Austin Ortho + Biologics: Kelly Cunningham, MD

Dr. Kelly Cunningham, a board certified orthopedic surgeon, is Austin’s joint & cartilage expert

Sports can be rough on joints and cartilage, especially shoulders, knees, and hips. Kelly Cunningham, MD, has cared for many young and mature athletes whose joints take a beating day in and day out. He welcomes patients from Austin, Texas, and its surrounding communities to experience the cutting-edge technology and skill offered by his team at Austin Ortho + Biologics. Dr. Cunningham works with e

12/28/2023

Mid-30's male athlete with years of medial knee pain, now symptoms of mechanical locking. Can ANY of this chronic, displaced meniscus be saved?? There are improving odds ...

https://lnkd.in/gDMyDZx6

Video-1 Complex medial meniscus tear with an obvious avascular flap , requires resection to relieve the locking symptoms

Video-2 After partial resection & "sculpting", a vascularized "fishmouth" horizontal tear remains. There are now options for repair of this - I utilized an "over/under" suture anchor technique to obtain an excellent closure. (Zimmer JuggerStitch)

Video-3 To augment healing in this difficult tear pattern & to save as much load-bearing function as possible, PRP is injected in the tear/capsule and joint


Kelly Cunningham MD

Board-certified Orthopedic Surgeon

Austin OrthoBiologics | austinorthobio.com | (512) 410-0767

Austin, Texas | [email protected]

Fellowship trained in Sports medicine & Arthroscopy
Orthopedic regenerative medicine specialist, knee & shoulder injuries, arthritis care - without joint replacement

PRP (Platelet Rich Plasma) & Cell-Based (formerly called "Stem Cell") Therapy

11/21/2023

BEAR Implant ACL Repair

BEAR ACL repair is another tool (in addition to BMC "stem cell" repair) to address acute tears of the anterior cruciate ligament (ACL) of the knee.

Traditional and time-tested ACL reconstruction using a graft has a long track record and excellent safety profile, but it is now becoming clear that some of these tears, in specific cases (partial tears, proximal tears off the bone, some snow ski injuries) may do as well or better with the repair rather than reconstruction, preserving the native ligament and function, perhaps shortening rehabilitation time.

Video linked below shows BEAR ACL Repair

Youtube: https://youtu.be/0FTcEfDPWps

Indications are still evolving; the younger the patient, the shorter the duration of injury, the better... Come see us to discuss your options

________________________

Kelly Cunningham MD
Board-certified Orthopedic Surgeon Fellowship trained in Sports medicine, Arthroscopy, Knee & Shoulder injuries
Orthopedic regenerative medicine specialist

Offering Office & Surgical Options:
PRP (Platelet Rich Plasma) & Cell-Based (formerly called "Stem Cell") Therapy, for cartilage injuries & joint arthritis Latest advances in knee ACL injury care

Austin OrthoBiologics | austinorthobio.com | (512) 410-0767
Austin, Texas | [email protected]

10/16/2023

Indications and Technique, Meniscus Root Repair

Studies increasingly show that stable, anatomic meniscus root repair, when feasible, slows the degenerative process. Supplemental biologics (PRP; BMC - formerly "stem cell") may aid in healing and recovery.

Video 1: Medial meniscus root tear, with Grade 4 medial condyle.
Do You Fix This? If so, How?

Video 2: An all-inside loop suture & mattress root repair with adjuvant PRP. This seems more anatomic here than pull-through tibial fixation.

Kelly Cunningham MD
Board-certified Orthopedic Surgeon
Austin OrthoBiologics | austinorthobio.com | (512) 410-0767
Austin, Texas | [email protected]

Fellowship trained, Sports medicine, Arthroscopy
Orthopedic regenerative medicine specialist

Offering office & Surgical Options:
PRP (Platelet Rich Plasma) & Cell-Based (formerly called "Stem Cell") Therapy, knee & shoulder injuries, arthritis

09/05/2023

Real Patient Results at Austin OrthoBiologics 2023

See what patients are saying about Dr. Cunningham's cutting edge use of orthopedic surgery and biologic (PRP & cell-based - "stem cell" - ) therapy.

