Drs. Guettler and Bicos part of national study on Cartilage Restoration!

Drs. Guettler and Bicos are part of a national study looking at Cartilage Restoration.

The goal is to use patients’ own cells to repair cartilage defects in the knee.

Here is the article as taken from www.clickondetroit.com

The story can be found here.

Dr. Bicos discusses Jones fractures from Kevin Durant’s Injury

Dr. Bicos was asked by Beaumont Hospital to discuss Jones fractures in regards to Kevin Durant’s injury.

This is the surgical fixation for a Jones fracture.  A screw can be seen in the 5th metatarsal bone.  (Note:  This is NOT a picture of Kevin Durant's foot)

This is the surgical fixation for a Jones fracture. A screw can be seen in the 5th metatarsal bone. (Note: This is NOT a picture of Kevin Durant’s foot)

Click here to read the article…

Dr. Bicos is an Assistant Professor in Orthopedics at the Oakland University William Beaumont School of Medicine

Subchondroplasty Procedure for Knee Pain

Often times, patients come into the office complaining of knee pain without one specific injury. When discussing their case, many things “look” negative — such as their x-rays and even their physical examination. What we are finding is that something called Bone Marrow Lesions (BMLs) can be causing their pain, and we have a new minimally invasive technique, called the Subchondroplasty Procedure that can relieve their pain.

What is Subchondroplasty?
The Subchondroplasty® (SCP®) procedure is a minimally invasive surgery designed to access and treat bone defects associated with chronic bone marrow lesions (BMLs) by filling them with a biomimetic bone substitute material (BSM).

SCP® leads to healing as the BSM is resorbed and replaced with new, healthy bone.

How are BMLs diagnosed?
BMLs can only be seen on certain MRI sequences, where they are marked by edmatous or “inflamed” areas that have been shown to represent a healing response surrounding a microscopic insufficiency fracture within the subchondral bone. Below is an example of an MRI with a BMLs. Notice how there is a bright area in the center of the bone.

MRI of Bone Marrow Lesions (BMLs).  The bright white areas show stress in the bone that is a result of micro-cracks.  These cracks can be the result of early arthritis. (Taken from Zimmer Knee Creations Website)

MRI of Bone Marrow Lesions (BMLs). The bright white areas show stress in the bone that is a result of micro-cracks. These cracks can be the result of early arthritis. (Taken from Zimmer Knee Creations Website)

What is the procedure?
The procedure is based on standard theories of fracture healing. Since the BMLs are a sign of micro-cracks in the bone, the theory is to fill those defects with a natural calcium cement that stabilizes the micro-cracks so that your pain goes away. Then with time your body also resorbs the calcium cement.

Below is a picture outlining the procedure. The subchondroplasty is a same-day procedure done with minimally invasive techniques. Often times, you are left with only a couple of small “poke holes” in the skin.

This is a graphic showing the subchondroplasty procedure.  (Taken from Zimmer Knee Creations website)

This is a graphic showing the subchondroplasty procedure. (Taken from Zimmer Knee Creations website)

How do I know if Subchondroplasty is right for me?
Dr. Bicos is trained in the procedure, and as always he would be happy to see you for a consultation to evaluate your specific knee problem to see if you are a candidate. There are many options — even if you do not qualify for the Subchondroplasty procedure, there are usually other treatment choices you can consider.

More specifically for the Subchondroplasty:
Does this describe you?

    — I have experienced symptomatic knee pain for 3+ months
    — I have increasing discomfort when walking or standing
    — I have seen limited benefits from NSAIDs, bracing, injections or physical therapy
    — My symptoms returned after an arthroscopy

If you answered yes to the questions above, you may be a candidate for the procedure!

Subchondroplasty Quick Facts

    — Utilizes a minimally invasive technique
    — Performed in a outpatient setting
    — Requires a short rehabilitation period
    — Future treatment options remain open
For more information on Subcondroplasty — please visit their website.

Find Dr. Bicos’ Bio here.

Please call us at 248-988-8085 for an appointment with Dr. Bicos!

