January 29, 2020

No matter the sport or the season, it’s important to keep your young athlete healthy and happy during practice. With these 10 tips from Beacon Orthopaedics & Sports Medicine, you can be sure you’re in the best possible position from practice to game day!

1. See a doctor and get a physical.

Many schools/organizations require a physical exam before your child can play a sport. Even if they don’t, it’s a good idea to make sure they are healthy enough to participate.

2. Get in shape before the season starts.

This is especially important if your child has had a long period of rest in between seasons.

3. Share your emergency contact information with your coach and supervisors.

Make sure the people running practice know what to do in case of an emergency. Also, ensure they are aware of any pre-existing medical conditions your child has.

4. Make sure the coach is prepared.

The coach and other adults should be prepared for injuries to occur. Ask them what their protocol is when a child is hurt. They should also be certified in CRP and first aid.

5. Check your gear before practice.

The right equipment can make all the difference. Check to be sure it fits properly and is in good repair.

6. Warm up and stretch before each practice and game.

Warming up helps prevent tears and sprains.

7. Stay hydrated.

Dehydration can lead to lightheadedness and fainting, putting your young athlete at risk of hitting their head or risking other injuries.

8. Follow a good diet.

While eating a well-balanced diet is important for everyone, it is especially important for athletes of all ages to eat enough to offset the calories burned during practice.

9. Get enough rest every night.

Getting plenty of sleep, especially before practice and games, will ensure your athlete’s senses and concentration are sharp and help them make smart choices.

10. Be a good sport.

Teach your child to play by the rules and avoid aggressive behavior. Fighting on the field is a sure-fire way to get hurt! Dr. Henry Stiene, Joint Medical Director and Team Physician for Xavier University Athletics, says, “Youth athletes should always have fun playing a sport they enjoy. Being prepared and staying injury free can help make the experience fun for the athlete and parents as well.”

Sometimes, injuries are inevitable. If your young athlete gets injured, come to Beacon Orthopaedics & Sports Medicine or visit our Urgent Care center to see a specialist today!

January 15, 2020

Each year, physicians are selected by their peers in a survey, asking them which physicians they would turn to for their own personal care. Beacon doctors – 25 Tri-State physicians – were named to Cincinnati Magazine’s Top Docs List of 2020. We are very proud of all of our physicians and thank the medical community for their recommendations. Click on any of the physician’s names below to view their personal profile page, orthopedic specialty and discover why their peers view them as top doctors in the Cincinnati region.

You can schedule an appointment with our Board Certified and Fellowship Trained physicians online or by phone 24/7 with no referral necessary. Beacon has nine convenient locations, evening and weekend appointments and urgent orthopedic care clinics so that patients can get the care they need quickly.

Top Docs 2020:

Foot & Ankle Surgery

Adam Miller, MD

Hand Surgery

Mohab Foad, MD

Sam Koo, MD

Orthopaedics Surgery

Robert Burger, MD

Haleem Chaudhary, MD

Matthew Johansen, MD

Andrew Razzano, DO

Robert Rolf, MD

David Sower, MD

Pain Medicine

Brian Braithwaite, MD

Physical Medicine & Rehabilitation

John Bartsch, MD

John Brannan, MD

Nicole Goddard, DO

Alberto Maldonado, MD

Spine Surgery

Michael Planalp, MD

Ian Rodway, MD

Michael Rohmiller, MD

Sports Medicine

David Argo, MD

Peter Cha, MD

Steve Hamilton, MD

Timothy Kremchek, MD

George Matic, MD

Glen McClung, MD

Henry Stiene, MD

You can schedule with our physicians 24/7/365 online or by phone at (513)-354-3700.

Cincinnati Magazine Issue

May 23, 2017

Henry Stiene, M.D. of Beacon Orthopaedics is thrilled to be the only physician (excluding spine) licensed in the TriState area to perform and treat patients with the Regenexx™ Family of Advanced orthobiologics Procedures which include concentrated Platelet Injections and Regenexx Treatments.

Regenexx is the leader in orthopedic orthobiologics in terms of research, tracking patient outcomes, presentations, and publications. For these reasons, Dr. Stiene chose to align with the Regenexx family to best serve his patients.

