Next week I am going in for elbow surgery to fix chronic tendinitis.
The doctor is asking if I want “biologic” treatments done at time of surgery, but isn’t providing much information on the 2 options. One is called platelet-rich plasma therapy and the other is called Amnion, which is something related to amniotic fluid.
Does anyone know about this? Had it done? I have to decide soon if I want either and there is very little online about the effectiveness of either. Insurance doesn’t cover either. Both are nearly $1,000 out of pocket in addition to the other costs of the surgery.
From what I’ve read, the platelet rich plasma therapy is where they basically centrifuge some of your own blood components (platelets and other stuff) out, and then slather them on the surgical wounds, and the excess of these platelets and other stuff helps it heal faster and more completely versus the natural concentration in your own blood.
The only study I could find was preliminary, and was using platelet-rich plasma therapy instead of surgery, but the results were promising. There aren’t large-scale, controlled studies that establish it as effective.
Amnion appears to be stem cells from the inside layer of the placenta. This also appears to fit under the heading of “it should work but has not yet been definitely proven”.
Good luck with the surgery no matter what you decide.
Thank you both for the replies. I have a good understand on what both do, but there just doesn’t appear to be hard evidence it works right now.
I also am turned off by the doctor trying to sell me extra shit. I’ve also gotten a call about leg compression things to prevent clots and some sort of ice sleeve as well. Insurance covers none of it.
Platelet-rich plasma treatment is a great example of an utterly unproven therapy taking hold as a result of a) the profit margin to the MD/hospital and b) many patients wanting not just the latest treatment but especially one that involves ‘stem cells’, ‘autologous cells’, ‘biologics’, etc.
But mostly it’s the money.
(I did a quick PubMed search and there seem to be no good, and few positive, trials of the therapy)
They are really up-selling you. I would do the leg compression, but that’s all. You might be able to buy your own compression socks and save that expense. The ice sleeve is worthless, IMO.
The 2 biologic treatments are not necessary for a good outcome.
Sounds like the doc has got a new boat or vacation house that he’s trying to pay off. That’s the normal case when physicians start trying to upsell you on procedures.
This would piss me off. If it happened to me I would decline everything and maybe even find a new surgeon, if not question the diagnosis and treatment itself.
It would piss me off too. Perhaps so far as to ask why the surgeon is using unproven procedures and charging me for the being the subject of an experimental trial. Of course you’ll likely be needing a different surgeon after this conversation.
They sell “ice sleeves” at Walgreens for maybe $30, I think. I have elbow tendonitis, too, and I bought one of these for myself. They’re a tube of gel-pack stuff that gets freezing cold but remains flexible, and it’s sewn into a tube of elasticiized fabric that also provides some compression. They do help with swelling and inflammation, but if he’s wanting to sell you a fancy one at a high price, you can just get the Walgreen one. I’m not sure, but I think they might be reimbursable through a flex plan, if you have one.
The leg compression things: is that for when you’re in the hospital? If so, it’s a bit shocking, as I thought those were pretty standard treatment for anyone undergoing surgery that might immobilize them. I know I had them when I had my gallbladder yanked (though not after I left the hospital).
Thanks everyone for the replies. The surgery is tomorrow morning and I decided not to do the PRP or amniotic fluid shot. Also, I turned down the “cooling sleeve” and compression sleeve things. I think I’ll manage fine without all this.
Kind of nervous because it’s going to hard to function without use of my right arm for a few weeks. Shall be interesting!
Some hints for surviving one-armed (from my wrist surgery last year):
If you’re using a sling, you can tuck small items in there for walking around the house. I wouldn’t count on that as a secure carrying option when out and about, as it’d be too easy to have something slide out and get lost. Some slings actually have little pockets for this purpose.
The hospital will probably have put you in a sling that absolutely sucks. Mine had almost no neck padding, the length adjustment was scratchy velcro right by the thin layer of foam “padding” and gouged my neck constantly. I bought a better one from Amazon.
Not sure whether you’re XX or XY, but if bras are an issue, there’s a gadget called a Bra Angel that can help with fastening them. Amazon carries them but I found one for half the price at another site. I personally did not like it, had no luck with it, so I gave it to my OT to offer to other patients. I bought several stretch bras from Decent Exposures, which were much easier to get on solo - though harder to take off, oddly.
Flossing your teeth: I bought one of these and it worked quite well.
Holding my cell phone: I used an Otterbox case with the belt-clip holder, with the clip part held open, so I could hook it over my right thumb (my hand was in a cast). While I’m 2-handed again now, I’ve been using a ring holder which I love - I can hook that ring on any finger I want, and it makes it much easier to hold the phone securely without risk of dropping. You may or may not have issues with holding the phone, but you want to minimize the risk of fumbling and needing to make a sudden move to grab it.
I bought a small wallet that zips closed, and has a keyring attachment. I also bought a bungee cord clip to attach to that. Then I used the bungee to attach the wallet to my belt loop. As with the phone, this is partly to reduce the risk of needing to do a sudden movement to grab a fumbled object. It also let me carry a wallet in my pocket versus in a purse, as a purse was difficult to handle. I actually liked this enough that I continue to carry my wallet that way.
Probably NOT an issue for you, but: I work primarily from home. I don’t sit at a desk; I work in the family room. I always had my laptop on a lap desk - but I couldn’t manage that one-handed. So I bought a rolling table that pulls up to the couch, and my computer lived on that. Still does, actually.
I was surprised at how much trouble I had with typing. I had a vague idea that I could manage well enough with thumb and index finger on that hand; it turned out the index finger was completely inaccessible and using my thumb entailed some movements that were… unpleasant. I actually got Dragon software from work when I went back. Hopefully your hand won’t be quite that restricted. Also, ctrl-alt-delete is VERY hard to do one-handed.
Fastening pants: At the OT’s suggestion, I used a hair elastic looped through the buttonhole on my jeans, to slip over the button. Dunno how that would work with a regular sewn-on button but it worked well with the metal post button on the jeans. Much easier to fasten than trying to actually do the button. Downside: if your pants are loose, this might make them too lose to be safe :).
Shoes that you can slip on, i.e. no laces or buckles. Sheer dumb luck that I had picked up a pair of lined Crocs a couple months earlier; I lived in those for 2 months. This might be less of a problem in warmer weather, but my surgery was done in March and sandals were not a good option.
I suspect that a lot of patients ask about platelet-rich plasma/“biologic” therapy, in part because it’s so popular among athletes (who are remarkably credulous about unproven treatments and supplements in general) and there’s plenty of publicity about it.
I would always want the doc to have a coherent response about the evidence for such treatments and be able to supply me with relevant scientific literature references - large-scale clinical trials and comprehensive reviews preferred.
There’s also a lot of dubious stem-cell therapy going on, but that’s fodder for another thread.