“I have been a patient of Dr Cunningham for 20 years, for knee meniscus & ligament surgery, rotator cuff tears, and biological treatments. He is a doctor who cares deeply for his patients’ well being, and who works hard to stay abreast of current developments in his field. He is an excellent surgeon, and spends the bulk of his time doing non-surgical, less invasive treatments. I trust him with my body, and he’s come through. He listens, offers advice, and helps to a well informed conclusion.”- SA 7/2023

“First rate experience with Dr. Cunningham and his staff! The two PRP injections into my hip worked very well and have allowed me to return to my regular exercise and daily routine without the constant, bothersome pain. I highly recommend Dr. Cunningham!” - EK 2/2023

“…with two previous surgeries on my left rotator cuff, an MRI found two tears in my right rotator cuff. After consulting with Dr. Cunningham, we opted for PRP (platelet rich plasma) injections - no more surgery if possible! I’m six weeks in, and have seen remarkable progress in strength, range of motion and pain reduction. Continuing physical therapy and diligence should have me close to 100% soon. Very pleased, and I highly recommend Dr. Cunningham!!! "- 4/2023

Kelly Cunningham MD
Austin OrthoBiologics | austinorthobio.com | (512) 410-0767
Board-certified Orthopedic & Regenerative Sports Medicine Specialist
Cellular "stem cell" & PRP therapy, with & without surgery of the knee, shoulder, elbow & hip
Alternative answers for knee & shoulder pain/arthritis

Schedule an office visit with Kelly Cunningham MD and Austin Ortho Biologics at the convenient Westlake office.

07/31/2023

Interesting findings when comparing long-term results of Cellular "stem cell" therapy, referred to as BMC, in avoiding progression to knee replacement.

Two methods are reviewed, both of which Dr. Cunningham uses in his patients...

Subchondral bone or intra-articular injection of bone marrow concentrate mesenchymal stem cells in bilateral knee osteoarthritis: what better postpone knee arthroplasty at fifteen years? A randomized study

Philippe Hernigou 1 , Charlie Bouthors 2 , Claire Bastard 3 , Charles Henri Flouzat Lachaniette 3 , Helene Rouard 4 , Arnaud Dubory 3

Int Orthop 2021 Feb;45(2):391-399. RCT Abstract

Purpose: There is an increasing number of reports on the treatment of knee osteoarthritis (OA) using mesenchymal stem cells (MSCs). However, it is not known what would better drive osteoarthritis stabilization to postpone total knee arthroplasty (TKA) targeting the synovial fluid by injection or targeting on the subchondral bone with MSCs implantation.

Methods: A prospective randomized controlled clinical trial was carried out between 2000 and 2005 in 120 knees of 60 patients with painful bilateral knee osteoarthritis with a similar osteoarthritis grade. During the same anaesthesia, a bone marrow concentrate of 40 mL containing an average 5727 MSCs/mL (range 2740 to 7540) was divided in two equal parts: after randomization, one part (20 mL) was delivered to the subchondral bone of femur and tibia of one knee (subchondral group) and the other part was injected in the joint for the contralateral knee (intra-articular group). MSCs were counted as CFU-F (colony fibroblastic unit forming). Clinical outcomes of the patient (Knee Society score) were obtained along with radiological imaging outcomes (including MRIs) at two year follow-up. Subsequent revision surgeries were identified until the most recent follow-up (average of 15 years, range 13 to 18 years).

Results: At two year follow-up, clinical and imaging (MRI) improvement was higher on the side that received cells in the subchondral bone. At the most recent follow-up (15 years), among the 60 knees treated with subchondral cell therapy, the yearly arthroplasty incidence was 1.3% per knee-year; for the 60 knees with intra-articular cell therapy, the yearly arthroplasty incidence was higher (p = 0.01) with an incidence of 4.6% per knee-year. For the side with subchondral cell therapy, 12 (20%) of 60 knees underwent TKA, while 42 (70%) of 60 knees underwent TKA on the side with intra-articular cell therapy. Among the 18 patients who had no subsequent surgery on both sides, all preferred the knee with subchondral cell therapy.

