“Regenerating and rebuilding damaged joints with your own immune system”
The Foot and Ankle Clinic continues to embrace the latest treatment therapies available and are now proud to offer the latest clinical advancements in Tissue Regeneration Therapy (TRT) using varieties of alternate, safe and clinically proven injection therapies. In particular, our Sale clinic based Musculoskeletal and Sports Podiatrist, Dr. James Ferrie, has done extensive research and training to provide him with the necessary skills for providing these unique therapies as well as the expertise and knowledge to diagnose and treat Musculoskeletal injuries of the lower limb.
The clinical applications and indications for each of these treatments vary and are case dependent as are the costs involved. Once you have been thoroughly assessed and diagnosed (including diagnostic imaging such as x-rays or ultrasound) your Podiatrist will provide detailed information and advice regarding the therapy that best suits your condition.
Dr. James Ferrie Your Tissue Regeneration Therapy Expert
About Dr James Ferrie
Dr. Ferrie is The Foot and Ankle Clinic’s Musculoskeletal Podiatrist. Having completed four years bachelor of Podiatry from LaTrobe University in 2011, he developed a strong interest in Musculoskeletal medicine and the innovative way to assessing and treating chronic conditions Musculoskeletal conditions. He has undertaken post-graduate training in blood collection, Platelet-rich plasma, Orthokine, Prolotherapy, Dry needling, Laser therapy and surgery, ECSWT, clinical diagnostic ultrasound and guided injection. He has also trained at the world leading Interventional Orthopedics Foundation in Colorado USA. James is also a teacher of diagnostic ultrasound.
What Conditions can Tissue Regenerative Therapy be used for?
- tendon pain
- tendon and ligament tears
- Nerve pain/entrapments
- chronic pain
- unstable joints
- post surgery pain
- slow healing injuries
- Chronic wounds
Autologous Condition Serum (ACS) and Orthokine
Orthokine Therapy involves the stimulation of your white cells and platelets to produce anti-inflammatory cytokines and growth factors. Successfully used in Germany for over ten years, this therapy consists of collecting your blood, incubating it overnight and centrifugation. Typically, this will produce six cytokine-rich serum samples that are stored in a medical grade freezer (<21°C). This is a natural therapy, and nothing is added to your blood. Both cytokines and growth factors are essential in the healing of injuries and in helping the management of arthritis.
Osteoarthritis is considered an inflammatory condition involving pro-inflammatory proteins circulating within the joint, eroding the hyaline cartilage covering the joint surfaces. Laboratory studies have shown that a patient’s blood treated using the orthokine technique produces a crucial anti-inflammatory cytokine, called IL-1Ra, amongst others. These anti-inflammatory agents are then injected into the joint neutralizing the inflammation and restore the normal joint homeostasis. As a result, there is often a reduction in pain and improvement in joint function. Furthermore, there are fewer pro-inflammatory proteins to erode the joint surface and cause osteoarthritis.
Your Cytokine rich serum is injected into the joint using sterile technique and under ultrasound guidance. A local anaesthetic is injected into the skin which makes the injection virtually pain-free.
How does Orthokine/Supakine Therapy Work?
What Orthokine / ACS Therapy does is help your body over-produce chemicals that shift the balance in favour of anti-inflammatory proteins. The most important of these is Interleukin 1 Receptor antagonist (IL-1Ra). It is a ‘protective’ protein that blocks inflammatory proteins in our joints, the effect of which is to provide relief of pain and inflammation.
Am I suitable for this therapy?
Our Podiatrist is best placed to advise you if you are suitable for this therapy. However, due to the autologous nature of this therapy, most people with joint injuries or degenerative diseases would benefit from this treatment. Patients with mild to moderate osteoarthritis tend to have better results than those with advanced states.
The studies suggest a positive response up to 2 years, but if symptoms return further injections can be performed as recommended by your Podiatrist. Clinical evidence suggest that Orthokine/Supakine may also help to maintain a healthy joint and most likely prevent, or at least slow down the degenerative process. Clinical trial results have shown that Cytokine therapy relieves pain and may delay the need for surgery in some patients. As Cytokine therapy is based on using only substances that originate from the body of the patient, the therapies are well tolerated.
Autologous Blood Injection (ABI)
What is ABI?
ABI is most commonly used for the treatment of diseased tendons, commonly known as tendinitis. It utilises the healing properties of blood and the growth factors found in the platelets.
What does the procedure involve?
