Orthobiologics Booklet : simplebooklet.com

What are Orthobiologics?Orthobiologics oer a conservave, non-surgical treatment for paents with joint degeneraon or musculoskeletal injuries. Orthobiologics are an excellent alternave for those who wish to avoid or postpone major surgical intervenon, such as tendon repair or joint replacement surgery. Orthobiologic therapies are naturally occurring substances injected into the injury site, which accelerate the body’s inherent healing process. These therapies aid in the healing of bone, muscle, tendon, carlage, and ligaments. Most commonly things like platelet rich plasma (PRP) and bone marrow concentrate (BMC) are used for this. Orthobiologics Oered at Tidewater Sports and Osteopathic Medicine 1. Prolotherapy2. Platelet-Rich Plasma (PRP)3. Stem Cell Procedures• Microfragmented Adipose Tissue (MFAT)What is Prolotherapy? Prolotherapy harnesses the body’s own healing ability to repair damaged tendons, ligaments, and joints. Ligaments are exible connecve ssues that connect our bones together, parcularly in the joints. When you injure a bone or tendon, your body naturally heals that area with inammaon, which produces new collagen and results in the strengthening and stabilizaon for the joint. Somemes this process is unable to complete itself which can cause pain, numbness, joint instability, and muscle spasms. Prolotherapy is a safe and eecve way to induce this inammaon response, which triggers the body’s natural healing process. Addionally, prolotherapy acts to “reset” painful nerves that become abnormally overacve as a result of the injury. Experiments in animals and humans have shown that ligaments and tendons are strengthened and thickened by prolotherapy. Studies also support the use of prolotherapy in relieving chronic joint pain and osteoarthris.What to Expect During the Procedure:Prolotherapy is performed in an in-oce seng. Through the use of ultrasound guidance an injecon of lidocaine (to numb the ssues and relieve pain) and dextrose (sugar water) is carefully placed at the site of injury. The strength of the injecon is adequate enough to irritate the ssue and smulate repair, creang a local inammatory response, which signals the body to start the repair process. Frequently Asked Quesons: What Condions Are Commonly Treated with Prolotherapy?Overview• Osteoarthris• Rotator cu tears• Patellar tendonis• Achilles tendonis• Plantar fasciis• Trochanteric tendonisAre Prolotherapy Injecons Painful?Tiny injecons of numbing medicine are administered prior to the dextrose providing pain relief during the procedure. Some paents do experience irritaon 24 – 48 hours aer the injecon. However, pain will gradually decrease as healing occurs.How Many Treatments Will I Need?Typically, prolotherapy requires 3 - 6 treatments occurring every 2 - 4 weeks. This number will vary from paent to paent depending on the injury. ProlotherapyTPMG Tidewater Sports and Osteopathic Medicine - Saunora Prom, DO | mytpmg.com TPMG - Tidewater Physicians Multispecialty GroupWhen Will I Start Seeing Results?Results are normally seen by the third treatment. This is a gradual process, which may take several weeks to months before improvement is seen.What Are The Risks?Complicaons are rare and prolotherapy is well-tolerated by most paents. A paent consent form will be given to you prior to the injecon, which includes a list of possible risks.Is this Covered By Insurance?Prolotherapy is not covered by insurance. Our sta can provide you with a pricing guide for this procedure. Prolotherapy Post-Care Instrucons: • Following the procedure, keep the injecon site(s) clean and dry with a bandage for at least 12-24 hours. Showering is permied any me aer prolotherapy.• Use ice only as needed. While ice can reduce pain and swelling it can also act as an an-inammatory, which can counteract the healing process. Use ice sparingly, if your pain medicaon alone isn’t helping. • If you start geng very sore within a few hours aer the treatment, please use your pain medicaon. Some paents may experience a post-injecon site are-up of pain due to their immune system being hyper-smulated. This may make the rst 24-48 hours aer the injecon painful. It is much easier to stay ahead of the pain rather than try to wait and catch up. In the long run, this will allow you to use less pain medicaon. • Do not use any medicaon including: ibuprofen, naproxen, aspirin, or other prescripon an-inammatory medicaons such as Motrin, Advil, Aleve, Voltaren, Mobic, Daypro, Feldene, Lodine, Orudis, and Ansaid beginning seven days prior to the procedure. In addion, we recommend stopping sh oil, garlic, Vitamin E, turmeric, and other supplements that ght inammaon. • You may use Tylenol and physician-prescribed pain medicaons as needed.