Conclusions: Implantation of MSCs in the subchondral bone of an osteoarthritic knee is more effective to postpone TKA than injection of the same intra-articular dose in the contralateral knee with the same grade of osteoarthritis.



This paper is a welcome follow-up to Hernigou’s earlier studies that seemed to indicate that BMC/MSC (used interchangeably here) may outperform knee arthroplasty for pain relief as well as longevity in selected patients. It also defines a typical patient population, painful arthritis of both knees.

The keys to this study:

- specific to osteoarthritis (as opposed to osteonecrosis in some previous series)

-“perfect” matched controls; same patient & arthritis grade, just different knees

- long-term (15-year) follow-up

Obviously, additional studies are needed to confirm the superiority of sub-chondral vs. joint BMC therapy, both of which may be effective in relieving arthritic joint pain.

In my practice, I use either/both modalities, when indicated on xrays, MRI & physical exam. This can be done in addition to arthroscopic surgery for meniscus tears, or as a "stand-alone" office procedure.

Let us determine if this approach will benefit your arthritis /joint pain. Telemedicine consults are available.

Kelly Cunningham MD

Austin OrthoBiologics | austinorthobio.com

Board-certified Orthopedic & Regenerative Sports Medicine Specialist

Cellular "stem cell" & PRP therapy, with & without surgery of the knee, shoulder, elbow & hip

Proximal ACL Tear Repair of the Knee Utilizing Cellular Therapy (“Stem Cell”) 07/05/2023

A ski injury that tears the anterior cruciate ligament is often right off of the femur/notch, allowing direct repair (vs. full reconstruction w/ a graft). Shorter rehab, quicker recovery, and often re-inforced with the Artelon flexgraft.

Youtube Link: https://youtu.be/dAf7_lXoLV8

video #1 posterolateral ACL bundle tear, off the femoral origin. The anteromedial bundle remains mostly intact, maintaining length.

video #2 microfracture awls to the origin/attachment site, providing healing factors from the bone. Note how the ligament still "reaches" the femur after debridment “clean-up”...

video #3 "luggage tag" type suture anchor repair to the femur. This will then be augmented with "stem cell"; injected into both the ligament itself and, after portal suture closure, the knee joint. This construct can be re-inforced with a load-sharing device such as the Artelon Flexgraft, to aid in repair & healing strength.

The native ligament is saved & rehab time is faster vs. reconstruction. In that respect, it is similar to the BEAR ACL repair construct...



Kelly Cunningham MD

Board-certified Orthopedic Surgeon

Austin OrthoBiologics | austinorthobio.com | (512) 410-0767

Austin, Texas | [email protected]

Fellowship trained Sports medicine Arthroscopy & Orthopedic Regenerative medicine specialist

Office & Surgical Options:

PRP (Platelet Rich Plasma) & Cell-Based (formerly called "Stem Cell") Therapy

Proximal ACL Tear Repair of the Knee Utilizing Cellular Therapy (“Stem Cell”)

Consider HSA & FSA Spending Accounts for Biologic Joint Treatments: Kelly Cunningham, MD: Regenerative Medicine Specialist 05/20/2023

PRP and Cell-based "Stem Cell" treatments of the knee, shoulder & hip are a covered expense in Flex & health saving accounts.

Read more on Dr. Cunningham's recent article discussing the use of HSA & FSA spending accounts for biologic joint treatments at:

https://www.austinorthobio.com/blog/consider-hsa-fsa-spending-accounts-for-biologic-joint-treatments

To learn more about Dr. Cunningham's practice, please contact us!