To contact Dr. Stiene about Regenexx please call (513) 389-3641

Platelet injections are an emerging treatment in the field of Regenerative Orthopaedics. It has been in use in Europe for many years and Beacon was one of the first centers in the Midwest to utilize this treatment having performed over 2000 treatments since 2007. platelet injections is basically an acceleration of the body’s healing and regenerative powers.

Platelets are particles found in the blood whose primary purpose is to respond to injury and begin the healing process. They migrate to the site of injury and when exposed to injured tissue and release proteins into the bloodstream called growth factors. Growth factors recruit the body’s repair cells to the area of injury.

Components of connective tissue such as tendons and ligaments have a very poor blood supply and once injured can be very difficult to heal. A tendon is made up of thousands of individual fibers called collagen and bundle together very neatly and orderly much like the fibers or wires in an electrical cable. When a tendon becomes injured because of overuse or injury, the body tries to repair the individual fibers and because of poor blood supply growth factors and injections can’t do their job correctly and fibers are repaired with poorly organized tissue commonly called scar tissue.

Scar tissue does not have the same strength and elasticity as healthy tissue so when the same force, overuse, or trauma is placed upon the tissue containing scar, it fails, more tissue tears, more scar tissue develops and a vicious cycle of pain and dysfunction occur called tendinopathy. Tendinopathy is a very difficult problem to treat and treatments to date aim at relieving pain and restoring function, but the injured tissue remains. As a result, recurrence is likely and becomes very frustrating for the patient.

Platelet Injections are very successful at replacing this unhealthy tissue with healthy tissue and restoring function and allowing a return to normal physical activities. platelet injections offers no quick pain relief and has no pain-relieving properties. The pain gradually subsides as the injured tissue repairs itself. This can take weeks or months, but when successful, the effect is lasting. Most patients will need 2-3 treatments spaced about 4 weeks apart and most people will not feel any relief until a few weeks after the second treatment and that relief is gradual and sometimes like a roller coaster ride in that there will often be a few pain-free days mixed in with a day or so of resolving soreness.

There are three populations of patients that benefit from platelet injections. First are those with chronic pain from tendon or ligament dysfunction such as Achilles tendinopathy in runners. The second group is those patients with acute injuries such as a tennis player with a muscle tear, and finally, it has been shown that platelet injections is effective in treating osteoarthritis.

Platelet Injections are an acceleration of the body’s own healing process and thereby is a purely natural process so there is no risk of allergic reaction or reaction. The patient is not being given anything that doesn’t belong to them. Infection is very unlikely as platelets by nature are anti-infective which why it is very unusual to develop an infection when you fall and skin your knee. The only drug that is used is the local anesthetic to numb the area prior to receiving the platelet injections treatment.

At Beacon, all treatments are done under ultrasound-guided needle placement to ensure precise placement of the platelet injections at the injured site and ensure the needle is not going where it should not such as uninjured tissue, nerve, or blood vessels.

The success rate for Dr. Stiene’s patients is well over 80% in terms of a full return to their desired level of physical, athletic, and recreational activities. Beacon Orthopaedics maintains electronic medical records (EMR) that allow data to be tracked and outcomes measured.
Over the last number of years, much has been learned about platelet injections in terms of the timing of the injections, the frequency of the injections and the concentration of the platelets that are used to treat injury or osteoarthritis. Dr. Stiene and have his staff have learned how to vary the concentration of platelet injections to suit the individual patient. This includes the removal of white blood cells. White blood cells are currently thought to be responsible for a good portion of the post-procedure pain. It has also been found that the use of Prolotherapy in conjunction with platelet injections can provide optimal outcomes. Dr. Stiene and his staff are the only medical providers in the Tri-State area licensed to perform Regenexx procedures.

Other Regenexx Links:
For Regenexx Informational Videos Please Click Here

For the Regenexx Website Please Click Here 

platelet injections FAQs

Learn More About Regenexx

January 6, 2017

The Regenexx™ Family of Procedures:

Bone Marrow and Platelet-derived growth factors are in all of us and they are responsible for healing injured bone, cartilage, ligaments, tendons and other tissues. They are the key components behind the Regenexx Procedures. As we get older or injured, we sometimes cannot get enough of these cells into the area to heal. The Regenexx™ Procedures help solve this problem by precisely delivering injections into the injured area aiding your body’s ability to heal naturally. Patients experience very little downtime and they typically avoid long, painful rehabilitation periods that often follow surgery to restore joint strength and mobility.

