Texas Orthobiologics

04/05/2026

She was told she needed a knee replacement…

Just 2 months later, she’s 60% better.

This is a real patient sharing her experience after a stem cell injection for knee arthritis.

Less pain. Better function. A completely different outlook.

If you’ve been told surgery is your next step, you owe it to yourself to at least hear stories like this.

▶️ Watch her story

💬 Would you consider a non-surgical option before committing to a knee replacement?

09/04/2025

Congratulations to IOF President Don Buford, MD and President-Elect Mary A. Ambach MD on being recognized by TOBI: The Orthobiologic Institute at their recent conference. Dr. Buford received the Lifetime Achievement Award, and Dr. Ambach was honored with the Lutz Excellence Award.

We’re proud to have such respected leaders guiding the future of IOF and the orthobiologics community!

10/15/2024

*Who cares about patient reviews*
I don't post much about patient reviews.
It used to be that most new patients came from other clinician referrals and other patient referrals. With the rise of the internet and the many doctor review sites.....along with the increasing cost of insurance and rising deductibles...things have been changing over the last 15 years.
The most common referral source listed by our new patients at Texas Orthobiologics is the insurance company website (searching for local in network docs) and then they go to patient reviews and see who is highly ranked on websites like doctor.com, healthgrades.com, vitals.com, usnews.com, trustpilot.com, google.com, and even yelp(ugh!).
So, like it or not, we have to care about reviews if we want to take care of patients... This is one major way potential patients get "social proof" about clinicians. Internet reviews are also a way patients get to "know, like, and trust" us.

10/14/2024

* Dosing Probably matters in aesthetics too!*
Ok, so I don't do PRP microneedling or hair loss or "P" or "O" shots or any other aesthetic procedures but because of my use of PRP I get questions from patients about these aesthetic uses. Last week I got a question from a patient that forced me to take a deeper dive. The question was whether or not the patient should pursue PRP injections to improve the appearance of her aging hands. I had no clue so I told her I would get back to her. Here is what I found. There is a just published level 2 study out of Mayo Clinic looking at this exact subject. There were only 18 hands in the PRP versus normal saline group so most likely underpowered. The protocol called for a total of 1cc of PRP injected into the hand dorsum every month for 3 months. At 6 month follow up there was no significant difference noted.

Thoughts: There was no mention of the PRP blood volume draw (we have the PRP volume) and there was also no mention of the platelet counts or leukocyte content. Extrapolating assuming a platelet count of 200 and a PRP count of 1200 (being generous based on other aesthetic studies)....the patients may have received 1.2 Billion platelets per month for 3 months.
Just like the recently published knee studies (PEAK trial and RESTORE trial) this study suggests that if we treat people with a platelet dose under a therapeutic level.....it doesn't matter how many times we inject.....the "response" never gets going.
Future PRP studies in aesthetics should mirror those in orthopedics....looking at and documenting higher platelet doses...not lower!

10/12/2024

Have you heard of exosomes? Exosomes are a type of regenerative medicine injection. It is not a stem cell injection. It is not a PRP or Platelet Rich Plasma Injection. Exosome injections are made from the secretions of stem cells which are purified and then shipped to a doctoer's office. The FDA has ruled that exosomes are a drug and therefore require derug approval for from the FDA. Currently, there is no FDA drug approval to use exosomes for anything. SO we cannot use them.....we could study them if we have a FDA approved study.....but that work takes many years and often millions of dollars. No such studies are currently actively registered in the USA as of this writing!

10/11/2024

Texas Orthobiologics

*Baseball Fun Fact*
55 years ago on this day, dad became the first player to ever hit a leadoff home run in the first game of the World Series. The Baltimore Orioles beat Tom Seaver and the New York Mets in that game but lost the World Series 4-1. The Orioles won World Series in 1970, beating Pete Rose and Johnny Bench and the rest of the Cincinnati Reds "Big Red Machine". They went back in 1971 but lost again to Roberto Clemente and Willie Stargell and the Pittsburgh Pirates.

(Check out my two youtube channels for more surgery and lectures and orthobiologics stuff....don't forget to like and subscribe lol!)

Back to regularly scheduled programming......

Don Buford Sr. Home run in 1969 World Series Game 1

10/09/2024

This brief presentation shows how we can use ultrasound in the office to diagnose a meniscus tear and avoid the time and expense of a MRI scan.It is faster a...

10/04/2024

If there is a better indication for recommending a well done bone marrow concentrate injection than Avascular Necrosis of the Femoral Head.....I don't know what it is.....
Too many papers now to list but here is a link to just one 2022 review.
Helping this friend out next week!
https://lnkd.in/gtmS6hh9

10/03/2024

*Why are we using ice ..... who started R.I.C.E and is it even the right thing to do?*
So, based on the fantastic review by British Journal Of Spoerts Medicine (see pics below) maybe clinicians should keep using ice for acute injuries BUT not for a long time. In the regenerative medicine world, I use it acutely after the injection but just that day in the office and at home for pain relief. In the orthopedic surgery world, I stopped using the chronic ice machines over a decade ago....and maybe that was a good move based on this summary....I know it sure has not make a difference in my surgical outcomes!

09/06/2024

*Surgical images in this post*
We might have saved a knee today!
Our friend had a large defect in the medial patellar facet.
He is under 23 years old.
The top row are the before pictures.
The bottom row shows the result after an osteochondral allograft bone/cartilage plug and some cartilage graft used to reshape the medial patellar facet.
Fingers crossed, he now has a good chance to recover and hopefully return to all his activities.

09/06/2024

*Can an ultrasound exam predict if a full thickness rotator cuff is repairable?*
Short answer: Yes!
Here is a level 3 paper published last year in the Journal of Shoulder and Elbow Surgery International where we figured out how to answer that question.
Spoiler Alert: If the tendon edge is clearly seen on the coronal then the positive predictive value is about 97%.
https://lnkd.in/gQsm9KZ7