11th Annual Sports Medicine Conference!  Sports Medicine from Head to Toe…

Come to the 11th Annual Performance Orthopedics Sports Medicine Conference. The conference will be held on May 3, 2014 at the William Beaumont Hospital, in the West Auditorium in the Administration Building. Join us of a day of training and informative seminars.

11th Annual Sports Medicine Conference

11th Annual Sports Medicine Conference

Sports Medicine Flyer

Beaumont seeks participants for a research study of a cartilage tissue implant for knee injuries

Beaumont Health System is participating in a research study evaluating an investigational treatment called NeoCart®, a tissue implant made from a patient’s own cells, aimed at repairing certain knee cartilage injuries.

(Original article here)

A total of 245 patients will participate in the research of the surgical implant procedure in up to 40 sites across the United States. Approximately 20 patients at Beaumont will participate.

guettler_surgery
Beaumont orthopedic surgeon
Dr. Joe Guettler, principal
investigator of the study.

Orthopedic surgeons Joseph Guettler, M.D. and James Bicos, M.D. will be leading the study at Beaumont.

The research study will look at damage to the knee’s hyaline articular cartilage, the smooth, white tissue that covers the ends of bones where they come together to form joints. Damage to this cartilage may be caused by an injury or repetitive motion. It is a common problem that results in pain and symptoms, such as swelling, locking of the knee and loss of knee function. Damaged hyaline cartilage has limited capacity to repair or restore itself. Left untreated, the damage may progressively worsen and may lead to chronic conditions such as osteoarthritis.

To perform the procedure, the surgeon first obtains a sample of healthy cartilage from the patient’s knee. The small sample is treated and placed under special conditions in the laboratory that allow for cell growth. These cells are used to form a hyaline-like cartilage tissue implant that is in the shape of a small disc. The implant is then returned to the surgeon for surgical implantation into the patient’s injury site in the knee.

“The current standard of care for knee cartilage injuries is a cartilage-repair surgical technique called microfracture which works by creating tiny fractures in the underlying bone. This procedure is thought to create new cartilage-building cells from a so-called super-clot,” explains Dr. Guettler, principal investigator of the study.

“The purpose of the study is to evaluate the effectiveness of the tissue implant compared with microfracture. We will evaluate the pain and knee function in both treatment groups,” says Dr. Bicos, the study’s co-investigator.

“The possibility of implementing a preventive treatment aimed at undermining the inevitable consequences of degenerative arthritis could be a very significant advancement,” says Dr. Guettler.

Criteria
Patients 18 to 55 years old who have symptoms of knee pain in one knee may be candidates for this study. However, those who have previously failed other treatments or smoke more than one pack of cigarettes per week may not be eligible.

Patients accepted into the study will have a random chance of being treated with the implant versus microfracture. Neither the patient nor the physician may choose the treatment. Patients in each group will have a specific rehabilitation plan and will be evaluated periodically for three years after treatment.

The study sponsor is Histogenics Corp. For more information, visit www.clinicaltrials.gov keyword “NeoCart Phase III” or contact Beaumont Research Nurse Clinician, Lisa Stellon at 248-551-6679 or at lisa.stellon@beaumont.edu.

About Beaumont Orthpedic Services
Beaumont Health System provides a full range of specialized care in the diagnosis, treatment and rehabilitation of all orthopedic injuries and conditions. Beaumont’s department of Orthopedic Surgery offers leading-edge treatments and technology including minimally invasive surgery, implants and trauma surgery. Beaumont is Michigan’s most experienced orthopedic hospital specializing in surgeries of the back, neck, foot, ankle, hand and upper extremities; hip and knee replacement; scoliosis treatment; tumor surgery; pediatric orthopedics; and sports medicine. Beaumont Hospital, Royal Oak is Michigan’s top-ranked hospital for orthopedic care by U.S. News & World Report. Find out more at http://orthopedics.beaumont.edu/.

Dr. Bicos to Discuss Shoulder Pain — Free Lecture!!