• Call your physician if you develop drainage from the injecon site, bleeding, or fever.• You may experience localized swelling and/or bruising at the injecon site that will take 3 - 7 days to resolve.• You will be given instrucons prior to leaving the procedure regarding physical acvity restricons. Typically, we recommend starng physical acvity to the aected area when tolerated. Light exercise, including walking or biking, is ne. Depending on the number of injecons you receive, you will begin a more structured therapy and intensive exercise typically within a few weeks.• In general, for upper extremity procedures, refrain from repeve moon, pulling, tugging, grasping, or heavy liing unl re-evaluated at your next visit.• For lower extremity procedures, such as injecons into the hip, thigh, knee, ankle, or foot, you may require the use of crutches or a cane depending on your discomfort. Usually, taking it easy and resng on the couch will be sucient.• You may drive home from the procedure if you had an upper extremity injecon without a nerve block and drive an automac transmission.• It is strongly recommended that if you have a lower extremity procedure, you have someone drive you home.

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Platelet-Rich Plasma (PRP)TPMG Tidewater Sports and Osteopathic Medicine - Saunora Prom, DO | mytpmg.com TPMG - Tidewater Physicians Multispecialty GroupWhat is Platelet-Rich Plasma (PRP)? PRP stands for Platelet-Rich Plasma. PRP is a high concentraon of platelets, which are injected into a joint or damaged ssue. Platelets are blood cells which contain properes to accelerate healing of damaged or degenerave ssue. What to Expect During the Procedure: PRP is an in-oce procedure. First, blood is drawn using a special centrifuge. The blood is spun down in the centrifuge which takes about 20 minutes to produce a platelet-rich plasma. This process yields a higher concentraon of platelets that is about 5-7 mes greater than normal blood. Next, an ultrasound is used to idenfy the aected area. The skin is cleaned, and a numbing agent is injected following the PRP injecon. Next, an ultrasound is used to guide the injecon, which allows for greater precision and accuracy. The injecon can be painful and pre-treatment medicaon can be used to help with this if needed.Frequently Asked Quesons:What Condions Are Commonly Treated with PRP?• Joint arthris• Rotator cu injuries or tears• Tennis and golfer’s elbow• Patellar tendonis• Plantar fasciis• Achilles tendinis• Back and neck arthris• Chronic ligament and tendon injuriesAre PRP Injecons Painful?Paents typically have mild discomfort. PRP works to smulate healing. If you noce discomfort this is a sign that the treatment is working as it should. Your physician may prescribe you medicaon to help alleviate discomfort.How Many Treatments Will I Need?The number of injecons depends on the injury. Most so-ssue injuries respond in one treatment. For osteoarthris paents, a series of three injecons each spaced a month apart has shown to yield the best results.Will the Results Last?Unlike corsone, PRP is intended to x and correct the problem. For arthris, there is no “cure”. However, PRP is an excellent opon to relieve and improve pain and funcon. For PRP injecons, a yearly booster is suggested to keep your joints operang at their best.How Lung Unl I See Results? The results are gradual. Typically, paents will noce a dierence in pain level within a few weeks to a few months.Is PRP Covered By Insurance? Not all insurances cover PRP injecons. Please check with your insurance carriers. TRICARE does oer coverage for those diagnosed with chronic knee osteoarthris and lateral epicondylis (tennis elbow).TPMG Tidewater Sports and Osteopathic Medicine - Saunora Prom, DO | mytpmg.com TPMG - Tidewater Physicians Multispecialty GroupPost-Care Instrucons: Keep the injecon site(s) clean and dry with a bandage for at least 12-24 hours. Showering is permied any me aer PRP.