Is Regenexx™ Right For You?

If you have been diagnosed with one of the following conditions, Regenexx is good news!

– Unstable Ligaments and Joints (shoulder, elbow, wrist, hand, hip, pelvis, knee, ankle, and foot)
– Avascular Necrosis ( stages 1-4 ) of the shoulder, hip, knee, or ankle
– Osteoarthritis of the knee, hip, ankle, shoulder, elbow, wrist, foot or hand
– Tears of the rotator cuff, tennis or golfer’s elbow, hamstring, gluteus, quadriceps, patella tendon, achilles, plantar fascia, sports hernia, groin pulls, peroneal, posterior tibial tendon
– Other cartilage injuries such as a knee meniscus tear, hip labral tear, shoulder labral tear, TFCC tear in the wrist, osteochondral or chondral injuries to the articular cartilage in all joints

Other Regenexx Links:
For Regenexx Informational Videos Please Click Here
For the Regenexx Website Please Click Here

Learn More About Regenexx

Learn More About Regenexx™ Treatments from Dr. Stiene

September 5, 2016

Written by Henry A. Stiene, M.D.

Perineural Injection Therapy (PIT) is a proven safe, effective treatment for patients who may not be candidates for joint replacement surgery or biologic options.  Perineural injection therapy treats inflamed and injured nerves.  Chronic nerve pain is often due to trauma, arthritis, sports, overuse, occupational, and surgical injuries.

Any sensation that is perceived by the brain is transmitted to the brain via the sensory nervous system.  This is true for sensations like pain, temperature, vibration, or pressure.  For example, when a nerve is stimulated by pain, the individual nerve cells generate an electrical current that is carried by the nerve to the spinal cord and then to the brain.

Imagine the individual nerve cell as being a room with a door (scientifically termed a receptor). When the nerve cell is stimulated, the door (receptor) opens and lets sodium, potassium, calcium, and other molecules in and out of the cell such as shown in the illustration below.

When this occurs and moves from one room to the next, an electrical current is created termed an action potential. When the stimulation is complete, the door once again closes. If the nerve is injured for whatever reason, this mechanism is disrupted.

The nerve cell signals the brain that things aren’t working right by producing substances that cause pain and these slip out of the cell and let the brain know something is amiss.  Biologically these substances are known as Nerve Growth Factor (NGF), substance P (P for pain-someone gets the Nobel for coming with that name) and calcitonin gene related peptide (CGRP) to name a few.  With the nerve being injured, it continues to send a pain message to the brain even though the nerve is not being stimulated by pain. This creates a “short circuit” much like an open wire lying on the floor with electricity flowing through it. The substances that cause pain also prevent tissues such as muscles, tendons, and ligaments from healing.  The term used to describe these inflamed nerves is called neurogenic inflammation.

A nerve can become inflamed in many ways.  A nerve can become inflamed as if courses through a tunnel in a bone such as the cluneal nerves shown below. These nerves are located in the back of the pelvic bone above the gluteal muscles, at the waist and are a frequent source of low back pain.

When a nerve branches it came become inflamed. When it moves back and forth over the surface of a bone, it can become irritated and inflamed such as in ITB friction syndrome, which produces knee pain in runners and cyclists. Nerves endings that become entangled in scar tissue that develops in tendons such as the achilles or patellar tendons become chronically inflamed and are thought to play a major role in pain that develops from those overuse injuries.  The end of the nerve that terminates in the skin and tissue immediately beneath it easily becomes inflamed.  A nerve such as the saphenous nerve can also become inflamed as a result of surgery in the knee when part of the hamstring is used to create a graft for ACL repair.

The illustration to the left shows sensory nerves (yellow structures) passing through connective tissue called fascia and when nerves pass through fascia they become inflamed.

These tender areas have been called trigger points.

Dr. John Lyfgogt (pronounced lift-off) discovered that these injured nerves can be treated with dextrose, which is a naturally occurring carbohydrate utilized by our body for energy.

When dextrose is concentrated at 5% and the pH is adjusted to around 7.4, the dextrose enters the nerve cell receptor to allow the “door” to open therefore restoring the cell to its normal function and leading to the decrease and eventual elimination of pain.

Think of the cells as being “hangry” in that the cell needs dextrose to function normally.

