Michael W Harper, MD

Husband | Father of 3 | Interventional Sports Medicine @OSMSGB | @HSSphysiatry Sports Medicine and Interventional Spine Alumni | @MCW_PMR Alumni

[AOSSM Journals @aossmjournals]

In this #AJSM editorial Scott Rodeo, MD, examines medical tourism for regenerative medicine: https://t.co/PVkvWRKVy5
Want more biologics? Join Dr. Rodeo at the @AAOS1 #Biologics Summit, July 8 at the @AOSSM1972 Annual Meeting in Seattle. Register at https://t.co/HjsJK8yQwE

[Wesley Troyer, DO, RMSK @WesTroyerDO]

New paper in JUM:
📝 Ultrasound-Guided Peripheral Nerve Blocks for Percutaneous Treatments of Common Tendinopathies
A practical, anatomy-driven guide to optimizing pain control during orthobiologics and US procedures

🔗https://t.co/n9YdJSA64q

#MSKUltrasound #SportsMedicine

[Robby Bowers DO, PhD @TheDrROBO]

Remember, chondrotoxicity is dose dependent. Pain relief is not. Use the lowest possible dose of corticosteroid to limit deleterious effects on cartilage. In this well done RCT we see 10 mg triamcinolone works just as well as 40 mg for knee OA.

https://t.co/cqZsIlAo4S

[British Journal of Sports Medicine (BJSM) @BJSM_BMJ]

🚨 Sharpen your brainpower in minutes with exercise 🏃‍♀️ 🤯

NEW #Infographic summarising the first meta-review on acute exercise and cognition 🧠

Full article ➡️ https://t.co/RdvzFHjF2M

[Jeffrey Peng, MD @JeffreyPengMD]

I just updated my knee osteoarthritis treatment table.

It has ALL the common treatments including short term benefits, mid-long term benefits, impact on arthritis progression, side effects, and cost

Weight, diet/nutrition, and exercise are by far the best overall treatments.

Platelet rich plasma is the best injection option.

[Zach Bailowitz MD, RMSK @ZachBailowitzMD]

PRP dose matters. Check out our new systematic review in @ArthroscopyJ on knee OA PRP dosing. @WBerriganMD you put together a hell of a team! @UCSFSportsMed @KPsportsmedNCal @UCSFOrthosurg https://t.co/XFePZoqpff

[Jeffrey Peng, MD @JeffreyPengMD]

There are three critical mistakes that can undermine the effectiveness of PRP injections and these mistakes directly translate into disappointing outcomes. But here’s the good news, each mistake is completely preventable.

[Jeffrey Peng, MD @JeffreyPengMD]

"Given the large body of existing literature and expert opinions, PRP was regarded as a valid treatment option for knee OA and as a possible first-line injectable treatment option for nonoperative management of knee OA, mainly for KL grades 1-3."

https://t.co/sJhKuPwBrg

[Hospital for Special Surgery (HSS) @HSpecialSurgery]

In a groundbreaking study published in @Nature, a team of researchers at HSS and @WeillCornell have discovered a new stem cell uniquely present in the spine. Vertebral stem cells, distinct from any stem cells in the body, hold the key to understanding a range of conditions affecting the spine – including its higher incidence of cancerous tumor metastases, particularly from breast, prostate, and lung cancers.

Learn more from primary investigator, Matthew Greenblatt, MD, PhD, associate professor of pathology and laboratory medicine at Weill Cornell Medicine and assistant scientist in the HSS research division, clinical collaborator Sravisht Iyer, MD, spine surgeon at HSS, and Mathias P. Bostrom, MD, associate surgeon-in-chief and director of quality and safety at HSS.

https://t.co/IDcbq7byob

[OSMS @OSMSGB]

Recently, OSMS Interventional Sports Medicine Physician, Dr. Michael Harper, was featured on @NBC26 where he talked about hamstring injuries in athletes.

To watch or read the story, click on the link! https://t.co/TXfyZ4J9CH

[OrthoEvidence @OrthoEvidence]

💊 The OPAL Trial: Opioids for Acute Low Back Pain and Neck Pain
Published in @TheLancet

Despite the risks, opioids are regularly prescribed for lower back and neck pain. Moreover, evidence supporting its effectiveness is limited and inconclusive.

Are opioids necessary? This multi-centred, triple-blinded RCT conducted in 157 centers across Australia 🇦🇺 aimed to find out!

🏗️METHODS
347 patients with acute low back and/or neck pain were randomized to receive either:

1⃣ Guideline-recommended care + opioids (up to 20mg oxycodone daily) (n=174)
2⃣ Guideline-recommended care + placebo (n=173)

The primary outcome of interest was pain intensity at 6 weeks.

Secondary outcomes of interest included physical function, quality of life, global perceived effect, ongoing pain, and the risk of misuse.

Follow-up was conducted up to 52 weeks post-randomization.

🔎RESULTS
Pain Scores
At 6 and 12 weeks, no significant differences were observed between the opioid and placebo groups.

At 52 weeks, there was a small significant difference in favour of placebo (p=0.041).

Physical Function
No differences in physical function were observed in people with neck pain.

However, for people with back pain, a significant benefit in favour of placebo was observed at 6 weeks (p=0.011).

Quality of Life
No differences in physical quality of life were observed between the opioid and placebo groups.

However, mental quality of life scores were significantly in favour of the placebo group at 6 and 12 weeks!

Global Perceived Effect
No differences in global perceived effect scores were observed up to 12 weeks of follow-up.

Additional Outcomes
The opioid group showed a higher incidence of ongoing pain and a higher risk of misuse!

✅INTERPRETATION
Opioids did not provide any benefit in pain scores, with placebo, and led to slightly worse pain at 1 year, worse mental quality of life, a higher rate of ongoing pain, and a higher risk of misuse!

[Jeffrey Peng, MD @JeffreyPengMD]

Let's discuss platelet rich plasma (PRP) injections for knee osteoarthritis in the context of a recent and compelling clinical study.

PRP could revolutionize your experience with pain and enhance your daily function.

A 🧵 :

https://t.co/VhONUEESHg

[Michael W Harper, MD @MHarperMD]

@generalorthomd @JeffreyPengMD any additional comments as I have seen you post on this topic on the past.

[Michael W Harper, MD @MHarperMD]

@generalorthomd We are continuing to research what the "gold standard" should be for preparation of PRP and the conditions it is useful for. It is misleading to say PRP does not work when the methods of the papers are not scrutinized.

[British Journal of Sports Medicine (BJSM) @BJSM_BMJ]

🚨THIS JUST IN
The brand new consensus statement on #ConcussionInSport is available now

💭 What's the latest in concussion?
✅ Find out now
https://t.co/tPdHHyX7Ye

#BJSMConcussionMonth
Fantastic work led by @jonpatricios @Kat_Schneider7

[USA Lacrosse Magazine @USALMag]

𝗕𝗨𝗜𝗟𝗧 𝗗𝗜𝗙𝗙𝗘𝗥𝗘𝗡𝗧

Lacrosse is for everyone. Everywhere. Of all abilities. This month, we share the stories of six athletes whose disabilities have not kept them from realizing their potential.

The Unlimited Edition hits homes this weekend.

[Michael W Harper, MD @MHarperMD]

@JeffreyPengMD I would have to dive into the data more but my first thought is given many surgeons have a BMI cut off, the bariatric surgery candidates who had sustained weight loss became candidates while those in the control who remained above the cutoffs continued with non-operative care