• Use ice only as needed. While ice can reduce pain and swelling, it also acts as an an-inammatory, which can counteract the healing process. Use ice sparingly if your pain medicaon alone does not help.• If you start geng very sore within a few hours aer the treatment, please use your pain medicaon. Some paents may experience a post-injecon site are-up of pain due to their immune system being hyper-smulated. This may make the rst 24-48 hours aer the injecon painful. It is much easier to stay ahead of the pain rather than try to wait and catch up. In the long run, this will allow you to use less pain medicaon. • Do not use any medicaon including: ibuprofen, naproxen, aspirin, or other prescripon an-inammatory medicaons such as Motrin, Advil, Aleve, Voltaren, Mobic, Daypro, Feldene, Lodine, Orudis, and Ansaid beginning seven days prior to the procedure. In addion, we recommend stopping sh oil, garlic, vitamin E, turmeric, and other supplements that ght inammaon. • Seven days aer your PRP procedure, you may resume medicaons and supplements.• You may use Tylenol and pain medicaon prescribed by your physician as needed.• Call your physician if you develop drainage from the injecon site, bleeding, or fever. • You will be given instrucons prior to leaving the procedure regarding physical acvity restricons. Typically, we recommend starng physical acvity to the aected area when tolerated. Light exercise, including walking or biking, is ne. Depending on the number of injecons you receive, you will begin a more structured therapy and intensive exercise typically within a few weeks.• In general, for upper extremity procedures, refrain from repeve moons, pulling, tugging, grasping, or heavy liing unl reevaluated at your next visit.• For lower extremity procedures, such as injecons into the hip, thigh, knee, ankle, or foot, you may require the use of crutches or a cane depending on your discomfort. Usually, taking it easy and resng on the couch will be sucient.• You may drive home from the procedure if you had an upper extremity injecon without a nerve block and drive an automac transmission.• It is strongly recommended that if you have a lower extremity procedure, you have someone drive you home.Stem CellsWhat are Stem Cells? Mesenchymal stem cells (MSCs) are unique cells that can mulply, dierenate into another type of cell with a more specialized funcon, and are capable of self-renewal. For example, stem cells can become carlage, bone, tendon, or ligaments. They also trigger other stem cells and repair cells living in surrounding ssue to “turn on” or become acvated in the healing process. It is believed that stem cells work by reprogramming and restoring the healthy pro-growth and low inammatory environment of a damaged area. The only viable way to get stem cells is from the paent’s own body. In our oce this is done by an MFAT procedure, which uses cung-edge technology to harvest the natural and reparave capability of your fat ssue. MFAT is harvested through a minimally-invasive operaon that involves making small incisions in the skin of your belly, ank, and part of your glutes. The cells contain valuable reparave stem cells that can help your body heal itself. Once these cells are extracted, ultrasound technology idenes areas of your body that require repair and those regions are injected with the collected cells to help the healing process.

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TPMG Tidewater Sports and Osteopathic Medicine - Saunora Prom, DO | mytpmg.com TPMG - Tidewater Physicians Multispecialty GroupFrequently Asked Quesons? What Condions Are Commonly Treated with MFAT?