Kelly Cunningham MD
Board Certified Orthopedic Surgeon
Austin Ortho+Biologics | austinorthobio.com | (512)410-0767
Fellowship trained sports medicine Arthroscopy and regenerative medicine specialist

PRP and cell-based (formerly "stem cell") therapy, either office-based &/or combined w/ surgery

Knee & shoulder cartilage injury/arthritis specialist, delay or avoid joint replacement.

Consider HSA & FSA Spending Accounts for Biologic Joint Treatments: Kelly Cunningham, MD: Regenerative Medicine Specialist PRP and Cell-based "Stem Cell" treatments of the knee, shoulder & hip are a covered expense in Flex & health saving accounts

Hitting the Slopes This Season?: Kelly Cunningham, MD: Regenerative Medicine Specialist 03/16/2023

Dr. Kelly Cunningham, a former US Ski team physician for the men's downhill athletes, weighs in on the prevention & care of snow ski injuries. Read his thoughts in his recent article, "Hitting the Slopes This Season?" at:

https://lnkd.in/gbgvPA73

Dr. Kelly Cunningham, a Board Certified Orthopedic Surgeon trained in Sports Medicine, is the area's leader in regenerative sports medicine and is skilled in the emerging science of Cell-based (“stem cell”), PRP-platelet plasma, and other innovative treatment protocols. He specializes in both knee and shoulder surgical treatments, as well as non-surgical arthritis treatment options.

Kelly Cunningham MD
Austin Ortho+Biologics
Austin, Texas
Board-certified, Orthopedic Surgery
Regenerative Sports Medicine

Hitting the Slopes This Season?: Kelly Cunningham, MD: Regenerative Medicine Specialist Dr. Kelly Cunningham, a former US Ski team physician for the men's downhill athletes, weighs in on prevention & care of snow ski injuries.

02/08/2023

Kelly Cunningham MD, of Austin OrthoBiologics has again been named a "Top Texas Doctor" for 2022, as named by Texas Monthly magazine.

The award "recognizes outstanding doctors who have obtained a high degree of ... professional achievement, as selected by their peers".

This is the seventh time that Dr. Cunningham, who is board-certified in orthopedic surgery and specializes in regenerative and biologic sports medicine, has been selected.

After decades in practice in Austin, he utilized cutting-edge office- and surgical-based treatment modalities for acute & chronic injuries of the knee, shoulder, elbow, ankle & hip.

Patient-specific treatments often merge arthroscopic/day surgery techniques with cell-based (formerly "stem cell') & PRP "platelet-rich plasma" modalities, with the goal of more rapid return to recreational activities, including the delay or even avoidance of joint replacement surgery.

Most arthritis issues can be addressed with injectable treatments in an office setting, with minimal downtime. Likewise, knee ACL and cartilage ski injuries offer innovative new treatment options, such as the BEAR &/or "stem cell" implants.

Dr. Cunningham is available for consultation at his new Westlake office at 5300 Bee Cave Rd., Bldg 1, Suite 260.

austinorthobio.com

Reach us at: 512-410-0767 | [email protected]

Kelly Cunningham MD

Austin OrthoBiologics

Austin, Texas

Board-certified, Orthopedic Surgery

Regenerative Sports Medicine

Advanced Knee Meniscus Repair: Role of Biologics 01/05/2023

Advanced Knee Meniscus Repair: Role of Biologics More complex tear-types are reparable with advanced techniques augmented by biologics such as PRPVideo appeared to be an irreparable posterior horn me...

Advanced Knee Meniscus Repair: Role of Biologics 01/05/2023

More complex tear-types are reparable with advanced techniques augmented by biologics such as PRP.

Youtube Link: https://lnkd.in/g3vfV6Wi

Video #1
What appeared to be an irreparable posterior horn meniscus tear is actually treatable with partial resection (basket/shaver) of the avascular areas, followed by salvage of a substantial portion of the vascular (blood-tinged) horizontal tear component. This is a tear type that has only recently been deemed reparable by evolving arthroscopic techniques.

