Platelet-Rich Plasma Injections for knee osteoarthritis …

Marc Darrow MD, JD. Thank you for reading my article. You can ask me your questions using the contact form below.

While we do offer stem cell therapy for knee osteoarthritis, the focus of this article will be onPlatelet-Rich Plasma Therapy. We receive many emails which ask which is the better treatment for me, stem cells or PRP? That answer comes best after a physical examination and when we have the opportunity to sit down together and discuss what are your goals of treatment. Goals of treatment would be different for a mountain climber than a stair climber at home.

In the same regard, we get many emails that ask us if PRP is better thanhyaluronic acid injections or cortisone injection. Many of these people already had cortisone andhyaluronic acid injections. They are somewhat skeptical because these treatments did not help them as much as they thought they would.

In our experience, we have found PRP injections to be the superior treatment. In fact we have submitted our findings for peer-review and upcoming medical journal publication. Supporting our view most recently is a2019 study in the medical journalOrthopade(1) which found thatIntra-articular PRP injections into the knee for symptomatic early stages of knee osteoarthritis are a valid treatment option. The clinical efficacy of Intra-articular PRP injections is comparable to that of the Intra-articular-hyaluronic acid injections and Intra-articular cortisone after 3 months, HOWEVER, the long-term effectiveness of PRP injections is superior to hyaluronic acid and cortisone.

In this article we will discuss research on grade 1 to 3 knee osteoarthritis and PRP treatments. When a new patient comes into our office for a consultation for their knee osteoarthritis, we do a careful assessment of the patient and then make recommendations. Sometimes, the lack of range of motion in this patients knee and other factors lead us to a recommendation of stem cell injections. This recommendation is based on a realistic expectation of what both treatments may offer. For some, having the PRP only may not offer the healing that they hope to achieve.

Doctors at the worlds leading medical universities and hospitals are showing that PRP can regenerate damaged knee cartilage and meniscus in patients suffering from knee osteoarthritis and PRP can also enhance healing after knee ligament reconstruction.

An October 2018 study in the journal Current reviews in musculoskeletal medicine(2) says this:

Recent research into the applications ofPRPfor knee osteoarthritis has further indicated both the efficacy and safety ofPRPtreatment. Although research has shown a tendency toward better efficacy at earlier stages ofosteoarthritis, evidence exists to indicate positive effects at all stages of osteoarthritis. In summary, since knee osteoarthritis is an extremely prevalent condition that can be a challenge to treat, it is imperative that safe and effective nonoperative treatment methods be available to individuals that are suffering from this condition.

In July 2018, medical university researchers in Ireland lead a multi-national European research team to conclude in their research:

Platelet-rich plasma therapy is a simple, low-cost and minimally invasive intervention which is feasible to deliver in primary care to treat degenerative lesions of articular cartilage of the knee. This therapy appears to have minimal associated adverse events and may have beneficial effects in terms of pain, health utility, patient satisfaction and goal-orientated outcomes.(3)

What is interesting about this study is who the PRP helped:

Even a single injection of PRP provided benefit.

In the video below (there is no sound), I demonstrate how why administer PRP. In this case the patient has problems of meniscus degeneration. We apply multiply injections to support regeneration of the whole knee. Below the video is research that showed positive results of even a single PRP injection against a single placebo injection.

In November 2017, researchers reported on the benefits of PRP compared to placebo injection in patients who had osteoarthritis in both knees.Published in the American journal of physical medicine & rehabilitation, the study showedPRP treatment significantly improves pain, stiffness, and disability in patients with knee osteoarthritis compared to normal saline (placebo) treatment.(4)

Also in November 2017, in the International journal of rheumatic diseases, researchers reported a summary of the most recent findings on the benefits of PRP for knee osteoarthritis.

In the medical journal Arthroscopy, a journal devoted to obviously arthroscopy, surgeons are told thatPlatelet Rich Plasma injections(PRP),offers better symptomatic relief to patients with early knee degenerative changes (than hyaluronic acid or placebo), and its use should be considered in patients with kneeosteoarthritis.(6)

This is a verification of early research from the Mayo Clinic which came to the same conclusion PRPshowed better improvement than hyaluronic acid injection and placebo in reducing symptoms and improving function and quality of life. Especially in in younger, active patients with low-grade osteoarthritis.(7)

This is from the Mayo Clinic research:

Intraarticular platelet-rich plasma (PRP) injection has emerged as a promising treatment forkneeosteoarthritis. Studies to date, including multiple randomized controlled trials, have shown thatPRPis a safe and effective treatment option forkneeosteoarthritis. IntraarticularPRPis similar in efficacy to hyaluronic acid, and seems to be more effective than hyaluronic acid in younger, active patients with low-grade osteoarthritis. Treatment benefits seem to wane after 6-9 mos. There are numerousPRPtreatment variables that may be of importance, and the optimalPRPprotocol remains unclear.