• Trochanteric tendonis• Rotator cu tears• Patellar tendonis• Achilles tendonis• Plantar fasciisHow Long Does the Procedure Take?This procedure usually takes 1 - 1.5 hours, including preparaon and aercare.Is the MFAT Procedure Painful? Paents are typically injected with a numbing agent which dulls most sensaon. Some paents report feeling pressure during the anesthec and harvesng poron of the procedure.Who is the Ideal Candidate for this Procedure? Stem cells from adipose ssue do not weaken over me, which makes them ideal for some cases. Paents with moderate to severe arthris or those over 60 are ideal candidates for this procedure because the fat provides a cushioning and support for arthric areas.What are the Risks and Complicaons? Paents could experience mild swelling, soreness, and bruising at the site for a few days to a week. The procedure carries the same amount of risk involved with other minimally invasive surgeries, which could lead to other complicaons. All paents will be informed of the potenal risks. While rare, these risks will be listed in a consent form prior to the procedure.How Long Will It Take To Recover?For most paents the inial recovery should only last a week. Your physician will provide you with strategies to minimize discomfort during this me.How Oen Will I Need MFAT? The MFAT procedure is meant to act as a long-term soluon for most paents; however, the frequency of the procedure is dependent on the severity of the condion, the paent’s health, and other treatment. This treatment should be paired with a healthy lifestyle including regular exercise, an an-inammatory diet, bracing, and other forms of treatment including PRP. No paent is the same. Your treatment will be tailored based on your unique needs.Is it Covered By Insurance?MFAT is not covered by insurance, however, our sta will oer a pricing guide for the procedure.MFAT Post-Care Instrucons • Your physician will provide you with a corset to wear 5-7 days post-procedure. Remove Tegaderm (plasc bandage) covering aer 72 hours. You may shower the day aer the procedure, however, do not submerge the area in a bath, pool, or hot tub unl the covering is removed and the wounds appear to be healed. Aer the Tegaderm is removed the wounds can be covered using a Band-Aid or Steri-Strips unl completely healed. Abdominal and groin bruising is normal and should go away within 1-2 weeks. • Use ice only as needed. While ice can reduce pain and swelling, it also acts as an an-inammatory, which can counteract the healing process. Use ice sparingly if your pain medicaon alone does not help.• If you start geng very sore within a few hours aer the treatment, please use your pain medicaon. Some paents may experience a post-injecon site are-up of pain due to their immune system being hyper-smulated. This may make the rst 24-48 hours aer the injecon painful. It is much easier to stay ahead of the pain rather than try to wait and catch up. In the long run, this will allow you to use less pain medicaon. TPMG Tidewater Sports and Osteopathic Medicine - Saunora Prom, DO | mytpmg.com TPMG - Tidewater Physicians Multispecialty Group• Do not use any medicaon including: ibuprofen, naproxen, aspirin, or other prescripon an-inammatory medicaons such as Motrin, Advil, Aleve, Voltaren, Mobic, Daypro, Feldene, Lodine, Orudis, and Ansaid beginning seven days prior to the procedure. In addion, we recommend stopping sh oil, garlic, vitamin E, turmeric, and other supplements that ght inammaon. • Seven days aer your MFAT procedure, you may resume medicaons and supplements.• You may use Tylenol and physician-prescribed pain medicaons as needed.• Call your physician if you develop drainage from the injecon site, bleeding, or fever.• You may experience localized swelling and/or bruising at the injecon site that will take 3 - 7 days to resolve.• You will be given instrucons prior to leaving the procedure regarding physical acvity restricons. Typically, we recommend starng physical acvity to the aected area when tolerated. Light exercise, including walking or biking, is ne. At your rst follow-up visit at three weeks, you will begin more structured therapy and intensive exercise. • In general, for upper extremity procedures, refrain from repeve moons, pulling, tugging, grasping, or heavy liing unl re-evaluated at your next visit.• For lower extremity procedures, such as injecons into the hip, thigh, knee, ankle, or foot, you may require the use of crutches or a cane depending on your discomfort. Usually, taking it easy and resng on the couch will be sucient.• You may drive home from the procedure if you had an upper extremity injecon without a nerve block and drive an automac transmission.• It is strongly recommended that if you have a lower extremity procedure, you have someone drive you home.