The procedure of ABI involves withdrawing whole blood from the patient, usually taken from the patient’s elbow or forearm, and then injecting it into the area of maximal abnormality of the tendon using ultrasound for guidance. No manipulation or concentration of the blood is performed before re-injection.
Ultrasound guidance is used to ensure that the blood is delivered precisely and safely to the area concerned.
Neural Hydro-dissection and Nerve blocks
Rarely, a patient presents with a chronic pain condition that relates solely to nerves. However, in such cases, ultrasound allows practitioners to hydro-dissect affected nerves (this involves administering small amounts of fluid around a nerve to help free it up from surrounding tissue) to help ease chronic pain. Ultrasound evaluation for peripheral nerve abnormalities, such as nerve entrapment disorders and nerve dislocation, is now common at many institutions as part of Musculoskeletal imaging.
Are there any disadvantages to using Ultrasound?
The main disadvantages are operator dependence. The same holds true for MRI, X-ray, and any other diagnostic tool. Ultrasound must be used as an adjunct to treatment. Palpation, physical exam, patient history and practitioner experience are paramount.
What can I expect at my 1st consultation ?
- Listen to you
- Accurate diagnosis from previous scans and on-site ultrasound assessment.
- Physical assessment/biomechanical assessment.
- Develop a tailor-made comprehensive treatment plan to manage your condition.
- Discussing your suitability for a regenerative tissue therapy.
Does it hurt?
We do not believe treatments should be painful. Before your injections, it is common for a nerve block to be performed ensuring a pain-free procedure.
What is the success rates of tissue regenerative treatments?
Success rates are high. 80% of patients receive significant relief after treatment. Success will vary depending on the severity of the condition and general health & age. There are some patients who, due to certain health conditions or medical history, will not be suitable for regenerative injections.
What are the risks?
Tissue regenerative procedures have a proven track record when it comes to safety; complications are very uncommon mainly as these procedures utilise your own cells and very fine needles.
There are some inherent risks which are present for any injection, and these include infection and injury to nerve or blood vessel. At The Foot and Ankle Clinic, we use the latest in clinical ultrasound guidance to ensure best practice, and all laboratory work is conducted in a sterile air environment to provide the highest safety standards.
On-site Musculoskeletal ultrasound
At The Foot and Ankle Clinic’s Sale Practice, Dr. James Ferrie utilises advanced ultrasound imaging onsite, allowing for a comprehensive treatment plan to be established at your initial consultation.
Clinical evidence and research support ultrasound as the first diagnostic test for numerous Musculoskeletal (MSK) conditions. Diagnostic ultrasound offers many important advantages compared to computed tomography (CT) and magnetic resonance imaging (MRI), in terms of safety and effectiveness. Diagnostic ultrasound is noninvasive and offers real-time imaging, allowing for examinations of structures at rest and in motion. This ability to capture the movement of Musculoskeletal components differentiates it from other imaging modalities and can permit more accurate diagnoses.
What are the benefits of onsite ultrasound?
Ultrasound allows for accuracy and safety when performing procedures such a nerve blocks, soft tissue and joint injection. Fast, accurate on-site diagnostic imaging reduces unnecessary therapies and allows for timely treatment of your condition without delay.
Ultrasound-guided joint injections
Ultrasound allows for visualising of musculoskeletal tissue. We can identify the injured tissue in the office without having to wait for an MRI. During treatment, we inject the injured structures and maintain continued needle visualisation of the targeted areas.
On-site Laboratory for Platelet-Rich Plasma Treatment
In most clinics around the world that do Platelet-Rich Plasma treatments, the process of creating the Platelet-Rich Plasma involves extracting a patient’s own blood and running it through a simple automated bedside centrifuge machine to separate the plasma and concentrate the blood platelets, which are then automatically extracted and used for the injection and in some case the blood is not enriched.
These machines are not very good at removing the undesirable cells from the resulting mixture. Our Platelet-Rich Plasma has greater purity, is concentrated and customisable since it is created in a lab environment by a skilled clinician who separates and concentrates all of the blood’s desirable components and removes the undesirable cells.
The laboratory we have onsite also allows for additional blood to be stored in our medical grade freezer. This is so it can be used for future treatments. Our medical grade freezers are temperature controlled and monitored by the latest technology ensuring safety and best practices.
At the Foot and Ankle Clinic our highly qualified team of Podiatrists are all members of the Australian Podiatry Association and offer a combined 50 years’ experience.
Put your feet in our hands! See Dr. Ferrie today at our Sale clinic.