Video #2
After all-inside mattress suture/anchor placement, the repaired & stabilized posterior meniscus is augmented by autologous (patient's own) PRP injection - both in the repair site & in the joint. This should improve the healing potential of this difficult tear-type & help preserve knee cartilage function, lessening the risk of degeneration with time & activity.

The role of orthobiologics such as PRP (platelet rich plasma) and cell-based (formerly "stem cell") therapy is expanding to include novel surgical as well as office applications, all in an effort to improve the healing power of knee, shoulder & hip sports injuries.
Likewise, joint arthritis may often be treated in similar fashion, delaying or avoiding joint replacement.

Kelly Cunningham MD
Austin OrthoBiologics
Board-certified orthopedic surgeon, Regenerative sports medicine

Come see us at our new, convenient Westlake location
5300 Bee Cave Rd, Bldg 1, Suite 260
Austin, TX 78746
512 410 0767
austinorthobio.com | [email protected]

Advanced Knee Meniscus Repair: Role of Biologics More complex tear-types are reparable with advanced techniques augmented by biologics such as PRPVideo appeared to be an irreparable posterior horn me...

FSA and HSA accounts can be used for Biologics: Kelly Cunningham, MD: Regenerative Medicine Specialist 11/13/2022

FSA and HSA accounts can be used for Ortho Biologics treatments such as PRP and cell-based (formerly “stem cell”) therapy.

Read Dr. Cunningham’s thoughts in this recent article at:
https://lnkd.in/gNRKXiyq

Kelly Cunningham M.D.
Austin Ortho+Biologics
Board Certified Orthopedics, Sports Medicine
Office & Surgical Options:
Cell-Based Therapy (formerly called “Stem Cell”) & PRP (Platelet Rich Plasma) Therapy

FSA and HSA accounts can be used for Biologics: Kelly Cunningham, MD: Regenerative Medicine Specialist As the end of the year approaches, why not use either Flexible or Health Savings Account dollars to get knee, shoulder or hip pain relief?

Thoughts on the BEAR Knee ACL Implant: Kelly Cunningham, MD: Regenerative Medicine Specialist 10/18/2022

Thoughts on the BEAR Knee ACL Implant: Kelly Cunningham, MD: Regenerative Medicine Specialist This novel procedure, still in the early stages of use and follow-up studies, holds great promise for younger, athletic patients. Several questions need to be a

Thoughts on the BEAR Knee ACL Implant: Kelly Cunningham, MD: Regenerative Medicine Specialist 10/13/2022

“Thoughts on the BEAR Knee ACL Implant”

Read Dr. Cunningham’s professional opinion on the recent Wall Street Journal article, ("An ACL Tear That Heals Itself?", WSJ 9/3/2022), as an orthopedic surgeon that utilizes regenerative sports medicine treatments at:
https://www.austinorthobio.com/blog/thoughts-on-the-bear-knee-acl-implant

WSJ Article:
https://www.wsj.com/articles/an-acl-tear-that-heals-itself-11662564861

Kelly Cunningham M.D.
Austin Ortho+Biologics
Board Certified Orthopedics, Regenerative Sports Medicine
Office & Surgical Options:
Cell-Based Therapy (formerly called “Stem Cell”) & PRP (Platelet Rich Plasma) Therapy

Thoughts on the BEAR Knee ACL Implant: Kelly Cunningham, MD: Regenerative Medicine Specialist This novel procedure, still in the early stages of use and follow-up studies, holds great promise for younger, athletic patients. Several questions need to be a

Patella Cartilage Graft in a Young Athlete: Kelly Cunningham, MD: Regenerative Medicine Specialist 08/30/2022

"Patella Cartilage Graft in a Young Athlete"

Read Dr. Cunningham's surgery on a young athlete where he performed a complete articular lesion coverage with improved & stable patella tracking.

https://www.austinorthobio.com/blog/patella-cartilage-graft-in-a-young-athlete

Kelly Cunningham MD
Austin Ortho + Biologics
Board-Certified Orthopedics & Sports Medicine
Office & Surgical options:
Cell-Based (formerly called "Stem Cell") & PRP (Platelet Rich Plasma) Therapy