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Shockwave TherapyTPMG Tidewater Sports and Osteopathic Medicine - Saunora Prom, DO | mytpmg.com TPMG - Tidewater Physicians Multispecialty GroupOverview: • Shockwave therapy, also known as Extracorporeal Shock Wave Therapy (ESWT), is a non-invasive medical treatment that ulizes high-energy acousc waves to promote healing and reduce pain in various musculoskeletal condions. The therapy is based on the principal of delivering mechanical energy to the aected ssues, smulang the body’s natural healing process. • The therapeuc mechanism involves the smulaon of blood ow, ssue regeneraon, and a reducon in inammaon at the target site. The shockwaves induce a controlled microtrauma to the aected area, promong the release of growth factors and cytokines, which in turn smulate the body’s natural healing process.• Shockwave therapy oers several potenal benets, making it a valuable treatment opon for various musculoskeletal condions. Here are some of the key advantages:Non-invasive: • Shockwave therapy is a non-invasive procedure, meaning it does not involve surgical incisions. This reduces the risk of complicaons associated with surgery, such as infecon or prolonged recovery mes. Pain Reducon: • One of the primary benets is its ability to alleviate pain. Shockwaves smulate the release of pain-relieving substances in the body, helping to reduce discomfort associated with condions like tendonis, plantar fasciis, and other musculoskeletal issues. Improved Blood Circulaon: • Shockwave therapy enhances blood ow to the treated area, promong beer circulaon. Improved blood supply is crucial for the body’s natural healing processes, as it delivers essenal nutrients and oxygen to the damaged ssues.Smulaon of Tissue Repair: • The mechanical energy from shockwaves triggers a biological response that promotes ssue regeneraon and repair. This is parcularly benecial for condions involving damaged tendons, ligaments, or other so ssues. Breakdown of Calcicaons: • In cases where calcicaons or deposits have formed in so ssues, shockwave therapy can help break them down. This is oen seen in condions like calcic shoulder tendinopathy.Quick Recovery:• Since shockwave therapy is non-invasive, paents typically experience minimal downme. This allows for a quicker return to daily acvies compared to more invasive treatment opons.High Safety Prole:• Shockwave therapy is generally considered safe when performed by trained healthcare professionals. It avoids the risks associated with surgical intervenons and is well-tolerated by many paents.Outpaent Procedure:• Most shockwave therapy sessions are performed on an outpaent basis, meaning paents can receive treatment without the need for hospitalizaon. This enhances convenience and accessibility for individuals seeking relief from musculoskeletal condions. TPMG Tidewater Sports and Osteopathic Medicine - Saunora Prom, DO | mytpmg.com TPMG - Tidewater Physicians Multispecialty GroupShockwave therapy is useful for treang a range of orthopedic and musculoskeletal condions, including but not limited to:• Tendonis/Tendinopathy: Shockwave therapy has been employed to treat condions such as Achilles tendonis, patellar tendonis, and rotator cu tendinopathy.• Plantar Fasciis: It has shown eecveness in reducing pain and improving funcon in individuals with plantar fasciis, a common foot condion characterized by inammaon of the ssue on the boom of the foot.Sources of Pain: Calcic Shoulder Tendinopathy:• Shockwave therapy can help break down calcicaons in the shoulder tendons, facilitang their absorpon and reducing pain. Elbow Condions:• Condions like lateral epicondylis (tennis elbow) and medial epicondylis (golfer’s elbow) can be treated with shockwave therapy. Muscle Injuries:• It may be used to promote healing in certain muscle injuries, such as strains or tears.Chronic Pelvic Pain Syndrome:Bone Healing: Procedure - Frequently Asked Quesons: The duraon of shockwave therapy sessions can vary depending on the specic condion being treated and the protocol chosen by the healthcare provider. Generally, a session lasts around 15 to 30 minutes. The number of sessions required can range from three to six, and they are usually spaced about a week apart. However, this can also depend on the severity and chronicity of the condion. The healthcare professional overseeing the treatment will determine the appropriate duraon and frequency based on the paent’s individual needs and response to the therapy.TenJetWhat is TenJet? TenJet is a needle-like device used to treat tendinosis or chronic tendinis. The device uses pressurized saline to selecvely remove diseased tendon ssue while sparing healthy ssue. The minimally invasive procedure can be performed in an outpaent seng, which aims to accomplish similar goals of tradional surgery. By ulizing ultrasound imaging, the physician can make a small incision and see real-me imaging of the diseased ssue. Frequently Asked Quesons? What Condions Are Commonly Treated with TenJet?• Tennis and golfer’s elbow• Jumper’s Knee• Achilles tendonis• Plantar fasciis• Calcicaons (shoulder, knee, elbow, hamstring, or hip)

