EMEDx

Total Tendon Network

2008-01-29T13:57:00.001-08:00

A new network has been created to help both patients and providers. The mission is simple: improve the diagnosis and treatment of tendon injuries and disorders. Novel new treatments including platelet rich plasma are discussed.

Members from all over the world including North America, South America, Europe, Asia and Australia have are helping each other via discussion groups, pictures, videos and connections.

Join the Total Tendon Network Now.

Total Tendon

Platelet Rich Plasma

PRP Research Blog

CBS Evening News Story: Platelet Rich Plasma

2007-06-06T09:44:00.000-07:00

Dr. Allan Mishra's novel techniques (Platelet Rich Plasma or PRP) for treating orthopedic injuries and disorders was feature on the CBS Evening News last night. Here is a link to the story: CBS Evening News Story.

For more details about PRP, please visit: ApexPRP.com

Platelet Rich Plasma Video

2007-05-24T08:31:00.000-07:00

This is a video of Dr. Allan Mishra discussing the basic science of Platelet Rich Plasma

Platelet Rich Plasma History

2007-05-24T08:26:00.000-07:00

Platelet rich plasma (PRP) has been around for a long time. Five years ago, Dr. Allan Mishra was the first surgeon to inject buffered PRP to treat chronic elbow tendinosis. The results of his research was published in the American Journal of Sports Medicine, Nov. 2006. In the last five years, the basic science and clinical research supporting the use of PRP has grown significantly.

Please visit: ApexPRP.com for an overview of Platelet Rich Plasma.

Please visit: Dr. Mishra PRP Research Blog for the latest published and presented information on the topic.

If you have any questions or comments, please send an email to: info@menlosportsmedicine.com

Meniscus Cartilage Tears Dr. Allan Mishra Emedx.com

2006-11-28T22:42:00.000-08:00


This is a video dicussion of meniscus tears of the knee. The video is narrated by Dr. Allan Mishra from Emedx.com

Platelet Rich Plasma Press for Tendonitis Paper

2006-11-05T08:53:00.000-08:00

The use of Platelet Rich Plasma for chronic tendinitis (tendinosis) was outlined in a paper by Dr. Allan Mishra and Terri Pavelko, PAC, PT in the American Journal of Sports Medicine. This paper has generated a significant amount of press so far. Here is a link to some of the articles:

PRP Press

For more platelet rich plasma information and research go to Apex PRP.com

Platelet Rich Plasma: Knee Replacement Surgery

2006-07-20T09:23:00.000-07:00

Another article was recently published about PRP and TKA (Berghoff et al Orthopedics July 2006). The patients treated with PRP during their total knee replacements had better early range of motion, less blood loss and a shorter stay in the hospital.

For more PRP information and research go to: ApexPRP.com

Sports Medicine Videos

2006-07-03T12:49:00.000-07:00

Words and static pictures can convey incomplete information. Our brains are built to view motion. Video, therefore is ideal for helping understand sports medicine related concepts. Emedx now introduces: "Sports Medicine Videos". This is a series of short videos related to the most common injuries and surgeries. They are narrated and produced by Dr. Allan Mishra.

To view the videos, you may either follow the link above or click on the video page link at the top of the Emedx.com homepage.

Please let us know what you think.

Emedx.com

Platelet Rich Plasma Talks in Europe

2006-05-25T07:51:00.000-07:00

Dr. Mishra is presently in Europe giving research talks about the use of platelet rich plasma for chronic tendinitis. To learn more, visit: ApexPRP or the PRP Blog

Platelet Rich Plasma is a fraction of blood that contains concentrated amounts of powerful growth factors. It is an emerging biologic tool.

