Texas Orthobiologics

Texas Orthobiologics Texas Orthobiologics is America's #1 Regenerative Medicine and Orthopedic Surgery Clinic.

Texas Orthobiologics was founded by Don Buford, MD, a Board Certified and Sports Medicine Fellowship Trained Orthopedic Surgeon. We are America's #1 regenerative medicine and orthopedic surgery clinical practice. We provide a concierge practice for patients with joint pain, sports injuries and back pain using regenerative medicine and orthopedic surgery. We help you maximize your quality of life a

nd achieve your best health and function using regenerative medicine...but if surgery is the best solution we can do that too!


Ever seen an ultrasound guided PRP injection for tennis elbow? Here is one example!

What could happen if you advertise stem cell therapies in the USA?  Well, the State Medical Board Could restrict your li...

What could happen if you advertise stem cell therapies in the USA? Well, the State Medical Board Could restrict your license for starters!!!!

We are seeing this nearly every month in Texas. This physician is getting penalized for the infractions listed below including advertising stem cell therapies, not doing an informed consent, and not doing an adequate H&P.
Do these penalties seem enough to discourage this behavior?

The  #1 USA organization for unbiased regenerative medicine training

The #1 USA organization for unbiased regenerative medicine training

NEXT WEEK: Join us as Rowan Paul, MD discusses orthobiologics for ligament laxity and joint instability during our last IOF NOW! Webinar of the year. Don't miss this one: https://bit.ly/47U3gE1


15 Common Ultrasound Guided injections with or This lecture was initially given at a Regenerative Medicine Meeting in Spain in 2022


Last real world evaluation in clinic today!
We are shutting down for the day...time to go operate :)
For this last patient we drew 60cc of blood to maker LP-PRP (note the WBC did not change despite the 5.5x increase in platelet concentration). We got 6cc of PRP at a count of 1493 making the dose right at 9 Billion platelets for a knee OA injection. Also note that the RBCs were removed and the Lymphocytes went up, granulocytes down, and monocytes up.

*Results from a Handcrafted   Protocol*Recently we had a chance to test a PRP protocol used overseas by colleagues witho...

*Results from a Handcrafted Protocol*
Recently we had a chance to test a PRP protocol used overseas by colleagues without ready access to PRP kits. They have to make PRP with a centrifuge and test tubes and syringes and needles that they source and put together separately.
The stats:
108 cc blood draw with 12cc of ACD-A (two 60cc syringes with 6cc ACD-A in each) and ultimately 8 cc of PRP was made.
The 120cc was divided into 4 centrifuge test tubes....30cc in each.
First spin was 2.5 minutes.
Decanted the yellow (plasma+platelets) from each of the four test tubes and left the red (RBCs)
Second spin (just two test tubes of Plasma) was 5 minutes.
At the end of the second spin the platelets are at the bottom of the test tube and we removed plasma from each to leave 4cc of plasma in each test tube (8cc total). We then resuspended the platelets in each test tube using the plasma and gentle "swirling".
We combined the PRP to end up with 8cc and below are the results.
Concentration: 8.69x (1747 PRP versus 201 Blood)
Platelet recovery %: 58% (14.0 Billion PRP /24.1 Billion Blood)
Platelet dose for 8cc: 14.0 Billion platelets
(remember we started with a 120cc Blood draw ...not a 60cc!)
Seems like another way to get a reasonable PRP result in parts of the world where kits are not readily available for whatever reason!

*The Cervos Key   Bench Test*Having an in house hematology analyzer means we test every single patient's blood and PRP a...

*The Cervos Key Bench Test*
Having an in house hematology analyzer means we test every single patient's blood and PRP and record the results in a registry. Very few clinicians can compare real world PRP results from different companies....we love the science!
Last week we got a chance to test the Key PRP system from Cervos Medical.
We used two of the Cervos 40ml kits so that we could process 60ml of Blood to match what we have done with other kits.
The instructions stipulate using the Eppendorf model 5702a which happens to be the same swinging bucket centrifuge that Emcyte uses so we had one on site already.
The kit includes ACD-A. We used a total of 6cc of ACD-A which meant we had 64cc of blood....matching what we did with other PRP protocols for consistency.
The first spin was at 3800 for 2 minutes.
We the used their unique plastic threaded rod to gently extract the plasma/platelet portion, leaving behind the RBCs.
We then added another 2cc of ACD-A to another canister, added the plasma and spun a second time at 3800 rpm for 6 minutes.
After the second spin we recovered 5cc of PRP.
The initial platelet count was 316 (60cc blood)
The PRP platelet count was 1617 (5cc PRP)
Concentration was 5.12X.
Platelet dose was 8.09 Billion platelets (1617 Plt x 5cc)
Platelet recovery % was 43%
You can see the other numbers below....essentially leukocyte neutral, no RBCs, good decrease in granulocytes.


I recently had a chance to interview with Dr. Ariana Demers on her "Business of Orthobiologics" podcast. In this 1 min. clip hear why uses and to help patients live better with less pain.