At the end of that paragraph the Mayo team points out that benefits may only last 6 9 months and that there is much variation in the way PRP is delivered so it is difficult to understand why PRP may not work.

When we see a new patient with degenerative knee disease who had failed PRP treatments at other clinics, we ask them how many treatments did they have? More often than not they say one injection. For some with minor osteoarthritis, as pointed out by the medical studies highlighted in this article, one injection provides benefit.

But one injection may not be sufficient for someone who has a more active lifestyle than others.

Here is a recent study where the patients received two PRP injections as the complete PRP treatment program. This treatment group was considered to be active. This research was published in the journal Sports Health.(8)

A paper published in the Journal of physical therapy science.(9) It comes from doctors working in medical university hospitals in Turkey.

Highlights:

Below is what doctors are saying to each other about athletes who want to stay active. It was published in the medical journal Cartilage: As a result of the complexity of the arthritic knee, athletes, particularly those with a history of knee injury, have an earlier onset and higher prevalence of osteoarthritis. This can present a clinical dilemma to the physician managing the patient who, despite the presence of radiologically confirmed disease, has few symptoms and wishes to maintain an active lifestyle.(10)

The difficulty or challenge is in the prevention of advancing of knee osteoarthritis. Here the typical recommendations of anti-inflammatory medications, knee braces, and ice, those that the athlete can impose upon themselves, will lead to further knee deterioration. It is a challenge to convince an athlete of this when it may get them on the course, track of field this weekend.

In a recentstudy, researchers at Hospital for Special Surgery gavepatients with early osteoarthritis an injection of PRP (6-mL), and then monitored them for one year. At baseline and then one year after the PRP injection, physicians evaluated the knee cartilage with magnetic resonance imaging (MRI). While previous studies have shown that patients with osteoarthritis can lose roughly five percent of knee cartilage per year, the Hospital for Special Surgeryinvestigators found that a large majority of patients in their study had no further cartilage loss. At minimum PRP prevented further knee deterioration.

A leading provider of bone marrow derived stem cell therapy, Platelet Rich Plasma and Prolotherapy 11645 WILSHIRE BOULEVARD SUITE 120, LOS ANGELES, CA 90025

PHONE: (800) 300-9300

1 Huang Y, Liu X, Xu X, Liu J. Intra-articular injections of platelet-rich plasma, hyaluronic acid or corticosteroids for knee osteoarthritis. Der Orthopde. 2019 Jan 8:1-8. 2 Cook CS, Smith PA. Clinical Update: Why PRP Should Be Your First Choice for Injection Therapy inTreating Osteoarthritis of the Knee.Curr Rev Musculoskelet Med. 2018 Oct 22. doi: 10.1007/s12178-018-9524-x. 3 Glynn LG, Mustafa A, Casey M, et al. Platelet-rich plasma (PRP) therapy for knee arthritis: a feasibility study in primary care.Pilot Feasibility Stud. 2018;4:93. Published 2018 Jul 4. doi:10.1186/s40814-018-0288-2 4 Wu YT, Hsu KC, Li TY, Chang CK, Chen LC. Effects of platelet-rich plasma on pain and muscle strength in patients with knee osteoarthritis. American journal of physical medicine & rehabilitation. 2017 Nov. 5 Xing D, Wang B, Zhang W, Yang Z, Hou Y, Chen Y, Lin J. Intraarticular plateletrich plasma injections for knee osteoarthritis: An overview of systematic reviews and risk of bias considerations. International journal of rheumatic diseases. 2017 Dec 5. 6 Campbell KA, Saltzman BM, Mascarenhas R, Khair MM, Verma NN, Bach BR Jr, Cole BJ.A Systematic Review of Overlapping Meta-analyses.Arthroscopy. 2015 Nov;31(11):2213-21. doi: 10.1016/j.arthro.2015.03.041. Epub 2015 May 29. 7 Pourcho AM, Smith J, Wisniewski SJ, Sellon JL.Intraarticular platelet-rich plasma injection in the treatment of knee osteoarthritis: review and recommendations. Am J Phys Med Rehabil. 2014 Nov;93(11 Suppl 3):S108-21. doi: 10.1097/PHM.0000000000000115. 8 Gobbi A, Karnatzikos G, Mahajan V, Malchira S. Platelet-rich plasma treatment in symptomatic patients with knee osteoarthritis: preliminary results in a group of active patients.Sports Health. 2012;4(2):162-72. 9 Kavadar G, Demircioglu DT, Celik MY, Emre TY.Effectiveness of platelet-rich plasma in the treatment of moderate knee osteoarthritis: a randomized prospective study.J Phys Ther Sci. 2015 Dec;27(12):3863-7. doi: 10.1589/jpts.27.3863. Epub 2015 Dec 28. 10 Kirkendall DT. Management of the Retired Athlete with Osteoarthritis of the Knee. Cartilage January 2012 vol. 3 no. 1 suppl 69S-76S 11 Wang-Saegusa A, Cugat R, Ares O, et al. Infiltration of plasma rich in growth factors for osteoarthritis of the knee short-term effects on function and quality of life. Arch Orthop Trauma Surg. 2011 Mar;131(3):311-7. Epub 2010 Aug 17. 12 Injection of platelet-rich plasma in patients with primary and secondary knee osteoarthritis: a pilot study.Sampson S, Reed M, Silvers H, ey al. Injection of platelet-rich plasma in patients with primary and secondary knee osteoarthritis: a pilot study.Am J Phys Med Rehabil. 2010 Dec;89(12):961-9.1537-2290

