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Regenerative Medicine

Regenerative Medicine

Regenerative Medicine

Platelet Rich Plasma (PRP)

Platelet Rich Plasma (PRP) therapy is a relatively new treatment (over 10 years now) designed to aid in the healing and regeneration of soft tissues such as bone, skin, cartilage, tendons and ligaments.

To fully understand the benefits of PRP therapy it is first useful to have some understanding of the basic science behind your bodies injuries.

Soft tissue structures like skin, tendons and ligaments are made up of fibers of collagen. When these fibers are stretched (sagging) or torn we may refer to the injury as a “pull”, “tear”, “sprain” (ligament) or “strain” (tendon). These structures are vascular which means there are blood vessels in them.  The cartilage of the knees and other joints the cartilage has no direct blood supply and must receive its “healing nutrition” via the surrounding fluids of the joint or soft tissues. These other soft tissues are injured they bleed.  Blood flow to the area increases to aid in healing.  The blood carries platelets and growth factors that allow for healing of the tissue by creating new collagen fibers. These new fibers need to be constructed in an organized, layered fashion to heal correctly and allow tissues like the ligament or tendon to regain its proper strength and flexibility.

Sometimes ligaments and tendons injuries heal and other times they do not. PRP helps the revascularization via angiogenesis.

PRP therapy is the solution to this problem.  In PRP treatment the patient’s own blood is taken with a simple blood draw. Using a special centrifuge machine this blood is spun down to separate out and concentrate the platelets and growth factors that are essential for tissue healing.  This small amount of fluid with concentrated platelets and growth factors is called platelet rich plasma (PRP).  Nothing else is added to the patient’s own blood products so there is no risk of allergy, reaction or rejection.  PRP therapy is a purely natural process using the body’s own healing factors.  The trick is getting them to the right place.

The physician then uses a diagnostic ultrasound machine to identify the area within the ligament or tendon that is injured.  The newest ultrasound technology provides resolution to see every millimeter of the collagen fibers as well as scar tissue and blood flow to the area.  The physician is then able to use a needle to inject the PRP directly into the injured area and even between tightly packed collagen fibers.  The PRP can even be injected directly into very small tears that are sometimes not apparent on MRI.  Once these platelets and growth factors are in the area of injury they then become activated.  They also recruit other healing proteins and factors to the area and healing and regeneration of the tissue can now begin.

This therapy has been used extensively in Europe for several years and is now more popular in the U.S. as more people become aware of its potential benefits and as more research is being done. Now with the development of PRP we can actually get the specific healing factors within the blood to the injured area.  This not only allows for healing of injuries which may not otherwise heal, but it also speeds up recovery of injuries which may eventually heal over a longer period of time.  PRP therapy is a great option for two different patient populations.  One is the patient with the chronic injury that never seems to go away, and the other is the patient with an acute injury which might otherwise take weeks or months to heal and is looking to do something to “speed up” the recovery process.  That is why PRP has become so popular among athletes and there have been many media reports of elite athletes highlighting how they are receiving PRP treatment for injuries that occur mid-season or even right before big events such as the Superbowl.  But PRP treatment is not just for athletes.

PRP therapy can be used with great success for the following conditions:

Acute and chronic tendon injuries (tendonitis, tendinosis, tendinopathy, tendon tears), Knee & Osteoarthritis pain, Foot and ankle: Plantar fasciitis, Achilles tendonitis and partial tears, Knee Patellar tendonitis and tears, Quadriceps tendonitis and tears, Hamstring strains, Elbow Medial epicondylitis (golfer’s elbow), Lateral epicondylitis (tennis elbow) and Shoulder: Rotator cuff tendonitis and partial tears.

Acute and chronic ligament injuries (sprains)

Elbow, Hand, Knee, Foot and Ankle

And many other conditions associated with scarred or non-healing tissue.

The latest exciting news is that PRP has also been shown to be effective in treating osteoarthritis (OA).  Arthritis is an inflammatory condition involving the breakdown of cartilage within a joint. PRP treatment can be effective in re-growing lost cartilage or slowing cartilage breakdown, there is now evidence that PRP is effective in treating the symptoms of arthritis.  In fact, several new studies have shown that PRP is more effective than typical conservative treatments and has even performed better than visco-supplementation (hyaluronic acid injections) in head-to-head studies. PRP may be an excellent non-invasive alternative to joint replacement surgery in treating the symptoms of arthritis.  PRP can be used to treat the symptoms of arthritis of the shoulder, hip, knee, ankle and foot.

 

Fat/Adipose Tissue graft (Adipose Derived Stem Cells ADSC’s)

Stem Cells from Autologous fat graft (fat from your own body) for the treatment of knee osteoarthritis. It’s a simple injection of autologous fat graft to improve chronic osteoarthritis. The treatment involves using the self-lubricating effect of their own abdominal/belly fat (autologous fat) inside the joint to improve joint function and reduce the pain and stiffness they experience. It is performed as day care procedure under local anesthesia and sedation. The fat is obtained and prepared, then injected inside the joint of the knee.

We see improvement in the pain and stiffness of the joint physical function by the combined lubricating and regenerative effect of fluid preparation.

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