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TPMG Tidewater Sports and Osteopathic Medicine - Saunora Prom, DO | mytpmg.com TPMG - Tidewater Physicians Multispecialty GroupWill I Feel Pain During the Procedure?You may feel some discomfort at the start of the procedure while anesthec is administered. Post-treatment, you may feel soreness in the treated area. How Long Will it Take to Recover? Typically, you should experience pain relief within three months of treatment. This may vary from paent to paent. Your physician will guide your post-recovery treatment plan with physical therapy and/or at-home exercises.Will I Need Stches Aer the Procedure? Since this is a minimally invasive procedure, stches are not needed.Is this Covered By Insurance? Parally covered by insurance. Please discuss payment opons with your provider and check with your insurance provider for more details.TenJet Post-Care Instrucons: • If you start geng very sore within a few hours aer the treatment, please use your pain medicaon. Some paents may experience a post-injecon site are-up of pain due to their immune system being hyper-smulated. This may make the rst 24-48 hours aer the injecon painful. It is much easier to stay ahead of the pain rather than try to wait and catch up. In the long run, this will allow you to use less pain medicaon. • Do not use any medicaons including: Ibuprofen, naproxen, aspirin, or other prescripon an-inammatory medicaons such as Motrin, Advil, Aleve, Voltaren, Mobic, Daypro, Feldene, Lodine, Orudis, and Ansaid beginning seven days prior to the procedure. In addion, we recommend stopping sh oil, garlic, vitamin E, turmeric, and other supplements that ght inammaon. • Seven days aer your TenJet procedure, you may resume medicaons and supplements. Iovera TherapyTPMG Tidewater Sports and Osteopathic Medicine - Saunora Prom, DO | mytpmg.com TPMG - Tidewater Physicians Multispecialty GroupOverview: • Iovera° is an FDA-cleared, non-invasive procedure that targets pain-causing nerves, providing immediate and long-lasng pain relief. Using a handheld device that harnesses cold technology, iovera° therapy works by freezing the signal-carrying parts of your nerve, reducing pain and restoring funcon.How Does Iovera° Work? • By applying cold therapy to very specic nerves, your doctor can pinpoint the exact areas that are causing you pain and block/relieve that pain for up to 90 days per treatment. Iovera° is not an injecon or a medicaon and delivers immediate results.• This procedure can be performed in the comfort of your doctor’s oce in only about 30 minutes, oering instant relief from your osteoarthris pain. Your doctor will administer a numbing injecon (local anesthec) for the treatment area to prevent pain or tugging during the procedure. Next, your doctor will insert the “Smart Tip” of the Iovera° system into your skin to introduce the cold therapy. This procedure is not painful; however, some paents report feeling a tugging sensaon or mild discomfort when the device is inserted. • Aer the treatment, paents may noce bruising, swelling, inammaon, redness, pain or tenderness near the applicaon site, but most of these side eects resolve on their own. As with any procedure, if you have quesons or concerns regarding your side eects, don’t hesitate to reach out to your doctor. Your doctor may cauon you to avoid strenuous physical acvity for 2 to 5 days following treatment as well.Pain Relief: • This cung-edge therapy oers a soluon for individuals suering from knee pain due to osteoarthris and have not found relief with other pain management treatments. While iovera° doesn’t replace the need for surgery, it can be an alternave for those who cannot have surgery. Iovera° can also be used prior to knee surgery to reduce pain and improve your recovery.Improved Range of Moon: • In addion to pain relief, iovera° can also help paents improve their range of moon, allowing them to bend and straighten the knee more easily. In fact, paents using iovera° reported reduced sness as early as 30 days following the procedure and had improved ability to complete roune tasks at 90 days.Why Choose Iovera°? • Do you struggle to enjoy the acvies you love because of uncontrolled pain? Are you looking for a way to treat your chronic pain that doesn’t involve opioids or invasive surgery? Iovera° is a cung-edge treatment that has helped many paents regain funcon and nd relief from debilitang osteoarthris pain. Schedule Iovera° Today: • Don’t let pain go untreated. If you’re experiencing unmanaged knee pain, contact TPMG Tidewater Sports & Osteopathic Medicine to schedule a consultaon or to see if you are a good candidate for this treatment.TPMG Tidewater Sports and Osteopathic Medicine - Saunora Prom, DO | mytpmg.com TPMG - Tidewater Physicians Multispecialty Group