"Doctor, Can I still do a   procedure if I am on a blood thinner like Plavix?"Answer:  Yes!Spoiler alert: We don't reall...

"Doctor, Can I still do a procedure if I am on a blood thinner like Plavix?"

Answer: Yes!

Spoiler alert: We don't really know the full effect of Plavix on PRP production or clinical outcomes....BUT I do have some ideas based on human biology.

#1 Plavix works by blocking platelet aggregation by binding to a surface receptor on the platelet.
#2 Plavix does NOT work by changing the contents of the platelets or the number of platelets....but rather by decreasing platelet release.
#3 We use platelets in PRP because they release their contents and not because we want them to aggregate and clot.

So, with my admittedly basic ortho surgeon understanding of this...anything that would decrease the contents of the platelets OR decrease the number of platelets that release their contents OR decrease the total number of platelets certainly could affect clinical outcomes. Plavix probably has the biggest potential impact on the platelet release part. There is some research that Plavix does not significantly decrease the total number of platelets. I haven't seen any research that Plavix actually can decrease the contents inside the platelets.

Without more data....I just double the blood draw...inject the same end volume....and track everyone in a registry. I am still getting worthwhile PRP results with this approach (others too!)
We could get more scientific if we knew the exact % that Plavix decreased platelet release....or the exact % of platelets inactivated by Plavix.
Any other ideas welcomed!!!

*Age is just a number.....*Orthopedic Clinicians often assume that older patients don't do as well with surgery or even ...

*Age is just a number.....*
Orthopedic Clinicians often assume that older patients don't do as well with surgery or even with regenerative medicine procedures. There may be some biological truth to that BUT we have ways to mitigate the effects of aging...and it really isn't that hard. With rotator cuff repair, several South Korean surgeons just published an excellent review comparing results of rotator cuff repair in patients older than 75 versus results for those under 75. 54 patients in each group....2 year follow up....MRI documented outcomes. The result? 18-20% retear rate in both groups....no statistically significant difference. How do we improve the soft tissue healing here? For me the answer is Biobrace....a suturable implant that adds initial strength but doesn't stress shield the tendon as it heals...and even adds size to the tendon by 3 months...and reabsorbs in about two years. We need the tissues to heal AND the tendon to reattach to the bone at the enthesis. With regenerative medicine procedures, authors like Hernigou have shown no difference in outcomes in seniors, even though the biology may be a little different. We can always draw a little more blood or bone marrow or adipose if necessary too!


When and how I do injections for a type 2 SLAP lesion...
Spoiler alert: PRP does not replace the need for surgery for this intra-articular tendon tear/detachment. continues to grow within but still can't replace surgery for many conditions.
The link is to a 1 minute video primer on this topic....would love to hear other approaches/clinical indications. With mounting registry data, we are able to tell patients and their families about how long a PRP injection might help with their shoulder pain/function. But surgery is still the gold standard for anyone who still has pain or dysfunction with a type 2 SLAP lesion.

"Why Do IV Stem Cells For Regenerative Medicine? "I saw two people last week ....one of whom was pitched IV stem cells b...

"Why Do IV Stem Cells For Regenerative Medicine? "
I saw two people last week ....one of whom was pitched IV stem cells by a nurse practitioner at a nationally franchised "regenerative medicine" clinic (because the cells will "know" where to go!!!) The second patient read about IV stem cells on a local regenerative medicine clinic's website. What is the truth?
Cells get trapped in the lung as the vascular tree gets smaller. This "first pass" effect is not a new discovery....it is known human biology for at least 35 - 40 years if not longer. With regards to any cellular therapy.....there have been lots of publications documenting the 95+ % first pass effect in which cells injected IV are trapped in the lungs....they don't make it back to your knee....they don't go to your spine....they stay in your lungs....so if you have a lung problem that really is the only reason to pay for an IV stem cell injection (once there is evidence that it a good treatment...) Anyone selling IV stem cells in regenerative medicine is a fraud at this point.


Do you have orthopedic issues that are nonoperative or are you trying to avoid surgery? Come learn about ALL your options at the Texas Orthobiologics Frisco location where we keep you doing the things you love!

Why we don't refer people to Mexico, Panama, Bolivia, Venezuela for    or  .  This is an incredibly sad story about some...

Why we don't refer people to Mexico, Panama, Bolivia, Venezuela for or . This is an incredibly sad story about someone trying to have less pain who believed that an IV stem cell injection could improve their pain. They suffered a cardiac arrest with no reported prior history of heart disease. These stories get buried by the promoters of these clinics. There is a legitimate way to practice and there are reputable clinics in the USA and other parts of the world.

* What is the average price for a knee   injection at the top 25 US Hospitals?* Well, we got a very basic survey answer ...

