In nature, some hair follicles stand alone while others are grouped together as neighbors or bundles of two, three and once in a while four hairs.
Whole blood is drawn and centrifuged to separate the blood components; RBC’s, WBC’s, proteins and platelets.
Positive Effect of an Autologous Platelet Concentrate in Lateral Epicondylitis A double-blind randomized controlled trial: PRP versus corticosteroid injection with a 1 year follow-up.
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Philosophy
What is OrthoBiologic PRP therapy?
Platelet Rich Plasma (PRP) is an exciting treatment known as "Orthobiologics.”. PRP therapy offers a safe promising solution to accelerate healing of tendon/ ligament injuries and osteoarthritis naturally without subjecting the patient to significant risk. The goal is to merge cutting edge technology with the body's natural ability to heal itself.
If a patient has undergone traditional therapy that failed, PRP therapy may have been used to heal acute and chronic injuries and many times avoid surgery. PRP is used in surgery to both “seal and heal” and may be use after surgery to promote more rapid healing.
Procedure
Blood is made of RBC (Red Blood Cells), WBC (White Blood Cells), Plasma, and Platelets. Platelets were initially known to be responsible for blood clotting, but in the past 20 years we have learned that when activated in the body, platelets release healing proteins called growth factors. There are many growth factors with varying responsibilities, however cumulatively they accelerate tissue and wound healing. Therefore after increasing the baseline concentration of these platelets, we are able to deliver a powerful cocktail of growth factors that can dramatically enhance tissue recovery.
While this treatment is still considered experimental it is safe because your healing capable cells are utilized. Non surgical cortisone injections alleviate pain and inflammation for a short time and can cause side effects like calcification of ligaments and tendons. This regenerative procedure restores and heals the injured cells enabling rehabilitation sooner.
This procedure has also been used on Yankees third baseman Alex Rodriguez, Mets shortstop Jose Reyes and golf superstar Tiger Woods, AFL star Hines Ward of the Pittsburgh Steelers, and soccer super star Cristiano Ronaldo.
Before and After Treatment with Platelet Rich Plasma (PRP)
Before treatment
If taking NSAID’s( anti-inflammatory medication i.e.: Motrin, Naprosyn, Advil, Aleve) please discontinue 5-7 days prior to treatment. If taking an 81mg Aspirin, continue.
Follow you normal daily routine on procedure day; make sure to drink plenty of water.
The procedure takes approximately 1 hr to perform.
Upon arriving at the clinic your peripheral blood will be drawn and you will be prep’d for your procedure. Your blood will be spun in a special centrifuge which takes about 15 minutes.
After treatment with PRP
You will be numb in the areas treated for 2-4 hrs after the procedure.
Due to the numbness we ask that you refrain from any strenuous activities but to stay mobile. Continue to move affected area to decrease soreness and stiffness.
After the anesthesia wears off you may resume activities to tolerance of pain.
You will experience some pain and soreness for 2-5 days after your treatment. The initial inflammatory phase last 7 days and secondary phase can last up to 14 days.
No anti-inflammatory medication (Ibuprofen, Motrin, Aleve, or Naprosyn) should be used for 4-6 wks after treatment.
Tylenol for pain, Ice as needed for pain and or swelling (10-20 minutes to cool the skin, repeat every 2-3 hours)
Follow a program for flexibility and core strength to rehabilitate and correct any imbalances in the kinetic chain.
You may experience the “roller coaster” syndrome where you feel great one day and for no apparent reason the area treated starts to hurt again, this is normal in the healing process.
The platelets are active for several weeks and it can take up to 12 months for normal collagen to form and heal completely.
Our goal is 60% improvement in pain with one injection, so you may or may not need more than 1 treatment to reach that goal. Sometime a series of 2-3 treatments are needed to achieve complete healing. If subsequent treatments are needed they are usually performed 8-10 weeks apart.
“Cortisone versus PRP”
Data was released from Krakow Poland at the International Meeting on the use of Autologous Growth Factors in Orthopedics and Sports Medicine: “State of the Art” – Krakow, Poland – 24 April 2009. The study found that patients receiving cortisone showed a 40% improvement compared to PRP 75% at 12 months. This is the first head to head study. Cortisone is well known to carry a risk of weakening & rupturing a tendon & is often discouraged.
Positive Effect of an Autologous Platelet Concentrate in Lateral Epicondylitis A double-blind randomized controlled trial: PRP versus corticosteroid injection with a 1 year follow-up.
Joost C. Peerbooms, Jordi Sluimer, Daniël J. Bruijn, Taco Gosens
Context: Platelet Rich Plasma (PRP) has shown to be a general stimulation for repair.
Objectives: To determine the effectiveness of PRP compared with corticosteroid injections in patients with chronic lateral epicondylitis.
Design: A double blind randomized controlled trial with a one-year follow-up between May 2006 and January 2008.
Setting: The trial was conducted in two teaching hospitals in The Netherlands.
Patients: 106 patients with chronic lateral epicondylitis were randomly assigned in the PRP group or in the corticosteroid group. Randomization and allocation to the trial group were carried out by a central computer system.
Intervention: Patients were randomized to receive either a corticosteroid injection or an autologous platelet concentrate injection through a peppering needling technique.
Main Outcome Measures: The primary analysis included VAS and DASH scores.
