By Dr. Jeffrey Peng, MD · Published March 08, 2026 · 8 min read Watch the Full Video A landmark randomized controlled trial published in the New England Journal of Medicine challenged one of the most common assumptions in orthopedic surgery: that patients with bone-on-bone knee arthritis inevitably need a knee replacement. The researchers took 100 patients who had been evaluated by an orthopedic surgeon and deemed eligible for total knee replacement, then randomly assigned

By Dr. Jeffrey Peng, MD · Published March 8, 2025 · 6 min read Watch the Full Video If you are over 40 and have had a shoulder MRI, there is a very good chance your report mentions something about your rotator cuff — tendinopathy, a partial tear, maybe even a full-thickness tear. Those words sound alarming. But a landmark study published in JAMA Internal Medicine is challenging everything we thought we knew about what these findings actually mean. The researchers scanned ov

By Dr. Jeffrey Peng, MD · Published March 6, 2026 · 5 min read Watch the Full Video Dextrose prolotherapy is one of the oldest regenerative injection therapies still in use today, yet most patients have never heard of it. The concept is simple: inject a concentrated sugar solution into or around a damaged joint to trigger the body’s natural healing response. But does the science actually support this approach for knee arthritis ? In this post, we review the clinical trial ev

By Dr. Jeffrey Peng, MD · Published March 6, 2026 · 6 min read Watch the Full Video Both hyaluronic acid (HA) injections and platelet-rich plasma (PRP) injections are well-established treatments for knee osteoarthritis. When used individually, head-to-head trials consistently show that PRP tends to produce more favorable outcomes than HA alone. But a growing body of research is now exploring whether combining the two injections could produce a synergistic effect — offerin

By Dr. Jeffrey Peng, MD · Published March 6, 2026 · 12 min read Watch the Full Video Myofascial pain syndrome and trigger points are among the most common — and most commonly missed — causes of chronic musculoskeletal pain. In my sports medicine practice, I regularly evaluate patients who have seen multiple providers, undergone extensive imaging, completed months of physical therapy, and sometimes even had surgery — all without relief — because the underlying myofascial tri

By Dr. Jeffrey Peng, MD · Published March 6, 2026 · 7 min read Watch the Full Video Stem cell therapy continues to generate excitement as a potential treatment for chronic joint pain. Among the various sources of stem cells being studied, umbilical cord-derived mesenchymal stem cells have emerged as a particularly interesting option. Unlike bone marrow or adipose-derived stem cells — which are harvested from the patient's own body — umbilical cord stem cells come from donate

By Dr. Jeffrey Peng, MD · Published March 6, 2025 · 7 min read Watch the Full Video Rotator cuff disease is one of the most common causes of shoulder pain, accounting for up to 70% of all shoulder complaints. The condition spans a wide spectrum — from tendinopathy and subacromial impingement to partial and full-thickness tears — and the vast majority of cases can be managed without surgery. But when pain is severe enough to prevent participation in physical therapy , injecti

By Dr. Jeffrey Peng, MD · Published March 6, 2026 · 5 min read Watch the Full Video Tennis elbow — clinically known as lateral epicondylitis or lateral elbow tendinopathy — is one of the most common causes of elbow pain. It develops when the common extensor tendon in the forearm is subjected to repetitive overuse or overloading, leading to microtears that weaken the tendon over time. The result is chronic pain, reduced grip strength, and difficulty performing everyday tasks.

By Dr. Jeffrey Peng, MD · Published March 6, 2026 · 8 min read Watch the Full Video Platelet-rich plasma ( PRP ) injections have become a widely studied treatment option for tendon conditions such as tennis elbow, fascial problems such as plantar fasciitis, and joint conditions such as osteoarthritis. PRP is increasingly used as a first-line therapy because it is both safe and effective. However, one often-overlooked factor that can significantly influence your outcomes is t

By Dr. Jeffrey Peng, MD · Published March 6, 2025 · 5 min read Watch the Full Video Myofascial pain syndrome and trigger points are among the most common causes of chronic musculoskeletal pain, affecting an estimated 85% of patients who visit chronic pain clinics. Despite how widespread this condition is, effective treatment remains a challenge for many patients and clinicians alike. Traditional management typically involves soft tissue modalities such as massage, acupunctur

