Ask Dr. C

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It’s that time again! This is where I ask for questions from readers and choose some to answer in long-form. So please leave your questions below in the comments!

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15 thoughts on “Ask Dr. C

  1. Michael Millstone

    Dr. C., In your recent blog post (Episode 14, October 25, 2020), you noted, …”PRP is made from the patient’s own concentrated blood platelets. There are dozens of randomized controlled trials that support that PRP is effective in treating orthopedic conditions. So why isn’t it yet covered by insurance?

    On the one hand, Tricare (the military insurer) is starting to offer coverage for PRP to it’s almost 10 million insureds.”

    I am one of those Tricare covered that have been waiting years for them to open the door. Every time I call, they say they are only approved for osteoarthritis. What is the magic key? Between disc degradation, torn hip labrum, hip osteoarthritis, bursitis, bulging disc, and a few other things, I am sure I can keep your clinic busy.


    1. Chris Centeno, MD Post author

      Tricare announced PRP coverage for lateral epicondylitis (tennis elbow) and knee arthritis. However, as I understand it, each case goes through utilization review.

  2. Robert

    Can cartilage be regrown?

    1. Chris Centeno, MD Post author

      This question answered in the 11/10/20 Ask Dr. C episode.

  3. Vanessa TANG

    Dear Dr. C,
    I was so happy to know that you, personally, can answer some long overdue questions, that’s personal to me.
    I had a same day bone marrow stem cell procedures done, on both knees, in Brussels, in May 2018.
    My condition is quite bad due to the long toll of competive badminton.
    I’ve completely stopped the sport, 5 years now, & currently only doing mild jogging. Recently the pain has returned with more noise, inflammation, dull pain, gliding, the lot. The upside is its happening at different times n I get some good days!!
    Please can you advise me on what more I can do to avoid the conventional surgeries.
    Many many thanks!
    Best regards,
    Vanessa TANG

    1. Chris Centeno, MD Post author

      Answered in 11/10/20 episode of Ask Dr. C.

  4. Louanne Thomsen

    In an article you wrote back on 12/17/10 about ‘Getting Rid of a Bone Spur with a Needle’, you talked of using a technique called barbotage to break up the bone spur. Could this technique possibly be used on Bouchard’s Nodes?

    1. Chris Centeno, MD Post author

      Likely not, these would be too small and I doubt it would help.

  5. Pamela

    I just read your answer to a lady in Brussels about having a second round of stem cell injections in her joint and bone because studies have shown longer results if the bone is also injected. Are these injections given at the same time? Is the bone injection painful? I had the stem cell and platelet injections in 2018 in both of my knees and am also wondering how long the effects will last.

    1. Chris Centeno, MD Post author

      For the type of injections, you had (intra-articular) the duration of effect is 2-7 years. We believe based on some recent research that injecting the bone will cause a longer-lasting result. I usually sedate patients for bone injections. Placing the micro-trocar isn’t painful, but injecting the bone marrow into the painful spots of the bone can be. hence, my patients are usually asleep with an iV during that part.

  6. Bob

    Just curious if you know of anyone who has treated intercostal neuralgia with orthobiologics.

    1. Chris Centeno, MD Post author

      I’ll answer this one is a special blog post, likely over the weekend.

  7. John Ingram

    Dr Centeno,
    I am a sufferer from Menieres Disease which is a chronic illness of the inner ear causing hearing loss, vertigo attacks, dizziness, tinnitus and many other associated symptoms.
    I’ve seen a number of clinics claim to be able to treat this successfully using stem cells. Some use stem cells from your own body, some use umbilical cord stem cells and a clinic I have come across in Germany have used stem cells from sheep.
    I run a charity representing Menieres Disease patients and we have been looking into this procedure.
    I was wondering if you had any evidence of success of this procedure in treating inner ear diseases and which stem cell procedure would likely be most successful?
    Best regards
    John Ingram

    1. Chris Centeno, MD Post author

      I’ll tackle this one tomorrow in a special blog post as it raises a bunch of really interesting questions!

    2. Chris Centeno, MD Post author

      Just finished a blog today on this topic.

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