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Platelet-Rich Plasma Injections for knee osteoarthritis ...

How Revolutionary Platelet-Rich Plasma Injections For Dogs …

This revolutionary treatment, which accelerates all kinds of healing, is now a favorite among vets for treating our beloved canine friends. It not just heals, but in many cases it revolutionizes how older dogs live their life. If youre an advocate for less invasive, safer, often less costly but effective, alternative treatment options, Platelet-Rich Plasma Injections are one of the rare kinds of treatment that fits the bill.

Treating dogs suffering with injuries to muscle, bone, or tendons has been by using Platelet Rich Plasma (PRP) injections has been shown to have a beneficial effect on recovery times, and the quality of the recovery.

Studies have shown that PRP promotes:

Two studies, one published in 2011 and 2013 by the US National Library of Medicine (NCIB) and the Journal of Surgical Research (JSR) respectively, demonstrate the beneficial therapeutic effects of PRP when administered to dogs with musculoskeletal injuries.

The 2011 study set out to report on the concentration of blood cells and growth factors in the animals used in the study. They sampled the blood cell density in untreated dogs and compared it to that of dogs that had received PRP. They also compared a number of growth factors between dogs that had been given PRP treatments and those that had not. They found that platelet counts in the treated animals were higher than they were in non-treated animals. Not all growth factors were found to have increased. Two sets of growth factors remained the same in the test and control populations. Despite the lack of change in a few growth factors, others showed a significant increase and the overall improvement to the therapeutic outcome had improved for the test animal population.

In the 2013 study, similar methods were used except two extra test groups were added; a control group where saline was added to the PHP solution, and a fourth group in which a random distribution of young and old beagles were tested. The results of this study brought the researchers to conclude that PRP alters the expression of certain targeted genes during the early stages of graft remodeling and that the platelet rich plasma can promote reinnervation and revascularization. They believe this explains the beneficial enhancement effect of PRP on graft maturation.

A study by Jeff Mayo DVM, Veterinary Medical Director of Ingeneron Inc. reports that his organization has been running studies on the effects of PRP on dogs. He says their studies have shown that they have proven that PRP is a safe and natural method to relieve the pain of injury or joint disease, promote healing and accelerate recovery time using the animals own blood. As a result of these findings, the Mobile Veterinary Surgical Services Serving of Seattle, WA are now confidently offering PRP treatments to the public in cases where the treatment is indicated.

The 2011 study mentioned above has been cited as conclusive evidence that that inflammation is reduced by PRP injection treatments and that enhanced healing results.

The KIM group (Kindred-Canines in Motion) reported in 2012 that PRP injections are safe and effective for most animals. KIM is now actively scheduling evaluations for possible candidates for PRP treatment of;

Further studies have found that PRP can be combined with Cold Laser therapies for even better cellular regeneration. In fact, they are complementary and synergistic. A research project published in Lasers Medical Science concluded that the deposition of collagen type I (a major contributing factor in regeneration) was higher when treatment with PRP and a Class 4 Cold Laser were combined, promoting an even faster rate of regeneration in the affected tissues.

And it looks like not all veterinary doctors are trained and equipped to use PRP treatments and Cold Laser therapy. As a result, owners who want their dogs to receive these treatments must go great lengths to seek out experienced practitioners. Fortunately, the awareness of these leading-edge treatments are spreading fast. Vets like Dr. R. Kraemer, who practices in orange county California and runs Vet4Bulldog.com, has expanded his offer for this groundbreaking combination to pet owners from anywhere in the State of California.