Patella Cartilage Graft in a Young Athlete: Kelly Cunningham, MD: Regenerative Medicine Specialist Still symptomatic months after patellofemoral subluxation and arthroscopic debridement/Carticel autograft harvesting - Definitive re-surfacing and re-alignment

A Re-Look at the Value of Cell-Based (Formerly "Stem Cell") Therapy: Kelly Cunningham, MD: Regenerative Medicine Specialist 07/11/2022

"Dr. Kelly Cunningham takes a re-look at the value of cell-based (formerly “stem cell”) Therapy in Orthopedics, specifically injection of subchondral bone"

Read Dr. Cunningham’s current thoughts on the use of this regenerative medicine technique in this article at https://www.austinorthobio.com/blog/a-re-look-at-the-value-of-cell-based-formerly-stem-cell-therapy

Kelly Cunningham MD
Austin Ortho + Biologics
Board-Certified Orthopedics & Sports Medicine
Office & Surgical options:
Cell-Based (formerly called "Stem Cell") & PRP (Platelet Rich Plasma) Therapy

A Re-Look at the Value of Cell-Based (Formerly "Stem Cell") Therapy: Kelly Cunningham, MD: Regenerative Medicine Specialist Experience after the study by the esteemed Dr. Philip Hernigou of Paris reveals the long-term success of bone marrow-derived cell-based therapy in knee arthriti

Ortho+Biologics Is...: Kelly Cunningham, MD: Regenerative Medicine Specialist 06/06/2022

"Ortho+Biologics is"

Read Dr. Cunningham’s current thoughts on the use of regenerative medicine technique ms in this article at https://www.austinorthobio.com/blog/orthobiologics-is

Kelly Cunningham MD
Austin Ortho + Biologics
Board-Certified Orthopedics & Sports Medicine
Office & Surgical options:
Cell-Based (formerly called "Stem Cell") & PRP (Platelet Rich Plasma) Therapy

Ortho+Biologics Is...: Kelly Cunningham, MD: Regenerative Medicine Specialist Facts and myths of regenerative medicine treatment PRP & Cell-based "Stem Cell" Therapy defined...

An Alternative Method of Meniscus Root Tear Fixation with Biologic Augmentation: Kelly Cunningham, MD: Regenerative Medicine Specialist 04/28/2022

"An Alternative Method of Meniscus Root Tear Fixation with Biologic Augmentation"

Read Dr. Cunningham’s thoughts in this article at https://www.austinorthobio.com/blog/an-alternative-method-of-meniscus-root-tear-fixation-with-biologic-augmentation

Kelly Cunningham MD
Austin Ortho + Biologics
Board-Certified Orthopedics & Sports Medicine
Office & Surgical
Cell-Based (formerly "Stem Cell") & PRP (Platelet Rich Plasma) Therapy

An Alternative Method of Meniscus Root Tear Fixation with Biologic Augmentation: Kelly Cunningham, MD: Regenerative Medicine Specialist An alternative method of meniscus root tear fixation with biologic augmentation performed by Dr. Kelly Cunningham.

TRIBEZA January 2022 Wellness Issue 01/17/2022

Tribeza Austin lifestyle magazine profiles Dr. Kelly Cunningham of Austin OrthoBiologics in the January, 2022, issue on healthcare, with answers to questions about orthopedic regenerative medicine, PRP & Cell-based therapy.
https://lnkd.in/ej4Urs3j

https://lnkd.in/epCkvTDV

TRIBEZA January 2022 Wellness Issue Read TRIBEZA January 2022 Wellness Issue by TRIBEZA Austin Curated on Issuu and browse thousands of other publications on our platform. Start here!

Have you been told that you need arthroscopic surgery of the knee?: Kelly Cunningham, MD: Regenerative Medicine Specialist 12/07/2021

Have you been told that you need arthroscopic surgery of the knee?

