INJECTIONS
Under ultrasound guidance, Dr. Bedford and his PA Meredith perform in-office injection procedures to treat injuries such as osteoarthritis or tendinitis. Different types of injection procedures treat different conditions. Read more below about injection types and make an appointment to find out which may best suit your needs.
Cortisone
Cortisone, or a steroidal anti inflammatory, is an injectable medication used to quickly bring down acute inflammation. Dr. Bedford may recommend a cortisone injection for new or severe swelling and pain due to a recent injury, trauma, or exacerbation of pre-existing arthritis. It is important to note that cortisone works temporarily, but quickly (most patients report feeling same-day relief).
Cortisone works most effectively in conjunction with other treatment measures such as physical therapy or wearing a brace. The injection itself is minimally painful and you will be able to walk out of the office and carry on with your normal daily routine. The procedure itself lasts less than two minutes.
Cortisone is not appropriate for every area of the body or every type of injury, and is not appropriate if you have an allergy to the components of the medication. A visit to the office is recommended to determine if cortisone is right for you.
Lubricants ("Gel")
Lubricant injections, or viscosupplementation, are injections of a gel-like solution used to treat knee osteoarthritis. Viscosupplementation injections are primarily composed of hyaluronic acid, a substance normally found in the fluid which lubricates joints (called synovial fluid). While lubricant injections may take up to four weeks to take effect (i.e. decrease symptoms of knee pain, swelling, and grinding), they are designed to last 6-12 months. They can safely be repeated for years on end every six or more months.
Lubricant injections are often, but not always covered by insurance. This will be determined prior to receiving an injection. If you are a patient waiting to receive your injections, our office will contact you once we have received your medication to help schedule your injection appointments.
Biologics: PRP or BMAC
Dr. Bedford may recommend PRP or BMAC if you are experiencing chronic tendinitis, osteoarthritis, or a small or partial tear (rather than a high grade, large, or complete tear) of a structure. Biologics are not currently covered by insurance and costs vary by procedure. Read more about each procedure below.
PRP, or Platelet Rich Plasma,
contains stem cell derivatives found in blood. Blood is drawn in the office from the front of the elbow (antecubital fossa). This blood is spun in a machine at a high speed for five minutes to separate its components by weight, and the plasma portion is then injected into the affected area. The procedure takes 15 minutes from start to finish.
A series of three injections, once weekly for three weeks, is the current standard of care. The healing effect of PRP is often felt 8-12 weeks (sometimes sooner) following completion of the series, and physical therapy following completion of the series is often crucial to healing. The duration of symptom improvement after PRP varies; however, PRP often lasts years at a time, with some patients never requiring a repeat series of injections.
BMAC, or Bone Marrow Aspirate Concentrate,
contains true stem cells found in bone marrow drawn from the hip bone (iliac crest) during a minimally invasive procedure in the operating room. The bone marrow is then spun in a machine at a high speed for 20 minutes to separate its components by weight, and the concentrated stem cells are then injected into the affected area. The procedure takes about 40 minutes in the operating room with light anesthesia.
BMAC is recommended as a one time injection due to the high concentration of stem cells. The healing effect of BMAC is often felt 8-12 weeks following completion of the injection, and physical therapy following the procedure is crucial to healing. The duration of symptom improvement after BMAC varies; however, BMAC often lasts years at a time, with some patients never requiring a repeat injection.