* What is the average price for a knee injection at the top 25 US Hospitals?* Well, we got a very basic survey answer here which is great. The mean is $800 per injection. But how many platelets are in that injection? We have an average price but we don't know how many platelets that is buying. As a result the conclusion misses out on some critical price factors that must be considered by doctors and patients alike when choosing PRP companies, following dosing protocols, and pricing the PRP for patients.
Let me explain.
Single Price does not equal the total cost to the patient.
Would you rather have 3 injections for $800 each or 1 injection for $1800 if the results were the same? Right.
What if the single $1800 PRP injection actually had a Better result? NO brainer right? Give me the $1800 injection.
Well that is exactly the situation based on level 1 studies on PRP dosing for knee OA. Virtually all of the multi-dose protocols are with PRP "kits" that produce less than 3 Billion platelets per injection. Probably because a single injection didn't work....reasonable doctors using those low blood draw and low dose kits started doing 2 or 3 injections to see if they could improve the result....because they were locked into a "low dose" PRP kit. With no constraints on PRP kits, other reasonable doctors have come at the problem by increasing the dose of a SINGLE injection with fantastic results. The best and widely quoted paper by Bansal was a level 1 study with a SINGLE injection of PRP at a dose of 10 Billion platelets in 8cc.....and it worked for about a year for mid-grade knee arthritis.
On the other hand, there are several papers in the past 3 years way showing that if the single PRP platelet dose is 3 billion or less.....even giving 3 injections is NO better than placebo!!!
Single injection, 60cc blood draw....8+ Billion platelets in 6-8cc of PRP....this basically brackets the best data we have today.
We need level 1 studies on HIGH dose PRP to see if multiple injections of high dose PRP are better than a single injection of high dose PRP.


America's #1 Regenerative Medicine and Orthopedic Surgery Clinic!
We keep you living your best live without surgery!


Texas Orthobiologics Frisco will be a sign sponsor for some holes at the 5-star Golf tournament!

Location: Onmi PGA Golf Resort
Hosted by: Frisco Chamber of Commerce.
Day: October 16th, 2023


We are excited to begin announcing featured speakers for the IOF MAX Experience. First up: the one and only Don Buford, MD, RMSK of Texas Orthobiologics.

Register here to attend: bit.ly/IOF2024


Mark your calendar! Our next IOF NOW! webinar presenter is Dr. Stanley Lam. Join us for a discussion and live Q&A with Dr. Lam about nerve hydrodissection with biologics and dextrose.

IOF board member and expert instructor Mary A. Ambach M.D. will serve as moderator.

Attend for free: https://bit.ly/3ZMiFD4


10 more days to save $300 on your IOF MAX Experience registration! ATTEND: bit.ly/IOF2024

Last year, IOF became the largest orthobiologics conference in the U.S. You know you're going to have FOMO if you don't attend this year, so make sure you save a little bit of money on the registriation fee!


Deviations/CFR/Regulations for Human Cells, Tissues & Cellular Products (HCT/Ps)

How we avoid steroid shots!  What to ask your doctor who is recommending intra-articular steroid shots......  What about...

How we avoid steroid shots! What to ask your doctor who is recommending intra-articular steroid shots...... What about Toradol?! Toradol injected into hip and knee joints works as well as steroid WITHOUT the potential steroid complications. There are level 1 studies supporting this..see below and find a clinician to discuss this with!

www.orthosono.comNewsflash!!! We have a new home.The Las Vegas Regenerative Medicine and MSK Ultrasound Course January 2...

Newsflash!!! We have a new home.
The Las Vegas Regenerative Medicine and MSK Ultrasound Course January 25-27, 2024 will be at Caesar's Palace on the Strip. Only 50 spots. 25 CME. Live demos. Evidence based Regen Med. 25 live models. 15 faculty. 4-6 ultrasound companies. 4-6 regen med companies. Since 2008...... The longest running private MSK ultrasound and Regen Med meeting...run by orthopedic surgeons!

Regenerative Medicine for Avascular Necrosis of the HipYes it works, yes there is level 1 data......Yesterday I got a ch...

Regenerative Medicine for Avascular Necrosis of the Hip
Yes it works, yes there is level 1 data......
Yesterday I got a chance to help someone with Ficat stage 2 AVN of the hip. The regenerative medicine treatment option with bone marrow concentrate injection is the state of the art. Replacing avascular bone marrow with healthy concentrated bone marrow from the iliac crest makes biologic and common sense. And has the data to back it up.
I used the Arthrex expandable reamer kit which made the job easy.
See the slide for references and some fluoro images!

  does NOT work in seniors....less effective, right?*Wrong!!!PRP works just fine in "seniors" if you get the dose right....

does NOT work in seniors....less effective, right?*
PRP works just fine in "seniors" if you get the dose right....just like in less experienced patients 😉
Of course to know that you have to have a machine in the office that examines the blood and PRP....we get the data on EVERY patient! Because we want to know what we are doing.....
Today we showed a 58 year old gentleman, who was told his platelets would be "too low" at another clinic, that his platelet dose was over 10 Billion for his knee injection....no different from anyone else at any age with normal hematology.
Hopefully he will do as well as our average patient with knee arthritis!


1015 North Carroll Avenue #2000
Dallas, TX

Opening Hours

Monday 8:30am - 4pm
Tuesday 8:30am - 4pm
Wednesday 8:30am - 4pm
Thursday 8:30am - 4pm
Friday 8:30am - 4pm




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