Non-Operative Services | The Orthopedic Institute of NJ

A doctor and patient discuss non-operative services to ease shoulder pain.

At The Orthopedic Institute of New Jersey, we firmly believe in exploring all non-operative treatment options before considering surgery.

In most cases, surgery isn’t a necessary option for relieving symptoms of orthopedic conditions. Our experienced physicians work closely with our patients to develop a customized course of non-surgical treatment that works best for them to alleviate pain and discomfort caused by acute and chronic orthopedic injuries and illness.

The tools of regenerative medicine help your body heal itself without surgery.

If you’ve seen a doctor for knee, hip or shoulder pain — and you’re frustrated by the fact that you’re still in pain — regenerative medicine might be the right option for you. Regenerative medicine focuses on non-surgical methods (used by Olympic athletes and sports stars) that harness your own body’s healing power.

In addition to injections and oral medications as treatment options, OINJ specializes in these regenerative medicine options:

  • Platelet rich plasma therapy
  • A2M therapy
  • Lipogems therapy
  • Viscosupplementation treatment
  • Percutaneous ultrasonic tenotomy, such as the Tenex Procedure
  • Steroid injections

When you’re looking at options for pain relief, here are a few things to remember about regenerative medicine:

  • It’s a purely natural process
  • There’s little to no risk for allergic reaction or side effects
  • It accelerates the natural healing process
  • No intensive rehabilitation is necessary (unlike surgery)
  • Many patients feel relief within 6-12 weeks

With regenerative medicine, you get the chance to live without pain — and also without surgery or pain medication. This field of medicine has been popular in Europe for several years and is becoming more mainstream in the United States.

Platelet Rich Plasma (PRP) Therapy

Platelet Rich Plasma (PRP) therapy is treatment designed especially for healing your body’s tendons and ligaments. It’s ideal for patients who aren’t ready for surgery or not even surgery candidates. PRP has been scientifically proven to help heal your body.

PRP is created from your own blood, which contains healing factors (growth factors and stem cell markers). These cells are important for tissue repair and regeneration. Platelets, which were once thought only to be responsible for clotting, have been scientifically proven to signal a healing response within your body. Now, scientists understand that platelets are rich in connective tissue growth and healing factors. For example, after you’re injured, your body’s natural and first response is to deliver platelets to the area. These platelets help restore the injured part of your body.

During your appointment, we’ll start with an orthopedic evaluation and standard blood draw. Then, we’ll put your blood into a machine that separates the platelets (growth and healing factors) needed for tissue healing. PRP is the bright layer of fluid with concentrated platelets and growth factors. This layer is purified and concentrated with a state-of-the-art centrifugation filtration machine. This sophisticated centrifugation and filtration process concentrates platelets and growth factors to create the optimal environment for healing within an injured region of the body. Then, it’s injected into the area of injury. Several studies have shown that the amplified concentration of growth factors and stem cell markers in PRP could speed up the body’s natural healing process.

A2M Therapy

If your current treatments aren’t controlling your osteoarthritis or back pain, you may want to consider this innovative therapy. A2M — shorthand for alpha-2-macroglobulin — is a naturally occurring molecule found in your blood. When provided in concentrated doses to a joint, it acts as a powerful protector against cartilage breakdown. A2M attaches to and removes the destructive enzymes — called proteases — that damage cartilage cells in the joint space.

How does it work? In most patients, pain results from the arthritic joint space containing more proteases than the body can handle. And though the A2M molecule is one of your body’s natural defense mechanisms, it has a large, complex structure that makes it unable to enter the joint space naturally in large enough quantities to provide relief. Research has shown that injecting a concentrated A2M solution that’s made from your own blood into a joint or disc space can restore balance and provide pain relief.

A2M treatment can reduce or eliminate your inflammation and pain, prevent further breakdown of your tissue, and restore health to your joint.

Lipogems Therapy

For those suffering from osteoarthritis, rotator cuff or meniscal tears, partial tendon tears such as tennis elbow, and similar conditions, Lipogems therapy may be the answer.

Adipose tissue — what we call “fat” tissue — has been the object of research for many years. The Lipogems system, rigorously reviewed and approved by the FDA for clinical use in 2014, is derived from that research. It is a cutting edge, innovative technology that harnesses the natural reparative capability of your own fat tissue reserves.