Platelet Rich Plasma

2006-04-16T07:51:00.000-07:00

Platelet rich plasma (PRP) is a component of your own blood that contains powerful growth factors. Researchers around the world are presently investigating how best to use PRP. Dr. Mishra from the Menlo Clinic and Stanford University Medical Center is one of the leaders in this field. He has studied the use of PRP for tendonopathy and in extensively in cell culture. PRP is one of the new "biologic" tools being developed for physicians to combat a variety of disorders. To learn more about Platelet Rich Plasma, check out APEX PRP. This is new website devoted to PRP research.

http://www.apexprp.com

Knee Pain: Online Diagnosis Tool

2006-04-02T16:38:00.000-07:00

We have created a new online Knee Pain Diagnosis Tool. It is a smart list of yes/no questions that can lead you to a diagnosis. This tool has been clinical tested. It is meant for general information and to guide you. It is not meant to replace an evaluation by a doctor or physical therapist. Importantly, it is FREE!

Check it out by clicking on the "Knee Pain Diagnosis Tool" link in the center of the eMEDx homepage. Send any comments back via this blog. Good luck.

EMEDx.com

ACL Graft Choices

2006-03-09T10:15:00.000-08:00

Anterior Cruciate Ligament Surgery requires the patient and surgeon to choose a type of graft. Presently there are two major categories--Autograft (your own tissue) and Allograft (cadaver tissue). There is a significant debate in the orthopedic literature as to which one is better.

The Autograft choices include: Patellar Tendon, Hamstring Tendon and Quadriceps Tendon.

The Allograft choices include: Achilles Tendon, Patellar Tendon and Hamstrings as well as tibialis anterior tendons.

This is an important discussion to have with your surgeon. His or her opinion and expertise should help guide you as to which of these choices is best for your surgery. The good news is that almost all of the options are good. The risks and benefits of each of them, however, are hotly debated even within the sports medicine community.

Good luck and send in your comments.

For more information about ACL Surgery, go to: EMEDx.com

Glucosasmine and New England Journal of Medicine

2006-02-26T16:45:00.000-08:00

The mainstream media overlooked the fact that for patients with moderate to severe knee osteoarthritis pain significantly improved with glucosamine and chondrontin. Also, the threshold for improvement (20%) was set too low. This artificially made placebo look better. According to their own data if the threshold for improvement had been 50% in the moderate/severe group, then only the combination of Glucosamine and Chondroitin would have shown a significant improvment.

The New England Journal of Medicine and the media have should be ashamed for not doing their homework. This data clearly supports the use of the combination for use in Moderate to Severe knee osteoarthritis at a much lower cost than Celebrex. I still recommend the combination of supplements for my patients.

For the full abstract click here.

For more sports medicine information click here.

Disclaimer: I have no financial interest in Celebrex or any supplements.

AM

Surgery, Insurance and the End of the Year

2005-12-04T19:59:00.000-08:00

Many patients request surgery toward the end of the year. This may be because they have met the year's deductable or they may have time off during Christmas. If you are in this position, it is best to schedule early with your doctor. Often the schedule fills up quickly. And remember, your surgeon also may want to spend some time with his or her family during the holidays and may not be available.

To learn more about sports medicine go to: http://www.emedx.com/

Rotator Cuff Tendonitis

2005-11-27T16:52:00.000-08:00

Rotator cuff tendonitis and tears are common disorders of some of the muscles that control movement of the arm and shoulder. Rotator cuff tendonitis and tears are collectively known as Impingement Syndrome.

The rotator cuff is a series of four muscles that function to stabilize your shoulder and allow your arm to move through a full range of motion. The muscle tendons are lubricated by a fluid filled sac called the subacromial bursa. Impingement occurs when inflammation or bony spurs narrow the space available for the rotator cuff tendons. The syndrome is divided into 3 stages:

Stage I: Swelling and Mild Pain
Stage II: Inflammation and Scarring
Stage III: Partial or Complete tears of the rotator cuff

To learn more about this topic please go to http://www.emedx.com or click the link below:
Rotator Cuff Homepage

Golf Fitness

2005-11-26T16:13:00.000-08:00

Much like skiing, getting in shape for golf is important.

A top notch fitness expert named Scott Bowman has developed an excellent program.

