Injections that can help relieve pain and inflammation in a specific area. These injections contain a corticosteroid medication and a local anesthetic. The number of shots you can get in a year is limited due to potential side effects of damage to the joint. However, patients generally have found great relief.

• Synvisc
• Synvisc One
• Monovisc
• Orthovisc
• Euflexxa
• Durolane

Bone marrow concentrate (BMC), also known as bone marrow aspirate concentrate (BMAC), is a fluid containing cells taken from bone marrow. Bone marrow is the soft, spongy substance that fills the inner cavities of bones. It is where blood is produced.

Tiny spaces in the bone marrow hold blood and stem cells, the primitive cells that are able to grow into various types of blood cells. Under certain conditions, some of these stem cells can also create new tissue like bone, cartilage, fat and blood vessels.

How is BMC obtained?

The first step in producing BMC is to collect bone marrow aspirate through a minimally invasive method that uses a needle to remove bone marrow from a large bone, such as the pelvic bone. The procedure is generally done under local anesthesia, sedation or in the operating room. The aspirate is then put through processing that uses a centrifuge.

Bone marrow processing methods vary widely and can affect the number and quality of cells.

What are the risks involved with obtaining bone marrow concentrate?

Risks are rare, but may include:

• Bleeding
• Infection
• Pain that continues after the procedure

How is BMC used to help repair or heal tissue?

Experts are still determining how BMC will work within the body (mechanism of action), as well as how well it will work (clinical efficacy). However, experts do believe that BMC decreases (modulates) inflammation and it can potentially help new tissue form.

Wake Forest Baptist was the first in the region to offer platelet rich plasma (PRP) therapy and we commonly treat patients at our sports medicine facilities.

Patients with arthritis or injuries undergo a full evaluation and medical teams explore all options to determine which is the best route for each individual patient. Orthopaedic and sports medicine experts work together from diagnosis through treatment, including follow-up appointments and post-treatment rehabilitation.

PRP therapy is becoming a more common treatment for joint pain, degenerative conditions, injuries to ligaments, tendons and cartilage, and osteoarthritis of the hip, knee, or shoulder.

What happens during PRP therapy?

During PRP therapy, the patient’s blood is drawn and spun in a centrifuge, a process that separates the various components of the blood. This isolates the platelets, a solid component in the blood, from other blood cells.

The platelet-rich solution is then injected in the area of the body that needs to be treated, sometimes with the guidance of an ultrasound machine.

Note that PRP therapy may not be covered by your insurance.

Benefits of PRP therapy

The platelets from the patient’s own blood contain growth factors that can help stimulate the body’s natural healing process to rebuild damaged tendon or cartilage and help reduce inflammation processes.

A more effective and complete treatment, PRP therapy allows for the regeneration of natural tissue and a potential decreased likelihood of repeat injuries. It can be an effective solution for those who have tried traditional treatments with minimal success.

PRP therapy can help patients avoid surgery, and is beneficial for those who want to postpone surgery or for athletes who want to avoid a potentially career-ending surgery.