Opportunities for Research

A Call For Primary Investigators

  Eliminating TMJ Symptoms

TITLE: Dextrose Injection For TMJ pain. RCT of saline versus dextrose for TMJ.

REASONS FOR STUDY: Previous pilot studies indicating ability of simple dextrose injection to eliminate symptoms of TMJ but not in Medline and not RCT design.

METHOD: Subjects will be accepted if they have TMJ localized pain and bruxism noticed by themselves or others. Temporal headache is not a requirement. Exclusions include stiff neck, neck pain, posterior headache or vertex headache. RCT study with assignment to usual care (oral bite guard), usual care plus saline injection at 0, 2 and 4 months or usual care plus dextrose injection. Timing of injections are at 0, 2 and 4 months. Open label after 6 months with treatment at 6, 8 and 10 months and follow-up of all patients at 12 months. Measurements of mouth opening, jaw pain on a 10 point scale and temporal pain on a 10 point scale.

RESEARCHER LOCATIONS Will NEED: Access to patients with TMJ. (96 patients are estimated to be needed.) Enough personnel for blinding the injector and patient to the solution given and for followup to avoid data loss.

RESOURCES AVAILABLE: Assistance with each stage of the study is available. IE: Human subject committee submission, design, data collection data base, statistics, data interpretation, writeup.

IF INTERESTED: Email DeanReevesMD@gmail.com

 

 

  Repair of Rotator Cuff (Supraspinatus) Tears

TITLE: PRP Injection For Non-Retracted Rotator Cuff Tear: Long Term Outcome with MRI monitor.

REASONS FOR STUDY: Previous case observations showing ability of dextrose to heal non retracted tears in the rotator cuff.

METHOD: Subjects will be accepted if they have MRI-demonstrated rotator cuff tear isolated to the supraspinatus and without retraction. Injections with PRP will include the inferior glenohumeral ligament and the supraspinatus. This will be a consecutive patient study. 0 and 6 month MRI. Timing of injections will be 0, 2 and 4 months. MRI reading blinded and MRI scans will be read by standard scale and arranged in order of severity.

RESEARCHER LOCATIONS Will NEED: Easy and inexpensive access to MRI scanning. Adequate personnel to make PRP and maintain followup contacts. Lab access for platelet counts on injectant.

RESOURCES AVAILABLE: Assistance with each stage of the study is available. IE: Human subject committee submission, design, data collection data base, statistics, data interpretation, writeup.

IF INTERESTED: Email DeanReevesMD@gmail.com

 

 

  Arresting Hip OA

TITLE: PRP Injection in Total Hip Arthroplasty Candidates: Double Blind Saline Comparison Followed by Long Term Outcome With Serial MRI and Radiographic Monitoring.

REASONS FOR STUDY: Demonstrate symptomatic benefit of PRP over saline in RCT fashion. Then in consecutive patient fashion with objective measures and non injection controls over a 2 year period prove stabilization of bony surface and symptoms in THA candidates by interval injection of platelet rich plasma.

METHOD: Subjects will be accepted if they have obvious cartilage narrowing on standing X-ray, inability to walk daily for exercise, pain 5/10 or more, and are medically appropriate and considered candidates for total hip arthroplasty. Hip internal rotation must imitate pain. 90% pain reduction with lidocaine injection. A plain weight bearing hip AP hip film will be obtained in all patients. Potential subjects will be excluded if there is evidence of flattening of the humeral head or aseptic necrosis. 

Assignment will then occur to 2 YEAR INJECTION or 2 YEAR USUAL CARE randomly. The incentive for participation is that all patients will be offered PRP either immediately or delayed by 2 years. Random assignment will assign 60% to the usual care group as some drop out to surgery may occur.

3 MONTH BLINDED STUDY. (WITHIN INJECTION GROUP)

LONG TERM OUTCOME STUDY: INJECTION VERSUS NON INJECTION GROUP: Plain X-Rays and MRI scans will be obtained at time 0 and 2 years in all patients. PRP patients will continue to receive PRP at intervals and Saline patients will receive PRP at intervals. Non injection group will continue to receive usual care. MRIs and standard films will be read blinded and readers will be asked to arrange X-rays in order of severity.

RESEARCH LOCATIONS WILL NEED: Easy and reliable long term access to fluoroscopy or ultrasound for injection. Easy and inexpensive access to MRI scanning and standard films with a similar Tesla value. Adequate personnel to make PRP and maintain followup contacts.

HELP AVAILABLE: Assist as needed with design, PRP preparation, human subject committee submission, data collection, statistics, data interpretation, and writeup. Help with personnel costs may be available.

SITES: To be determined. Multiple sites are feasible.

IF INTERESTED: Email DeanReevesMD@gmail.com

 

 Eliminating Hand OA Symptoms

TITLE: Vitamin D Cream Application In Hand Osteoarthritis. Long terem outcome with ring size monitor.

