From shoulder pain to knee pain: this new technique for using stem cells to help patients cope with knee pain is garnering attention even before the results are in. The procedure is something of a hybrid, combining hyaluronic acid (HA) with concentrated stem cells to promote healing and “seed” the creation of new cartilage:

Patients who undergo the Abicus operation have the cartilage cut and tidied and undergo microfracture, but their cartilage tissue is then coated with a substance made up of bone marrow cells, platelet gel and hyaluronic acid.

During the 30-minute procedure, the bone marrow sample is spun in a centrifuge in the operating theatre to give a concentrated amount of the patient’s own stem cells.

These cells are then mixed with the gel and acid to create a “glue” substance which is placed over the cartilage defect and allowed to set.

If clinical trials show a clear benefit, it will represent yet another advance in our treatment of knee pain, and a new avenue forward for orthopedic knee surgeons who are always on the lookout for the latest innovations in patient care.

If you have chronic knee pain and want to avoid a more invasive knee replacement procedure, I urge you to contact my San Diego knee surgery offices today.




It has long been known that the orthopedic elbow surgery procedure known as Tommy John surgery can help restore many baseball pitchers’ speed and accuracy on the mound. But that doesn’t mean the procedure is without a downside or potential for complications: indeed, as with any procedure, it’s not uncommon for a certain percentage of patients to heal without ever regaining the full effectiveness of their youth.

Now a new study has found a clue why this might be: there is a strong correlation between years played and the need for Tommy John surgery, suggesting that wear, and not age, is the primary determining factor:

About 60 percent of the pitchers who required UCL reconstruction had the surgery within their first five years of being in the major leagues. Compared to pitchers who did not have the surgery, those who underwent the procedure had more major league experience at the same age, which suggests that arm stress from earlier major league experience contributed to the elbow damage, the study authors said.

Athletes should read such statistics as a warning about the value of proper care and maintenance, especially if your job entails throwing a ball almost a hundred miles an hour on a daily basis. Good stretching, warmups, warm-downs, and plenty of rest can help mitigate some of the erosive effects of pitching on the ligaments in your arm.

But if the time comes that Tommy John surgery is recommended, be sure and see an expert San Diego orthopedic surgeon. Please contact my offices here to learn more about elbow surgery, recovery, and management.


It’s always exciting to work at the forefront of a field defined by so much innovation. I have written before about the many ways technology is changing orthopedic medicine. Now doctors and entrepreneurs are finding new paths to intuitive medical designs via 3D printing.

No two bodies are the same. This fact has long bedeviled designers and specialists looking to create braces that cover a variety of shapes and ranges of movement. Scoliosis in particular has been infamous in this regard, which is why it is encouraging that some people are finally creating ways to design utterly customized, one-of-a-kind braces:

The 3D printing and design company on Monday released its plans for a scoliosis brace that is devised to be sleek and comfortable. Dubbed “Bespoke,” the 3D-printed brace can be personalized to the backs of children and young adults who have the condition.

It is yet another sign that medical devices are finally catching up to other wearable technologies in terms of versatility and comfort. To learn more about how to relieve and treat back pain, please contact a San Diego orthopedic surgeon today.

© 2023 Dr. Robert Afra – San Diego Orthopedic Surgery Shoulder – Knee – Elbow