Check it out at:

www.bowmantrainingsystems.blogspot.com

Knee Exercises for Skiers and Snowboarders

2005-11-26T16:10:00.000-08:00

Getting ready for skiing or boarding is important. I have developed a program I call the PowerKnee Program that is perfect for skiers and boarders. Check it out at:

http://www.emedx.com/powerknee/index.htm

Paying Cash for Surgery

2005-08-17T09:39:00.000-07:00

As more of us use health savings accounts or have high deductible insurance, paying cash for health services has increased. Surgery is the most expensive of these services so ask your doctor to explain the charges that will be involved. Typically, there are three separate bills. One for the surgeon's fees, one for the anesthesiologist's fees and one for the surgery center or hospital where the procedure will be performed. Many of these fees are set in advance and cannot legally be changed by your doctor. It is still a good idea to ask for a cash discount. Look here for more later on this important and evolving topic.

AKM

Who is best at choosing a doc?

2005-08-09T17:21:00.000-07:00

We all typically get a referral to a specialist from our primary care doc or a trusted friend. Do we ever question that referral? How do you decide if that doc is a good one? I think we need a better way of figuring out who the good docs are and who the bad ones are.

As previously stated in this blog, board certification is one way of sorting through your HMO/PPO book of docs. Dig a little deeper and find out where your doc went to medical school or did his/her residency. Also, when you are receiving a referral, ask the person why that particular doc?

Remember we all do to the "best docs". Who out there is going to a bad doctor on purpose?

Tendinitis vs Tendinosis

2005-08-04T13:14:00.000-07:00

It is important to know the difference betwteen Tendinitis and Tendinosis when trying to understand why you have pain around a joint. Tendinitis refers to an ACUTE inflammatory problem with a tendon. This can occur if you have used a specific muscle too much over a short period of time. The classic example is achilles tendinitis that occurs after a long or hilly run. It can also occur by playing too many sets of tennis or swimming excessively. Tendinosis, conversely, is CHRONIC problem with a tendon that usually has lasted at least 6-8 weeks. In this case, there isn't any direct inflammation but rather a poorly organized attempt at repair of the tendon by the body. This results in partial or complete tendon tears in some cases and manifests itself in pain and weakness when trying to use the muscle that is attached to the tendon.

The treatments for this two problems initially are the same. Rest from the activity that is causing the problem, anti-inflammatory medication and a stretching and strengthening program. For more information, go to http://www.emedx.com

AM

Knee Exercises for Arthritis

2005-08-03T14:21:00.000-07:00

Knee Osteoarthritis is a common problem with a variety of moderately effective treatments. Exercise is one of these treatments that is often ignored. For my patients with mild to moderate knee osteoarthritis, I recommend using an exercise bike 3-4 times per week for 30 minutes at a time. If you are consistent about this simple regimen, you'll likely improve your walking ability, decrease you pain and burn enough calories to shrink your waistline. Adding in hamstring, quadriceps and achilles stretching and you have a simple yet effective program that should improve your quality of life without any medication.

Try it and let me know how it may work for you.

Always consult with your physician before beginning any exercise program. That is a disclaimer for all the lawyers out there.

Choosing Your Surgeon

2005-05-29T08:50:00.000-07:00

Choosing your surgeon is clearly an important task. If your problem is not urgent or emergent you will have time to evaluate the credentials of your surgeon. Here is a list of questions to ask:

1. Are you board certified?
2. How many years have you been in practice?
3. How many of these procedures have you done?
4. Where did you go to medical school?
5. Where did you did your residency training?

You can also find online if your surgeon has any medical board disciplinary actions (a very bad sign). Finally, and importantly, do you feel confident in your surgeon and does he or she listen to your questions. These are simple ways to decide who should perform your surgery.

I'd love to here your comments on this topic.

AKM

EMEDx Blog

2005-05-08T19:29:00.000-07:00

Welcome to the EMEDx Blog.

This will be a direct link off the EMEDx site and will serve its users.
To make suggestions about this blog, send an email to:

med@emedx.com

I will answer questions via this blog for selected topics. All answers will be posted on the site and are not meant as specific medical advice but rather general information to be shared by all EMEDx users. No names will be posted.

This blog will also contain links to topics within and outside of the EMEDx site. I look forward to interacting on this new platform.

Sincerely,

Allan Mishra, MD
President EMEDx