Insights & Injuries:

A blog by Dr. Dolf R. Ichtertz, Nebraska Hand & Shoulder Institute

The Dr.
So you think platelet-rich plasma (PRP) will help your arthritis16 February, 2017
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Fly-by-night marketing attempts even occur in medical field!

For the past 20 years there has been a plethora of questionable studies suggesting that possibly hyaluronic acid originally derived from rooster comb could benefit arthritic joints (sold as Synvisc, Hyalgan and Euflexxa, etc.).  Careful research discloses that actually it is a very high-cost alternative with no better response and more side-effects thatn cortisone injections.  A number of studies have now been published mostly in Europe comparing the rooster comb chemical to PRP but suggests that PRP is slightly better.   No carefully performed study has been done to compare it with corticosteroid at much lower cost.  Also, there is a dearth of information to compare simple use of well-researched, inexpensive and quite safte NSAIDs with PRP.  Studies previously done with NSAID vs. rooster comb extract were using subtherapeutic (less than optimal) dosages of naproxen.  Compare this to shady ads on television targeting elderly people with knee arthritis offering expensive knee "braces" that are guaranteed to be paid for by Medicare!  Don't be fooled.

When the fog settles, at the end of the day maintaining an ideal body weight, i.e. avoidance of obesity, exercising and, if there is no medical reason/intolerance to taking NSAID (oral more so than topical due to cost), NSAID and possible use of a cane (mandated by Medicare and Blue Cross before paying for a joint replacement) are still the best alternatives.

Patient Satisfaction with treatments for Dupuytren's Disease

Collagenase rather than Surgery - that is the question

Computers and CTS - Is there an association?

Review of a recent study on the use of computers and the development of carpal tunnel syndrome.

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Nebraska Hand and Shoulder Institute, P.C.