Read Dr. Cunningham’s thoughts in this article at https://lnkd.in/g3-5afb6

Kelly Cunningham MD
Austin Ortho + Biologics
Board-Certified Orthopedics & Sports Medicine
Office & Surgical
Cell-Based (formerly "Stem Cell") & PRP (Platelet Rich Plasma) Therapy

Have you been told that you need arthroscopic surgery of the knee?: Kelly Cunningham, MD: Regenerative Medicine Specialist The pros and cons of knee surgery can be discussed with a board certified orthopedic surgeon skilled in regenerative medicine techniques, to find what is the b

Title: An Unusual Knee Cartilage Graft "Complication": Kelly Cunningham, MD: Regenerative Medicine Specialist 11/03/2021

An Unusual Knee Cartilage Graft “Complication”

Read Dr. Cunningham’s thoughts in this article at https://austinorthobio.com/blog/title-an-unusual-knee-cartilage-graft-complication.

Kelly Cunningham MD
Austin Ortho + Biologics
Board-Certified Orthopedics & Sports Medicine
Office & Surgical
Cell-Based (formerly "Stem Cell") & PRP (Platelet Rich Plasma) Therapy

Title: An Unusual Knee Cartilage Graft "Complication": Kelly Cunningham, MD: Regenerative Medicine Specialist Dr. Cunningham, as an expert in arthroscopic and open surgical cartilage grafting for knee and shoulder injuries, present an interesting follow up of an allogra

The "Holy Grail" of Joint Arthritis Treatment: Kelly Cunningham, MD: Regenerative Medicine Specialist 09/30/2021

An excellent lay article on the future of joint arthritis care, from the Wall Street Journal.

Our “Austin OrthoBiologics” take on the research…

https://www.austinorthobio.com/blog/the-holy-grail-of-joint-arthritis-treatment

The "Holy Grail" of Joint Arthritis Treatment: Kelly Cunningham, MD: Regenerative Medicine Specialist With millions of Americans suffering from knee, hip & shoulder arthritis pain, future treatment may hinge on prevention & perhaps repair rather than replacement

A New Tool for the arthroscopist's kit 08/26/2021

A New Tool for the Arthroscopist's Kit

Interesting case of an athletic male in his late 30s with right knee pain; MRI shows "intermediate" medial condyle signal and no meniscus tear, with a previous resection. He hasn't responded to conservative care.

What is one to do?

My evolving plan for patients like this, when the MRI is equivocal and the patient is not improving, is to consider evaluating another "piece of the puzzle" - the poorly visualized (by MRI) chondral articular cartilage.

This can be done by office or procedure room-based "needle" arthroscopy ( I use the Arthrex Nanoscope system). In this case, "intermediate signal" turns out to be grade 3 articular cartilage changes with obvious mechanical impingement of flap tears and delamination, in addition to a small recurrent medial meniscus tear. I could also clearly see that there were no full thickness areas of damage.

None of these specific findings were forthcoming on the scan.

Now, I can plan a definitive procedure; whether or not a chondral graft/resurfacing is indicated (in this case, just debridement), and appropriate CPT coding for the staged/treating arthroscopy, which should also facilitate proper reimbursement.

Dr. Kelly Cunningham Board Certified Orthopedic Surgeon

Austin OrthoBiologics are your experts in Orthopedic regenerative sports medicine, utilizing cellular "stem cell" and PRP therapy for the treatment of joint and musculoskeletal problems, including shoulder, knee, hip, elbow and ankle.

https://youtube.com/shorts/UiL_oVTyrmY?feature=share

A New Tool for the arthroscopist's kit Interesting case of an athletic male in his late 30s with right knee pain; MRI shows "intermediate" medial condyle signal and no meniscus tear, with a previo...