A small volume of fat is collected from your midsection using a minimally invasive technique that requires only a very small incision. That fat is then put into a specialized, sterile, system to create the Lipogems tissue, which is then injected into the treatment site.

The Lipogems micro-fragmented injectable fat is used to repair injured or damaged tissue. It provides cushioning and structural support that enhances your body’s natural healing process.

Viscosupplementation Treatment

This type of treatment is ideal if you have osteoarthritis of the knee, one of the leading causes of disability in the United States. Viscosupplementation treatment was approved by the FDA in 1997 and has been perfected over the last two decades to provide longer-lasting relief of arthritic pain.

There is no cure for osteoarthritis. You might have tried the following: weight loss, physical therapy, pain relievers and corticosteroid injections to help manage pain. But if that’s not working, viscosupplementation might be the next step for pain relief.

A viscosupplementation treatment is an injection of hyaluronic acid (a gel-like lubricating fluid) in the knee joint. It’s a more natural alternative than a corticosteroid injection because everyone has an amount of hyaluronic acid in their knees already. However, patients with osteoarthritis have low amounts of hyaluronic acid in their joints. The extra hyaluronic acid from the injection is given to bring the levels back to normal.

The goal of the treatment is to supplement the natural lubrication of the fluid in the joint to help heal injured cartilage, reduce pain, and stimulate the growth of healthy tissue. This type of treatment is offered twice a year. Some patients opt for this treatment as a form of maintenance therapy. It’s an ideal way to minimize the overall wear and tear of the body.

Percutaneous Ultrasonic Tenotomy such as the Tenex Procedure

The Tenex Procedure was developed with Mayo Clinic and alleviates pain for patients with issues with their tendons or fascia. Our musculoskeletal ultrasound expert Dr. Shamim will examine and map the injured areas within the tendon that would benefit from a precisely guided treatment. Areas of the body that can be treated include:

  • Rotator cuff tendons
  • Flexor and extensor tendons of the elbow (tennis elbow or golfers elbow)
  • Gluteal tendons that produce trochanteric bursitis of the hips
  • Patellar tendons
  • Achilles tendon
  • Plantar fascia

This is a minimally invasive treatment, performed in a sterile environment, that aims to provide the body with a second chance to heal correctly from an injury. The goal of the treatment is to remove diseased tissue. Unhealthy tissue makes it harder for blood to flow, and thus harder for the injury to repair itself.

During the procedure, we use an ultrasound to pinpoint the exact area of the scar tissue. By using ultrasonic energy that targets and aspirates necrotic (scar) tissue, healthy tissues remain intact. The procedure takes about 15 minutes.. Afterward, we will put a bandage around the area of incision (no stitches) and most patients say they feel better within a month.

The Tenex Procedure is meant to help the body rejuvenate itself and promote the growth of healthy tissue.

Steroid Injections

Corticosteroid injections are used to help relieve pain and reduce inflammation in the joints of the body including:

  • Shoulder
  • Elbow
  • Wrist
  • Finger joints
  • Spine
  • Hip
  • Knee
  • Ankle
  • Toe joints

Using ultrasound, fluoroscopic or sonographic guidance to ensure accuracy, the corticosteroid medication combined with a local anesthetic is injected into the affected joint. The injection may relieve pain and discomfort resulting in everything from injury following an accident to chronic diseases such as arthritis.

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If you’re ready to get back to things you love without surgery, call 908.684.3005 or email us.

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Meet Our Specialist

Dr. Ferheen Shamim

Dr. Ferheen Shamim, MDOrthopedic Physician
Dr. Ferheen Shamim, MD is a sports medicine physician with The Orthopedic Institute of New Jersey. Board certified by the American Board of Physical Medicine and Rehabilitation.

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To learn more about our comprehensive services, contact us, or to make an appointment with one of our specialists, fill out the appointment form to the right.

The Orthopedic Institute of New Jersey is a premier multi-disciplinary center offering complete orthopedic care, rehabilitation and pain management services to patients of all ages and activity levels using a customized treatment plan to fit individual needs.

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