Perineural Injection Therapy involves the physician understanding the anatomy of these sensory nerves as they course throughout the body.  A series of injections containing the dextrose solution is placed underneath the skin much in the same way as getting a TB test or a “pinprick.”  A very short, small needle is used to treat along the course of the nerve.

The illustration above shows the median nerve entrapped between the pronator muscles in the forearm.  The median nerve (like all other sensory nerves) sends hundreds of tiny nerve endings that reach just below the skin as shown below and for the treatment to be effective,  the needle only needs to get below the skin to reach the individual nerve fibers.  This allows the use of a very short small needle.

The number of injections that are given depends on various factors such as the number of different nerves inflamed, how much of the nerve is inflamed, and how long the nerve has been inflamed.

For instance, in a patient that has had a total knee replacement, their pain many only be along the surgical incision and that is a very simple treatment that takes a few minutes.   If a patient had a knee replacement and has pain that involves their entire knee, the treatment can be very lengthy and involves all the nerves supplying sensation to the joint.  The same would hold true for a patient that has suffered a whiplash injury to the neck.

Most patients will require 4-6 Perineural Injection Therapy treatments spaced anywhere for 7-10 days to 2-4 weeks apart depending on their condition. No pain meds or local anesthetics are required.

After the first Perineural Injection Therapy treatment, the pain relief only lasts a few hours and the pain returns. After the second treatment, there is about 25% or so improvement and although the pain returns, it may not be as intense, widespread, or frequent as it was prior to treatment.  As the patient receives further treatments, the pain eventually goes away and normal function returns.

There are no medication restrictions for patients receiving Perineural Injection Therapy and well over 85% of patients respond.  Anti-inflammatory medicines taken for other conditions do not need to be stopped. Patients taking opiate pain medications tend not to do as well because the opiate competes with the receptor on the cell and can keep dextrose from getting into the cell.

As far as activity restrictions, patients are encouraged to remain active but only to the point where the given activity does not increase the pain during or after the activity.

Since this is drug-free treatment, and dextrose is a part of normal human function, side effects are rare and including occasional small bruises at the site of injection.  Allergy is not an issue. Although infection is a potential side effect anytime the skin is infiltrated, we have not had any occur in our patient population.

Insurance companies in the States and Britain consider the treatment “unproven” although insurers in the remainder of the world routinely cover these treatments. The cost of the treatment is dependent on the number of nerves treated as well as the complexity of the neurogenic inflammation.

Perineural Injection Therapy is performed at Beacon Orthopaedics and Sports Medicine by Dr. Henry Stiene and Dr. John Bartsch.  For more information or to schedule a consultation, please call (513) 354-3700.  If you wish to read more, including published scientific journal articles, please click here to visit Dr. Lyftogt’s website.

July 7, 2016

Prolotherapy (short for proliferant therapy) treats pain arising from joints, tendons, ligaments, muscles, and the connective tissue that holds these structures together.  Pain from these structures may be due to injury, overuse, normal wear and tear (degeneration) and nerve injury or irritation.

Prolotherapy uses solutions such as concentrated dextrose that produce a minor injury or inflammation to these structures.  Connective tissue such as ligaments and tendons have a very poor blood supply and this severely limits the ability of these tissues to heal themselves as living tissue needs a healthy blood supply to maintain nourishment and repair itself.

A tendon, for example, is made of millions of individual collagen fibers woven together much like a cable is comprised of individual wires that adding greatly to its strength. Through normal wear and tear and overuse, microtears occur in these individual collagen fibers, which heal with scar tissue.  This process begins long before any sort of pain message is relayed to the brain.  This scar tissue is not as strong nor does it have the same strength as healthy tissue.

As the process continues over time, more microtears develop leading to more scar tissue and finally significant pain and decreased function of the tendon. This degenerative process is known as tendinopathy and also occurs in ligaments and the synovium (the connective tissue that holds bones together). This process of degeneration of ligaments and synovium occurs in conjunction with osteoarthritis and leads to pain, instability, and decreased function of the joint and structures in question. Nerve endings in these tissues may become chronically irritated as well.  When this occurs, the situation is much like an exposed electrical wire with current running through it that never shuts off.