Dr. Jeffrey Peng, MD · Published March 6, 2025 · 5 min read Watch the Full Video Amniotic fluid injections have generated significant interest as a potential treatment for knee osteoarthritis. One of the most compelling use cases is for patients who continue to experience pain despite standard treatments such as hyaluronic acid and corticosteroid injections. But does this treatment actually work? A recent clinical trial offers some encouraging — though nuanced — answers. Wh

By Dr. Jeffrey Peng, MD · Published March 6, 2026 · 6 min read Watch the Full Video Platelet rich plasma injections and stem cell injections are two of the most talked-about orthobiologic treatments for knee osteoarthritis. Both have demonstrated clinically significant pain relief and functional improvement in clinical trials. However, stem cell therapy is often marketed as a superior treatment and comes with a much higher price tag. But does the evidence actually support th

By Dr. Jeffrey Peng, MD · Published March 6, 2025 · 7 min read Watch the Full Video If you have been diagnosed with a degenerative meniscus tear, you have likely heard conflicting advice about treatment. Some physicians recommend arthroscopic surgery to remove the damaged tissue, while others advocate for physical therapy and structured exercise. The disagreement often depends on whether you see an orthopedic surgeon or a nonoperative sports medicine specialist. So which app

By Dr. Jeffrey Peng, MD · Published March 6, 2025 · 7 min read Watch the Full Video Rotator cuff disorders are among the most common causes of shoulder pain, contributing significantly to lost function and decreased quality of life. When conservative measures such as physical therapy and activity modification fall short, many patients are offered cortisone injections. While cortisone provides strong short-term pain relief and anti-inflammatory effects, growing evidence sugge

By Dr. Jeffrey Peng, MD · Published March 6, 2025 · 5 min read Watch the Full Video Hyaluronic acid injections and PRP therapy are two of the most effective non-surgical treatments for hip osteoarthritis. Both have been shown to reduce pain and improve function — but is one better than the other? And if both work, does combining them into a single injection produce even better results? A recently published randomized clinical trial directly compared PRP alone, hyaluronic ac

By Dr. Jeffrey Peng, MD · Published March 6, 2025 · 8 min read Watch the Full Video If you are considering a platelet rich plasma injection , one of the most important questions you can ask your provider is: how many platelets will be in my PRP? Research increasingly shows that platelet count is one of the strongest predictors of treatment success — and not all PRP preparations deliver an adequate dose. A growing body of evidence suggests that achieving at least 5 to 10 bill

By Dr. Jeffrey Peng, MD · Published March 6, 2025 · 5 min read Watch the Full Video There is considerable debate within the orthopedic community about the best treatment options for a meniscus tear. What is becoming increasingly clear is that cutting out the meniscus should be seen as a last resort. Newer techniques for meniscus repair surgery have shown lower failure rates, and with advances in orthobiologics and cellular therapy, many providers are exploring whether augme

By Dr. Jeffrey Peng, MD · Published March 6, 2025 · 7 min read Watch the Full Video Achilles tendon ruptures are among the most devastating injuries an active person can experience, leading to significant pain, disability, and time away from work and sport. While surgical repair was once considered the default treatment, a growing body of evidence now supports nonsurgical management for many patients. This raises an important question: if we can treat Achilles tendon tears w

By Dr. Jeffrey Peng, MD · Published March 6, 2026 · 6 min read Watch the Full Video If you are dealing with knee osteoarthritis and have been told that arthroscopic surgery might help, you may be wondering how it compares to platelet-rich plasma (PRP) injections. Head-to-head trials comparing PRP to placebo, hyaluronic acid, and cortisone injections have consistently shown that PRP produces superior and more sustained symptom relief. But how does PRP stack up against surger

By Dr. Jeffrey Peng, MD · Published March 5, 2026 · 7 min read Watch the Full Video Platelet-rich plasma (PRP) injections have become one of the most effective non-surgical treatments for reducing pain and improving function in patients with knee osteoarthritis . But an important question remains: can PRP actually slow down the progression of arthritis itself? A landmark randomized controlled trial by Chu et al. (2022) set out to answer that question — and the results were