Orthopedics

An orthopedic visit is necessary in the case of a significant acute trauma (suspected fracture, dislocation, ligament injury), persistent joint pain that does not improve with rest, or whenever a formal medical diagnosis supported by imaging (X-ray, MRI) is needed to establish whether the approach should be surgical or conservative.

Cortisone injections have a powerful, fast-acting anti-inflammatory effect, indicated in the acute phases of pain and arthritis to settle the inflammation. Hyaluronic acid injections (viscosupplementation) instead act as a natural lubricant and shock absorber within the joint (for example a knee or hip affected by osteoarthritis), improving mobility and protecting the cartilage in the medium and long term.

Hyaluronic acid has a mainly mechanical, lubricating action: it works as a biological shock absorber inside the joint, reducing friction and relieving pain caused by osteoarthritis. PRP (Platelet-Rich Plasma) has instead a biological, regenerative action: it is a concentrate of growth factors obtained from the patient’s own blood, which stimulates tissue repair and supports the healing of worn tendons, muscles and cartilage.

A PRP injection is well tolerated and comparable to a standard joint injection: it is performed with very fine needles on an outpatient basis and takes a few minutes. PRP is an autologous platelet gel, meaning it is obtained from the patient’s own blood, so the risk of rejection or allergic reactions is nil.

Intratissue Percutaneous Electrolysis (E.P.I.) is a minimally invasive technique used to treat chronically degenerated tendons and muscles. The procedure is performed under real-time ultrasound guidance to pinpoint the exact area of fibrosis or tendon disorganisation: the galvanic current acts only on the damaged tissue, sparing the surrounding healthy fibres. It is a quick outpatient treatment, indicated for conditions such as Achilles tendinitis or groin pain (pubalgia).

The difference lies in the depth of action and the precision of the treatment. Radial shockwaves release their energy diffusely from the skin surface and are suited to more superficial muscle treatments. Focused shockwaves concentrate the energy on a single deep focal point, adjustable by the doctor: they allow targeted treatment of deep structures such as shoulder calcifications or heel spurs, without traumatising the healthy superficial tissues.

The three therapies can be combined within the same clinical protocol. In a chronic tendinopathy, E.P.I. or focused shockwaves act on the degenerated, disorganised scar tissue; a PRP injection then delivers the growth factors that support the regeneration of new healthy fibres. This combined approach can help shorten recovery times, both in sedentary patients and in athletes.