What does an orthopedic consultation with Dr. Silva include?
Your first visit with Dr. Silva will include a comprehensive new patient evaluation with up to 60 minutes of his time focused solely on you.
Your consultation will include:
Physical Exam with Ultrasound Examination of peripheral joints (if appropriate)
Review of imaging (MRI/X-Ray, CT) (*Dr. Silva will review the actual images with you as well as the report to educate you regarding your pathology*)
Review of pertinent medical records such as Op reports, EMG, etc. (if appropriate)
Discussion of the root causes of your condition, Dr. Silva’s findings, assessment and diagnosis
Discussion regarding medical condition(s) and treatment options
Education about regenerative medicine and your potential candidacy for treatment
Education and tools to optimize your overall health through: Lifestyle, Nutrition, Exercise, Supplements and/or Medications
Diagnostic Injections performed under Ultrasound or Fluoroscopic Image Guidance may be offered to obtain precise findings for your pain generator(s) after the New Patient Consultation. Typically, Diagnostic Injections must be scheduled for a future visit after the initial visit. *Treatment(s) of any kind, including diagnostic injections are not included in the New Patient Consultation fee.*
What can I expect at my initial orthopedic consultation?
During your consultation Dr. Silva will discuss your diagnosis, as well as the treatment options and recommendations he has for you. (A detailed list of items that will be covered in the consultation can be found at the top of this page.)
Following the consultation, our procedure coordinator will review your case with the doctor and promptly send you a packet that summarizes what your recommended treatment includes, a transparent outline of expected fees associated, as well all pre-procedure instructions and post-procedure rehabilitation protocols for the proposed procedure.
What are the fees for the initial orthopedic consultation?
What is PRP?
How much does PRP cost?
Dr. Silva will tailor your PRP treatment plan for you, and there are numerous variables that he will take into account as he does this. For example, the degree of pathology, the specific regions he will be treating, and the number of regions that will be addressed in a single intervention are all variables that will be different for you than another patient.
We always want you to know the fees prior to your procedure and will provide you with a breakdown following your consultation.
How much does Cellular Therapy cost?
Do you accept insurance?
Dr. Silva has opted out of all insurance contracts, including Medicare. He has done this for your benefit. He does not want your insurance company dictating what he can and cannot do for you, as they are often very limiting. In addition, eliminating a billing department enables him to pass those financial savings on to you. Dr. Silva accepts Visa, MasterCard, Discover, Debit, and Cash/Check for all services performed at IOW.
I live out of state or out of the country – how do I get a consultation and treatment with Dr. Silva?
Do I need an MRI before my consultation?
What is the difference between autologous stem cell therapy and the amnion/cord blood products that others are offering?
What is stem cell therapy?
Stem cell therapy for musculoskeletal conditions is derived from bone marrow concentrate (BMC). Inside your bone marrow live a variety of immune cells, including mesenchymal stem cells, which are extracted and then concentrated into to be used as your cellular medicine in orthopedic procedures. BMC is one of the strongest biologics used in orthopedic procedures and is typically used for more severe cases of tendon or ligament tears, osteoarthritis, and joint degeneration. Stem cells act as a general contractor to organize the repair through a variety of cytokines and exosomes, but they may also become the brick and mortar needed for tissue repair. The end result is stronger tissue and an improved ability to handle stress which will result in better biomechanics and decreased pain.
What is prolotherapy?
There are multiple types of prolotherapy, from mild to very strong, and this should be customized to the patient’s pathology.
What is regenerative medicine?
A regenerative procedure works with the body’s natural process of healing, starting by stimulating inflammation, followed by the proliferation of new tissue, and then maturation of that new tissue over time. When utilizing Prolotherapy, PRP and/or Cellular Therapy, these stages of healing occur over several weeks to months. In order for this process to occur, and for the patient to achieve their optimal outcome, these must be precisely placed under image guidance into the degenerative tissue. You cannot get this result of healing by just blindly injecting the substance into the joint (be it PRP or Cellular Therapy), although this is how many of the less skilled practitioners administer PRP and fake “stem cells” from a bottle. Always check your “regenerative medicine” doctor’s credentials, as many practitioners inflate or misrepresent their experience, credentials, and expertise with regard to the substances they inject, ultrasound and fluoroscopic image guidance, and musculoskeletal injection techniques. Dr. Silva is a board-certified Physical Medicine & Rehabilitation doctor with specialty fellowship training in Interventional Orthopedics. Click here to learn more about his credentials.
What is the recommended follow-up protocol after regenerative procedures?
Many times, this includes lifestyle modifications, rehabilitation exercise, changing /reducing/discontinuing medications, optimizing disease, and utilizing a brace. Dr. Silva recommends a PREhab protocol to prepare for the procedure and then a rehab protocol for a minimum of 6 weeks after injections. Your PREhab and rehab will and should be customized to you, and Dr. Silva will talk about this at length during your evaluation in order to maximize your long-term results.