When prolotherapy injections cause local injury and irritation, it serves as a “wake up call” to the body that there is a problem that needs to be fixed. This alerts the body’s repair systems to try and start to heal the injured structure.  This injury will help increase blood supply to the area, which aids the healing process. Part of this healing process involves the regeneration of collagen fibers. This helps the injured structure regain its normal function leading to a decrease in pain. If tiny nerve endings are entrapped in the scar tissue, prolotherapy can shut off these nerve endings by simple osmosis leading to a decrease in pain.

Most patients will need a series of 3-5 injections over a number of weeks. The dextrose solution is mixed with an anesthetic and may be done under ultrasound guidance and visualization to ensure precise placement of the solution in the injured area as well as avoiding areas that should not be injected such as blood vessels and nerves.

This is a very safe and well-tolerated treatment as there are no drugs (other than local anesthetic) being injected. The site of injection will be sore for a number of days and Dr. Stiene will discuss with you limitations based on the soreness that you experience.  You may be prescribed mild pain medicine, but anti-inflammatory medicine needs to be avoided during the treatments.

Prolotherapy is most often used as part of an overall comprehensive treatment plan that may include other regenerative treatments.

It may take 6-8 weeks before a significant decrease in pain is noted. Prolotherapy, for the most part, is a healing treatment. By nature of its healing process, pain relief follows.

Prolotherapy rarely works alone. This is the main reason that insurance companies, as well as Medicare, do not cover the treatments. Research has shown prolotherapy can be very effective when combined with other treatments and we have found this to be the case as well.  However, it is unlikely insurance will cover the treatments until it has been shown to be an effective “stand-alone” treatment. Recent research has shown this to be the case in humans, but for the time being insurance carriers view the treatment as experimental.

Prolotherapy has been around for many years and because large pharmaceutical companies and surgical instrument companies have no financial stake there is very little advertising directed at the public.

Dr. Stiene and his staff will be more than happy to answer any questions regarding this type of treatment and if it may work for you.

May 5, 2016

January 18, 2016

Viscosupplementation

Joint fluid therapy, or viscosupplementation, has long been an option for those suffering from osteoarthritis. There are many products available on the market, which have differing molecular makeup, but all have a similar mechanism of action. Some use synthetic hyaluronic acid while others use an avian base. The injection of intra-articular hyaluronic acid can help relieve osteoarthritis (OA) pain by re-lubricating the joint and releasing proteins that help the body produce its own natural synovial, or joint, fluid.

The goal of joint fluid therapy is to give the patient relief for a period of time but ultimately it does not fix the underlying OA. Many patients, however, would like to avoid joint replacements, or cannot afford the cost of orthobiologics. Viscosupplementation offers these patients an option for an insurance-covered procedure that can help extend the life of the joint with a low risk of complications. Those who have chicken and egg allergy should only be given products with synthetic hyaluronic acid. If you have this allergy please discuss it with Dr. Stiene.

Each patient has a differing length of time of relief from these products. To keep the positive effects of these medications viscosupplementation injections can be repeated every 6-12 months. This is because they do not have the same deleterious effects of repeat corticosteroid injections; which have been shown to cause a further breakdown in the joint.

As of now, in the United States, joint fluid therapy is only approved and covered for use in the knee. However, patients with OA of the hips, shoulders, and ankles can benefit from this procedure as well. If you are interested in this please discuss the options at your visit with Dr. Stiene.

platelet injections and Viscosupplementation

An article published in 2016 examined three different courses of treatment: Joint fluid therapy alone, platelet injections alone, and a combination of the two. The results show promising data for the use of platelet injections and viscosupplementation together. This randomized, double-blind, controlled trial produced results that show that HA alone is beneficial, platelet injections alone is beneficial as well, even more so, and that the combination of HA and platelet injections produced the best and longest-lasting results of the three interventions.  The authors believe that the lubrication and extracellular matrix support that is provided by the HA creates an environment that allows the platelet injections to have an earlier effect, therefore allowing for better rehabilitation and quicker return to activities of daily living.

Lana JFSD, Weglein A, Sampson S, Vincente EF, et al. Randomized control trial comparing hyaluronic acid, platelet injections and the combination of both in the treatment of mild and moderate osteoarthritis of the knee.

Talk to Dr. Stiene about your treatment options. He tailors treatment to each individual patient. He may recommend Visco, platelet injections, or a combination of these therapies for the treatment of your OA.

October 6, 2015