Atlanta Center for Cartilage Restoration and Joint Preservation

Dr. Jon Hyman is a Harvard trained, board certified Orthopaedic Surgeon who specializes in advanced cartilage restoration and joint preservation - for hip, knee, shoulder and elbow conditions. He has over 20 years of experience as a physician and has worked successfully with many professional athletes, injured workers, weekend warriors and every day people like himself.

It’s easy to damage the tissues in your joints but it’s hard for them to heal. Bones usually heal well, but soft tissues like cartilage, ligament and tendon lack a lot of bloodflow like bones. Injury to cartilage is often not as obvious as a broken bone. If left untreated, cartilage, ligament and tendon injuries cause joint problems which can lead to serious disability and, in severe cases, premature joint replacement. As the population grows, people are living longer, and many of them are damaging their joints with intense activity or obesity. Our practice has a high volume of active adults and young athletes who need special attention to optimize their health in a way that preserves their joints.

Dr. Hyman specializes in non-surgical joint preservation strategies involving physical therapy, massage, nutrition, aquatics, braces and when needed, injections or medications. If these are not likely successful, he has the surgical expertise to repair, restore or replace damaged cartilage before more advance deterioration sets in. Early treatment can delay or sometimes prevent the need for joint replacement surgery. Our goal is to relieve your pain, prevent continued joint damage with leads to arthritis, and restore you to an active lifestyle.

The Atlanta Center for Cartilage Restoration and Joint Preservation is pioneering innovating treatments for treating early cartilage, ligament and tendon damage in the hip, knee, shoulder and elbow. Whether re-shaping the bones or transplanting cadaver tissue into the body, Dr. Hyman’s surgical techniques can help you achieve better outcomes than you might think possible. Our staff at the Advanced Orthopedic Surgery Center are privileged to provide you with safe and compassionate care for your procedures.

Some of the procedures which Dr. Hyman has special expertise in:

• Arthroscopic surgery of the Knee, Hip, Elbow, Shoulder
• Hip arthroscopy for any condition, especially FAI
• Labral repair of hip and shoulder
• Labral reconstruction
• Reconstructive Surgery for shoulder, hip and knee
• Meniscal Transplantation
• Cartilage Transplantation
• Microfracture, OATS, Mosaicplasty
• OrthoBiologics
• ACL, MCL, PCL Ligament Reconstruction
• Autologous Chondrocyte Implantation
• Fresh Osteochondral Allograft
• Iliopsoas Tendon Surgery or Ischiofemoral Impingement
• High Tibial Osteotomy & Distal Femoral Osteotomy
• Partial Joint Replacement
• Unicompartmental Knee Replacement
• Patellofemoral Arthroplasty
• Shoulder, Hip and Knee Biological resurfacing
• Tendon Repair (gluteus medius, rotator cuff, biceps, triceps, patella, quad, achilles, etc)
• Diagnostic Ultrasound
• Ultrasound guided joint injections (No radiation)
• Platelet Rich Plasma and Stem Cell Therapies in very select instances*
• Viscosupplement Injections

How do you know if you’re a candidate for Cartilage Restoration or Joint Preservation treatment?

We may be able to help you if:

• you have pain doing activities you enjoy
• physical therapy, chiropractic or other treatments haven’t fully resolved your pain
• rest, medications, or injections are not helping your pain
• your pain is getting worse or is lasting for months
• you’ve been told you’re too young for joint replacement
• you’ve had surgery already but are still in pain
• you were told to live with the pain until you’re ready for joint replacement
• you were told your X-rays and MRI don’t explain your pain
• you were told you have mild arthritis, but it’s not bad enough for joint replacement

We are not selling hope or dreams, like many of the Regenerative Medicine practices out there. Many patient’s ask us about certain therapies: eg. Regenexx, PRP, Prolotherapy, Stem Cell & Bone Marrow Concentrate injections. Unfortunately, at the time of this writing, despite hundreds of thousands of these Regenerative Medicine injections for Osteoarthritis, there isn’t a single study proving their efficacy. This is one reason why insurance companies don’t pay for these therapies. We see some patient’s who benefit from them, and many who do not. The improvements, when they occur, could be 'placebo effect' or there could be benefits yet unproven. The ‘nocebo effect’ is another possible explanation.

Some practices are simply selling hope in the form of these injections, magical vitamin supplement potions and other unproven formulas. As much as we try to find non-surgical options to heal our bodies, the difference between orthopedic surgery and many of these orthobiologics is that surgery has been proven to work and is a legitimate treatment with predictable results. But clearly surgery doesn't always work either. Therefore we need to compassionately work with orthobiologics and the body’s natural healing potential to improve wellness and avoid surgery - but not in a way that takes cash from vulnerable and suffering people by selling them on unproven remedies.

What the research says on PRP (Platelet Rich Plasma)

Platelet-rich plasma (PRP) injections are increasingly used in patients with sports-related injuries, but data from randomized trials to assess their efficacy are lacking. The basis of interest in PRP is the suggestion that the biological growth factors from the plasma can promote healing in various tissues and treat joint pain. However, ongoing efforts to produce convincing evidence from randomized, controlled trials have been made and continue to show no real benefit. In light of the lack of substantive evidence, the cost of PRP injections is particularly high. While some clinicians typically charge $1000- 800 for a single injection and $600 for subsequent injections in the same area, patients typically have to pay for it because insurance companies will likely not cover the cost. All major payers consider PRP for musculoskeletal conditions to be experimental. The current use of PRP seems driven as much by marketing and cash incentive as it is by treatment efficacy.

A few of the many unknowns about PRP Therapy:

• Timing of injections
• Immobilization or Mobilization/Rehab after injections
• Frequency or # of injections needed
• Expected time for improvement after injection
• Which of the many different cellular/chemical compositions is optimal

One review article showed some possible benefit in knee osteoarthritis but the studies included were likely biased by industry sponsorship.

Br J Sports Med 2014
Review: Efficacy of platelet-rich plasma injections in osteoarthritis of the knee: a systematic review and meta-analysis

New England Journal of Medicine 2014
Platelet-Rich Plasma Injections in Acute Muscle Injury N Engl J Med 2014; 370:2546-2547