Results: Successful treatment was defined as more than a 25% reduction in VAS or DASH score without a reintervention after 1 year. The results showed that 21 of the 55 patients (40 %) in the corticosteroid group and 38 of the 51 patients (75 %) in the PRP group were defined as successful with the VAS score, which was significant different (P < 0.001). 23 of the 55 patients (42 %) in the corticosteroid group and 36 of the 51 patients (71 %) patients in the PRP group were defined as successful with the DASH, which was also significantly different (P < 0.003).
Conclusions:
Treatment of patients with chronic lateral epicondylitis with PRP reduces pain and increases function significantly, exceeding the effect of corticosteroid injection. Future decisions for application of the PRP for lateralepicondylitis should be confirmed by further follow-up from this trial and should take into account possible costs and harms as well as benefits.
Trial registration: ClinicalTrials.gov. Identifier: 2007-004947-31.http://www.clinicaltrials.gov
Comments:
This is probably the most convincing evidence so far for the benefit of PRP for persistent tennis elbow and demonstrates similar success rates to surgery with a 75% success rate in significant pain improvement.
References
International Meeting on the use of Autologous Growth Factors in Orthopaedics and Sports Medicine: "State of the Art" - Krakow, Poland - 24 April 2009.
The governing body the World Anti-Doping Agency (WADA) clarified their stance on the use of PRP for Professional Athletes.
A pro athlete suffering from tendinitis or a similar nagging injury goes to the doctor looking for a solution. With millions of dollars on the line, the athlete demands something between the extremes of invasive surgery and the boring old standby of RICE - rest, ice, compression and elevation.
More and more often, sports medicine's answer is platelet-rich plasma therapy, or PRP, the procedure in which a doctor withdraws about 50 cubic centimeters of a patient's blood, spins it in a centrifuge to isolate the platelets, and injects them directly into the injured area, where they promote the body's natural healing response.
In the past, PRP was banned entirely by the World Anti-Doping Agency, and it is currently off limits if the injection is aimed at a muscle (rather than a joint or tendon). But as of Jan. 1, the procedure will be entirely legal - and hugely popular among top athletes.
Julie Masse, a WADA spokeswoman, said the anti-doping agency eased restrictions on PRP because there is no evidence that the procedure enhances performance.
"Current studies on platelet-derived preparations do not demonstrate potential for performance enhancement beyond a potential therapeutic effect," Masse said. "WADA will, however, continue to closely monitor developments of these preparations."
BY Michael O'Keeffe, Christian Red and Nathaniel Vinton
DAILY NEWS SPORTS WRITERS
Sunday, September 26th 2010, 4:00 AM
Testimonials (Case Studies)
“Torn Surgically Repaired Triceps Tendon”
This 50 year old Male presented with a torn “surgically repaired” right triceps tendon. The patient tore the triceps tendon and had it surgically repaired, tore it a second time and was facing a second surgery to repair the tear. PRP autologous graft was proposed.
Platelet Rich Plasma with protein matrix (OroGen Plus) was injected into the tear and a second treatment followed 6 weeks later. Eight weeks after the second treatment the patient reported.
“I wouldn’t say the injection you gave me was a miracle, but pretty darn close. I have 60% of the strength in my treated arm than in my left arm and I had zero percent before the treatment. I am doing 40 push ups now and at this point I would never have surgery. It feels to darn good”.
CG
“Partially Torn Rotator Cuff and Lateral Elbow Tendonitis”
This 52 year old electrician had rotator cuff surgery on his right shoulder and was out of work for six months. He presented with pain in his surgically repaired shoulder, a partial rotator cuff tear in his other shoulder and a painful left lateral elbow. The pain in all three areas made it difficult for him to even hang a fan.
PRP matrix graft was injected in all three areas and at one week the patient reported “zero” pain. Three weeks later the patient complained of, “difficulty sleeping at night”. When asked if his shoulders were painful when he was sleeping he replied, “ I don’t have any pain, in fact, two days after my injections I didn’t have any pain. I stopped taking the six hydrocodone I was taking daily for six months for the pain”.
The patient was obviously in withdrawal from stopping all the pain medicine so abruptly. Today the patient said, “ this treatment save my marriage because I was not the same person when I was on all the pain medicine”. He only had one PRP treatment!
M. Tores
PRP injection for bulging disc!
June 22, 2010
I am writing this testimonial one year after an injury that I thought was the end of my pole vaulting career. Please read on as I hope my success will help you see how great PRP really is:
As a college sophomore I injured my back and thought my pole vaulting career was over because in February 2009 an MRI showed a bulging disc located at L5/S1 in my lower back. At first the pain was excruciating. Car rides were uncomfortable, sleeping and walking all gave me pain. Physical therapy sessions consisting of heat and electric stimulation only lessened the pain a little. Nothing seemed to make the pain disappear. Frustrated and unhappy I decided to research non surgical options and this new treatment called PRP. After doing my research I and hearing about the results from previous patients so I decided to fly to Clearwater, Florida and give it a try.
Before the treatment, my freshman year at Shippensburg University the highest I pole vaulted was 14 feet 9 inches (To see proof visit http://www.directathletics.com/athletes/track/2209874.html and look for Bucknell Heptagonal 1/17/09). After receiving treatment in October 2009 the highest I jumped was 15 feet 9 inches, “one foot of improvement” after receiving the PRP treatment (To see proof visit http://www.directathletics.com/athletes/track/2761625.html and look for ECAC Division III Outdoor Championships 5/31/10).
To this day I have no back pain what so ever. I can continue my post season workouts and lifting regimens without any hassle. Back burden lifts such as squat and dead lift are pain free. I can now focus on improving my pole vaulting marks even more!