REASONS FOR STUDY: Demonstrate a simple method of arresting OA symptoms and preserving functional ability without need for injection.

METHOD: Subjects will be accepted if they have hand pain and stiffness with grip. Cream application with be BID for a 6 month period. Ring sizes will be followed as an objective measure and VAS for pain and stiffness.

RESEARCH LOCATIONS WILL NEED: S

HELP AVAILABLE: Assist as needed with design, PRP preparation, human subject committee submission, data collection, statistics, data interpretation, and writeup. Help with personnel costs may be available.

SITES: To be determined. Multiple sites are feasible

IF INTERESTED: Email DeanReevesMD@gmail.com

 

 

  Repairing Medial Meniscus Tears

TITLE: PRP Injection For Medial Meniscus Tear: Long Term Outcome with MRI monitor.

REASONS FOR STUDY: Previous pilot study showed ability of simple dextrose injection to repair medial meniscus.

METHOD: Subjects will be accepted if they have demonstrated medial meniscus tear by MRI. Exclusions include Knee locking or a demonstrated bucket handle tear . injections with PRP will be intraarticular and in the coronary ligament. This will be a consecutive patient study. 0 and 6 month MRI. Timing of injections will be 0, 2 and 4 months. MRI reading blinded and MRI scans will be read by standard scale and arranged in order of severity.

RESEARCHER LOCATIONS Will NEED: Easy and inexpensive access to MRI scanning. Adequate personnel to make PRP and maintain followup contacts. Lab access for platelet counts on injectant.

RESOURCES AVAILABLE: Assistance with each stage of the study is available. IE: Human subject committee submission, design, data collection data base, statistics, data interpretation, writeup.

IF INTERESTED: Email DeanReevesMD@gmail.com

 

 

 Repairing Loose and Partial Torn ACL

TITLE: PRP Injection For Symptomatic ACL laxity or Partial ACL Tear in Athletes: Long Term Outcome with MRI and KT-1000 monitor.

REASONS FOR STUDY: Previous pilot study showed ability of simple dextrose injection to tighten ACL ligament in older patients with objective machine (KT-1000) monitor and often with concurrent advanced osteoarthritis. Radiographic monitoring for ACL status was not available at the time.

METHOD: Subjects will be accepted if they have subjective laxity of the knee, definite ACL continuity by MRI, ACL laxity by KT-1000 (2 mm or more side to side difference), pain with sport or alteration of sport due to same sided knee determined by Nirschl scale, and asymptomatic opposite knee. Injection will be by ultrasound or fluoroscopic guidance. 6 ml PRP will be utilized Injections will be at 0,1, 2, and 4 months. Followup KT-1000, Nirschl scale and MRI at 6 months and 1 year.

RESEARCHER LOCATIONS Will NEED: Easy and reliable long term access to fluoroscopy or ultrasound for injection. Easy and inexpensive access to MRI scanning. Adequate personnel to make PRP and maintain followup contacts. Lab access for platelet counts on injectant.

HELP AVAILABLE: Assist as needed with design, PRP preparation, human subject committee submission, data collection, statistics, data interpretation, and writeup. Help with personnel costs may be available.

IF INTERESTED: Email DeanReevesMD@gmail.com

 

 

 Prophyalaxis of ACL Injuries in Athletes

 

TITLE: Prevention of Loss of Practice or Game Time Due to Any Knee Cause Diagnosed as a Partial or complete ACL Tear

REASONS FOR STUDY: Previous favorable studies on ACL repair, osteoarthritis and medial meniscus tear using dextrose alone. Determine if dextrose injection will significantly decrease loss of practice or game participation due to knee causes.

PROPOSED METHOD: Athletic teams will be contacted to seek permission to offer voluntary injection of dextrose on a quarterly basis with or without ultrasound guidance. Exclusions are locking of the knee (implying free floating tear with joint motion obstruction) , history of a complete ACL tear (repaired or not), and current jumping impairment due to pain and lack of access to an MRI scan. Athletes must agree to small needle injection of knee and to random assignment and to a brief phone call at 6 month intervals for 2 years. Random assignment to injection or no injection groups. Dextrose injection will be intraarticular only, preferably with dextrose injection. VAS for pain, days lost in practice and games due to knee pain, and presence or absence of and ACL injury will be followed.

RESEARCHER LOCATIONS Will NEED: Sports team connection. Agreement of team trainers to provide a location for treatment at no cost to athletes with understanding that they cannot have any influence on determination of who is included in the study. Ultrasound use will be encouraged but is not mandatory.

HELP AVAILABLE: Assist as needed with design, PRP preparation, human subject committee submission, data collection, statistics, data interpretation, and writeup. Help with personnel costs may be available.

IF INTERESTED: Email DeanReevesMD@gmail.com

 

 

   Resurfacing Cartilage in End Stage Knee OA

This research project is currently in progress.  Click here to read an overview of the study.

 

 

 

  Healing Osgood Schlatter's Disease

This study is nearing completion.  More information is available here.