Regenerative Medicine

Apple Healthcare is offering exciting new opportunities for patients with knee and ankle osteoarthritis. The Advanced Arthritis Relief Protocol (AARP) is for patients who have tried conventional treatments such as rest, medication, prior injections, physical therapy, and home exercise. These patients may have been told that they are “bone on bone” and need complete knee or ankle replacement surgery.

But what would you say if you were told that surgery can be delayed for years or even prevented entirely? The first step to finding out is to schedule a consultation to see if you are a candidate for AARP.

Osteoarthritis occurs when a joint and its surrounding tissues degrade. This is caused by a loss of fluids in the joints. The joint hurts, so you don’t move it as much, and this actually makes it worse. You begin to have pain, stiffness, and decreased range of motion.

AARP uses a multi-pronged approach that offers an 80 percent positive outcome. AARP incorporates:

  • Prolotherapy
  • Viscosupplementation (hyaluronic acid protocol)
  • Physical therapy
  • Specialized bracing based on region and diagnosis
  • Platelet Rich Plasma (PRP) treatments


In viscosupplementation, we replenish the lubrication you’ve lost. We use Supartz, is a pure, natural form of hyaluronic acid and is the most effective form of HA due to its long-lasting results. Supartz cushions and lubricates your joints and has very few side effects and interactions. It is not considered a drug and is the most effective of all viscosupplements. It works by binding with your own fluid-producing cells to teach them to start producing cells again. It is safe, with few side effects, and it is FDA-approved for use by medical specialists.


For PRP treatments, we take your blood and put it into a centrifuge. Golden liquid rises to the top. This is platelet-rich plasma, which contains up to eight times the concentration of normal platelet levels. PRP contains several different growth factors and other cytokines that can stimulate healing of soft tissues such as muscles, ligaments and tendons. We inject that concentrated PRP back into the injured or degraded area, where it stimulates your body to heal itself.

The therapy has been shown to be safe and effective in treating conditions and injuries such as:

  • Rotator cuff tendinitis and partial tears in the shoulders
  • Lateral and medial epicondylitis in the elbows
  • Facet joint arthritis, sacroiliac joint pain, hip girdle muscle pain, and hamstring tendonitis in the back and hips
  • Ligament sprains in the wrists and hands
  • Patellar tendonitis, meniscus tears, and cartilage defects in the knees
  • Plantar fasciitis, Achilles tendonitis, and sprains in the ankles and feet

How do you know if PRP is right for you?

  • Your pain has lasted at least three months (for chronic conditions)
  • You have sprains, strains, or tears of muscles, ligaments or tendons (acute conditions)
  • Your symptoms and examination results are consistent with diagnosis
  • You have persistent pain despite standard non-operative treatment
  • Your condition can be seen on diagnostic imaging, such as x-ray, MRI, CT, and/or ultrasound
  • You wish to delay or avoid surgery

PRP is not currently covered by health insurance, but the cost ranges in the hundreds, not thousands, of dollars and flexible financing options are available.


Our bodies have an amazing ability to heal themselves, but sometimes they shut down the healing process a little too soon to experience complete recovery. That’s where prolotherapy can make a big difference.

Prolotherapy uses a special formula of irritating agents to stimulate the body’s natural healing response. A typical treatment involves using a long, thin needle to inject a solution to several points around your target pain area, such as joint space, ligament or tendon. This solution usually contains a local anesthetic and a concentration of dextrose.

To ensure the solution goes to exactly the right place, we use an ultrasound or fluoroscope to target the injection. Most appointments take around 30 minutes, and many patients are able to resume their normal level of activity very soon after the procedure.

Depending on their needs, patients usually have between two and six courses of treatment, separated by about a month between visits.

Your knee is surrounded by a synovial fluid, made up of hyaluronic acid, which lubricates, cushions and nourishes the knee. As a person ages, this fluid can thin, changing from very thick to very watery, and eventually even go away completely. Cartilage becomes thinner, and bones begin to rub together.

Patients may have as few as one injection or as many as five. Studies show that patients who do not have HA therapy average 8½ months until they are forced to have knee replacement surgery (TKR). Patients who have one round of HA average 17 months until TKR. The delay of surgery increases with each subsequent dose.

We use fluoroscopic x-ray imaging to ensure that our injections go exactly where they need to go. According to the American Journal of Sports Medicine, such imaging is 99 percent accurate, as opposed to 75 percent accuracy for injections that are done without imaging.

We follow the injection with physical therapy, which increases your success rate by 25 percent. If needed, we use specialized bracing that reduces the pressure on your joint and helps it heal properly.

This treatment is covered by insurance, including Medicare.

The primary purpose of plasma in your body is to transport nutrients, hormones, and proteins to the parts of the body that need it.