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TPMG Tidewater Sports and Osteopathic Medicine - Saunora Prom, DO | mytpmg.com TPMG - Tidewater Physicians Multispecialty GroupViscosupplementationOverview: • Viscosupplementaon is a treatment for arthris involving the injecon of hyaluronic acid directly into your joints in order to reduce pain and swelling. Viscosupplementaon is a treatment oen considered for paents who have already undergone non-surgical treatments including weight management, acvity modicaon, physical therapy, over-the-counter an-inammatory drugs like ibuprofen, and corcosteroid injecons.How Does Viscosupplementaon Work? • A gel-like uid is injected directly into the joint, reducing the inammaon that leads to pain and discomfort. Viscosupplementaon is oen used to treat those with mild to moderate osteoarthris of the knee or hip and also for someone with rheumatoid arthris.• If you’re struggling with pain or discomfort relang to your osteoarthris, Viscosupplementaon is a great alternave, especially for those who cannot nd relief from other treatments. While some paents report feeling relief from their symptoms as early as 48 hours aer injecon, it can take up to several weeks to receive the full benet of the treatment.Frequently Asked Quesons:Side Eects/Complicaons • Aer the procedure you may noce a local reacon at the site of the injecon including pain, warmth, or slight swelling. These are normal symptoms and typically do not last long. To provide relief, apply a cold ice pack to the aected area. If the symptoms do not go away soon, contact your healthcare provider. How Many Injecons Will I Need? • The number of injecons varies depending on the paent. Viscosupplementaon is most eecve if the arthris is in its early stages (mild to moderate). It may take several weeks before you begin to noce a dierence. Some paents report seeing pain relief that lasts for several months following the injecons. If the injecons are eecve they may be repeated aer a period of me, typically every 6 months. Post-Care Instrucons • For the rst 48 hours post procedure, avoid standing for long periods, excessive walking, jogging, or heavy liing. Do not use hot or warm packs at the injecon site for the rst 24 hours. Treatment GuidelinesTPMG Tidewater Sports and Osteopathic Medicine - Saunora Prom, DO | mytpmg.com TPMG - Tidewater Physicians Multispecialty GroupCondions Treated With Orthobiologics:Contra-Indicons or Cauons When Using Orthobiologics:• So ssue injuries (muscle, tendon, and ligament injuries)• Degenerave condions such as arthris and tendinosis• Nonunion fractures • Poor ssue and bone quality problems • Chronic non-healing condions tears• Patellar tendonis• Achilles tendonis• Plantar fasciis• Anemia • Low platelet count• Abnormal platelet funcon or diseases• Ongoing or recurrent infecons • Undergoing cancer treatments• Pregnant or breaseedingFactors That Can Reduce Eecveness of Healing: Factors That Do Not Seem to Eect Outcome: Before Injecon• STOP the following medicaons: • All NSAIDs and corcosteroids two weeks prior to the injecon. This includes: Motrin, Advil, Aleve, Naproxen, prescripon NSAIDs, etc. • Tylenol is OK to take• Aspirin three days prior • Supplements - garlic, ginseng, ginkgo biloba, green tea, vitamin E, zinc• Please discuss your use of ancoagulants with your doctor/ cardiologist prior to stopping. This includes Coumadin, Plavix, Eliquis, Pradaxa, etc.• Pre-treatment medicaon for pain/anxiety is available if needed. These need to be requested one week before the procedure to provide the pharmacy me to ll and you me to pick up before the procedure. These can be taken before and aer injecon. • NO DRIVING - make sure you have a driver with you• DRINK plenty of uids to make sure you are well hydrated for the blood draw and/or procedure• EAT prior to the procedure - you do not have to be fasng• Wear comfortable clothes• Smoking• Diabetes• Immuno-compromised condions• Body Mass Index• Sex• Mild or controlled Diabetes• Use of Immunosuppresive medicaons

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Orthobiologics Booklet

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