Bone Marrow Concentrate (BMC) to Delay / Avoid Knee Replacement Surgery: Kelly Cunningham, MD: Regenerative Medicine Specialist 07/29/2021

Another ingenious, groundbreaking study of the uses of Cellular "stem cell" Therapy for knee arthritis... my take on Dr. Philippe Hernigou's paper re: delay/avoid knee replacement surgery

https://www.austinorthobio.com/blog/bone-marrow-concentrate-bmc-to-delay-avoid-knee-replacement-surgery

Bone Marrow Concentrate (BMC) to Delay / Avoid Knee Replacement Surgery: Kelly Cunningham, MD: Regenerative Medicine Specialist Interesting findings when comparing long-term results of Cellular "stem cell" therapy, referred to as BMC, in avoiding progression to TKA. Two methods are revi

06/15/2021

An Update on "Stem Cell" Therapy

The orthopedic regenerative medicine treatment commonly referred to as “Stem Cell” has evolved as more scientific study and clinical use has occurred.

Current knowledge of the action of these cells on joints, cartilage, tendons and ligaments is one of a paracrine “signaling” function, attracting the patient’s own healing growth factors, multi-potent cells, macroglogulins and IRAP, fancy terms for blood-borne healing factors that are concentrated for long-term action at the site of injury.

Reference to “Stem Cell”, MSC, mesenchymal stem/stromal cell will eventually fade, as these terms are less accurate and outdated by current standards…

For simplicity’s sake, we refer to this mode of treatment as “Cellular Therapy”. It is still most commonly harvested/concentrated from a patient’s own bone marrow (or occasionally fat).

Thus, for complete transparency –

Cellular Therapy “Stem Cell”

Bone Marrow Aspirate BMC



Kelly Cunningham MD

Austin Ortho Biologics

PRP and Cellular Therapy Specialist

Board-certified Orthopedic Surgery

Trimming & Ablation 05/25/2021

After trimming & ablation “sculpting” of the medial meniscus rim, a root tear of the posterior horn is observed & probed to demonstrate instability. Note the grade 3 cartilage changes of the overlying femur.

Kelly Cunningham, MD
Austin OrthoBiologics.
PRP. Cellular “Stem Cell” Therapy

Trimming & Ablation After trimming & ablation "sculpting" of the medial meniscus rim, a root tear of the posterior horn is observed & probed to demonstrate instability. Note th...

Suture Repair 05/25/2021

After suture repair (augmented by PRP), the re-attached root is stable, hopefully to restore some protective cushion with weight-bearing. The femur cartilage needs more clean up...

Kelly Cunningham
Austin OrthoBiologics.
PRP. Cellular “Stem Cell” Therapy

Suture Repair After suture repair (augmented by PRP), the re-attached root is stable, hopefully to restore some protective cushion with weight-bearing. The femur cartilag...

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Kelly Cunningham MD : Austin Orthopedic Biologics

Orthopedic Surgery. Sports and Regenerative Medicine

Dr. Kelly Cunningham, a board certified orthopedic surgeon, is Austin’s joint & cartilage restoration expert, utilizing the latest non-surgical & surgical

Videos (show all)

Video 2: An all-inside loop suture & mattress root repair with adjuvant PRP. This seems more anatomic here than pull-thr...
Video 1:  Medial meniscus root tear, with Grade 4 medial condyle.               Do You Fix This?   If so, How?

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Helping You With Your Dizziness & Balance Disorders

Hutch Health Services Hutch Health Services
208 W. Powell Lane
Austin, 78753

Concierge sports physical therapy and strength coaching serving Austin, Texas. Hutch Health Services

Life Line Screening of America Life Line Screening of America
901 S Mopac Expressway
Austin, 78746

Leader of annual screenings for stroke & heart disease risk. Our highly trained technicians identify potential disease and you will receive an accurate physician reviewed report of...

ENT & Allergy Center of Austin ENT & Allergy Center of Austin
2765 Bee Caves Road Suite 205
Austin, 78746

The ENT Center of Austin Serving Cedar Park, Round Rock and Central Austin, Texas. Home of the Sinus

The Timothy Center The Timothy Center
11754 Jollyville Road Ste 110
Austin, 78759

A place for adolescent and family healing.