses what the therapy treatment entails, what types of injuries it treats, candidates for the therapy and the recovery process after the treatment.

“It is important for people, especially athletes, to be aware of platelet rich plasma therapy and what it can do for treating an injury,” said Galland. “It is an alternative, non-surgical treatment for athletes and non-athletes to improve joint and tendon injuries that could affect their daily lives.”

To listen to the podcast, click here: PRP Therapy.


Tags: , , ,
Posted in Platelet-Rich Plasma Therapy (PRP), Podcast | 1 Comment »

Orthokine Therapy: Modern Day Fountain of Youth?

Written by admin on October 1, 2012 – 9:52 am -

Orthokine therapy is a new sports medicine treatment recently receiving widespread interest and acclaim. It was developed primarily for the treatment of osteoarthritis (OA) by German doctors, Dr. Peter Wheling and Julio Reinecke, PhD., of Dusseldorf, Germany. Little is known about this experimental technique, and there is scant data to support its efficacy, but anecdotal reports have been, high-profile and promising. Much like the mythical fountain of youth, the technique, its clinical mechanism, and its results are shrouded in mystery. Similar to Platelet Rich Plasma Therapy (PRP therapy), whose mechanism and effect has been discussed at great length, and is now widely-recognized in the public consciousness as the standard musculoskeletal rejuvenation therapy, Orthokine therapy is also an autologous treatment provided as an injection of the patient’s own blood. There are no foreign materials or substances used, so risk of adverse side effects is minimal, and the injections are well-tolerated.

In theory, proteins commonly found in patient’s blood –such as Interleukin – 1- Receptor – Antagonist (IL -1Ra) – possess inherent anti-inflammatory and analgesic properties that serve to protect and to preserve the cartilage in an arthritic joint against degradation by osteoarthritis.

During the Orthokine procedure, blood is obtained from the patient using a syringe containing beads that will enhance and/or release the production of these cartilage-protective proteins. The blood is stored at body temperature for up to 9hours, during which time, the concentration of the joint preserving proteins, have increased up to 100 times greater than normal. After the incubation period, the sample is centrifuged to isolate the enriched serum of proteins from the other elements of blood. It is then divided into numerous vials that may be used immediately or frozen for future treatments. The serum is then injected into the affected joint to decrease pain, increase range of motion, and decelerate the progression of degenerative joint disease, and (hopefully) improve the joints longevity. The practitioners report almost immediate improvement and symptom resolution for 2-4 years.

Orthokine therapy is being used throughout Europe but is not yet FDA approved for use in the United States. Professional athletes such as Kobe Bryant and Alex Rodriguez are among those who have traveled to Europe to receive the Orthokine therapy with the hopes of alleviating pain, enhancing their performance and extending their athletic careers.

It is unclear whether Othokine is the long-sought OA treatment (minimally invasive, long-lasting, relatively inexpensive to provide), the next innovation, or just the latest “snake oil” cure-all. It is certain, however, that despite the lack of clinical data, many more modern day Conquistadors will travel to Europe to imbibe this latter day fountain of youth, following the examples of the superstar “Ponce de Leon” that preceded them.–at least until it is “discovered” again somewhere else.

Dr. Mark Galland is a Board Certified Orthopaedic Surgeon specializing in sports medicine, practicing in Wake Forest and North Raleigh. He serves as team physician and Orthopaedic consultant to the Carolina Mudcats, High-A Affiliate of the Cleveland Indians of Major League Baseball, as well as several area high schools and colleges. Dr. Galland can be reached at (919) 562-9410 or by visiting www.orthonc.com or www.drmarkgalland.com.

Caitlin Davis, ATC/LAT is a post graduate fellow at GOSM… For more information, visit us at www.atcfellowship.com

References
Wehling, P. D. P. (2012). Molecular orthopaedics. Retrieved from http://www.wehling-hartmann.de/en/wir-ueber-uns/
Wheling, P. D. P. (2007). Osteoarthritis: The individual osteoarthritis therapy. Retrieved from http://alfa-arthro.com/dokumenti/BookletOA_Pat_05062007.pdf


Tags: , , , , , , , ,
Posted in Uncategorized | 1 Comment »