Dr. Bicos will discuss the common causes of shoulder pain at The Community House in Birmingham, Michigan on April 23 from 6:30 to 8:30 PM.

Registration is free!!

If you have shoulder pain and want to know a little bit more about why you have it and what the treatment options are, please sign up for this informative lecture.

You can register here.

The Tommy John Injury:  Myths Debunked

With the baseball season in full swing (literally), we are seeing an increased incidence of elbow injuries…especially in pitchers.

Tommy John

Tommy John

The ulnar collateral ligament (UCL) is a ligament on the inside of the elbow that can get torn, stretched, or frayed with a significant amount of throwing. An injury to the ligament, also called the Tommy John ligament can be devastating to a pitchers career. Techniques to reconstruct the ligament have improved over the years and more athletes are returning to a high level of play.

Ulnar collateral ligament repair -- Tommy John Surgery)

Ulnar collateral ligament repair — Tommy John Surgery)

With the upswing in the injury of this ligament, there are also multiple myths that surround this injury and its treatment.

Here are the myths debunked by your very own Dr. Bicos…

1) If I play in multiple leagues, I just have to watch my pitch count for each league and not the total count combined.

    – Wrong!! First of all you should not play on multiple leagues. Studies have shown that athletes who play on multiple leagues have a higher likelihood for severe elbow injuries. Second, the pitch count is the total pitch count for both leagues combined. Just because you are under the limit for both leagues does not mean that you are OK. It is the total pitch count. The players, parents, and coaches need to be responsible and realize the importance of pitch counts and make sure that the athletes do not exceed them in total for all the leagues they are in.

2) If I have the Tommy John surgery, that will make me better than I was before.

    – Wrong!! Players believe that if they make the UCL tighter (“zipping up the ligament”), then this will add speed to their pitches. This is not true. Surgery should only be done when the ligament is torn or degenerated to the point that the player loses accuracy, speed, and has pain. In addition, surgery has its own risks such as infection, post-operative pain, and occasionally loss of motion. If you are not having pain, do not have the surgery.

3) The ligament tears with one bad throw.

    – Wrong!! Although athletes describe a pop at the elbow when the ligament tears, there are usually symptoms that have been at the elbow for quite some time before the tear. This means that you should take elbow pain very seriously because it could be the start of a pathway the leads to UCL rupture. Being proactive can save you a surgery and a year’s worth of rehab.

4) Full recovery after the Tommy John surgery is over a year.

    – Correct!! Full recovery from the Tommy John surgery is typically 12 – 16 months.

Take home point…

Elbow injuries are on the rise in overhead throwing athletes. It is typically because of overuse and the superman (or superwoman) mentality that “I cannot get hurt.” These injuries are real and they do not discriminate between sports or talent. Give your self time to rest and let someone know if you are having elbow pain when throwing. Remember that the physicians at Performance Orthopedics are here to keep you in the game, whatever your game may be.

Play Ball!!

Justin Verlander

Justin Verlander

How to get your child started in sports

This is a great article on how to get your child started in sports.

Remember that the main reason for starting children in sports is for the lifelong benefits from exercise.

Kids_and_sports

Listen to your child for clues of burnout from sports!

The article is from In Motion: Active Living for All Ages.

You can read the article here.

Catch Dr. Bicos on BCTV!

Dr. Bicos does an interview with The Community House on his upcoming shoulder lecture in April.

You can catch the show this week:

Tuesday at 7:30pm
Wednesday at 8pm
Friday at 2pm

Comcast Customers:
In Bloomfield Hills and Bloomfield Township BCTV is on Channel 15. In Birmingham, Beverly Hills, Franklin and Bingham Farms BCTV is on Channel 18.

AT&T/U-verse Customers:
In Bloomfield Hills, Bloomfield Township, Birmingham, Beverly Hills, Franklin and Bingham Farms BCTV is on Channel 99.

WOW! Customers:
In Birmingham, Beverly Hills, Franklin and Bingham Farms BCTV is on Channel 18. BCTV is not available to Bloomfield Customers on WOW!