This combination works exceptionally well for joints and ligament healing which is a boon for older dogs. They are particularly affected by osteoarthritis and hence are badly in need for a combination treatment like this.

How laser therapy works Cold laser therapy is a non-invasive treatment that uses coherent light to induce cellular regeneration and improve circulation. The infrared laser light interacts with tissues at the cellular level.

Benefits of the combination treatment Cold Laser treatment increases cellular energy (ATP) to trigger an increase in cellular function, and health. Its light based and when it comes in contact with the cell, metabolic activity increases. Hence the improvement in the mobility of nutrients across cell membranes. Which means your pet gets healthier faster than ever.

Is PRP and Laser Combination Right for Your Dog? First of all, both PRP and Laser are noninvasive procedures. One uses growth factors in blood and the other uses light to stimulate cell regeneration and increase blood circulation. There isnt any other perfect combination of treatments that I can think of.

Almost Zero Downtime Both treatments may leave with soreness or inflammation, the typical side-effects of any injection/laser treatments. Under normal circumstances they are minor and will go away without any intervention. However, if symptoms are intense, icing the treatment area for 15 minutes 2-3 times a day for the first few days will help ease the pain and inflammation. Elderly animals and those with unusual conditions may require longer recovery times and closer attention.

Vets whove tried these report, that in most cases the results are almost instantaneous (as in obvious from day 1.) And as high as 80% of the animal patients treated with PRP have a noticeable improvement in their mobility within fewer than 10 days. Pets can resume normal activity in under a week: but may need recovery and rehabilitation therapies tailored to its condition, age, temperament, goals, and abilities.

As far as precautions are concerned, there isnt any to worry about. Except that for PRP, the animal patient needs to be off Anti-inflammatory medication at least a week prior to the treatment. Other than that, PRP comes with very few side effects. The same is the case for cold Laser therapy: zero known side effects. That is other than the obvious contraindications. Animals with any of the following conditions should not receive Cold Laser treatment.

PRP improves the quality of a dogs life as well as the life of its owner. Older dogs and dogs with osteoarthritis can benefit tremendously from PRP as it is a low-intensity treatment.

With emerging knowledge of the positive effects on the health and well-being PRP and Cold Laser treatments have on our animals, the only things standing between many dogs and better health is a lack of public awareness and the availability of these treatments.

Although these treatments look simple and easy to the untrained eye, theres more to it than what meets the eye. Experience counts. Proper training is a requirement. You dont want your vet to practice these treatments on your pet. So do your due diligence. Ask your vet if he/she does these treatments on a regular basis.

One of the things you need to clearly verify with your vet is the number of treatments required. Depending on the condition of your pet, your vet may prescribe 3-5 treatments. And thats perfectly okay. Because weve seen that repeated treatments often produce better results.

Also ask if theyll use sedatives.

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How Revolutionary Platelet-Rich Plasma Injections For Dogs ...

Does Medicare Cover Platelet-rich Plasma Injections

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Does Medicare Cover Platelet-rich Plasma Injections

Houston Platelet Rich Plasma – houstonsportsmedicine.com

What is Platelet Rich Plasma (PRP)? It is an emerging biologic tool in orthopedic and regenerative medicine. Platelets may be small in size but they are an intricate part of the bodys healing process. When injury occurs, one of the first repair cells to travel to the injury site are platelets. Platelets are rich in many different growth factors. These growth factors help attract other repair cells to the injured area. These repair cells are thought to stimulate the healing process. By increasing the concentration of platelets (platelet rich plasma PRP) in the injury site (tendon, ligament, muscle tear or joint) physicians attempt to encourage tissue healing. If you are looking for platelet rich plasma injections in Houston, youve come to the right place! We have years of experience in platelet rich plasma treatments and use the latest procedures including advanced ultrasound-guided injection techniques.

The centrifuge separates and concentrates the plasma up to 10X normal solution.

How is the Procedure Process?First, blood is drawn from the patients arm, and is placed into a special centrifuge which concentrates the platelets up to 10X baseline strength. Once the platelets are concentrated they can be called platelet rich plasma (PRP). The platelet concentration can be customized depending upon the physician directed treatment goals. Through specialized training from the American Association of Orthopedic Medicine and years of experience, our physicians will determine a customized treatment plan. State of the art ultrasound injection techniques can be used to guide the injection of the PRP. These powerful platelets work to begin the growth factor induced healing process.

How is the Recovery?Following the PRP injection, patients are instructed to rest for the remainder of the day. A normal part of the healing process may involve discomfort or pain at the target site for a few days or so. It can take weeks for proper healing and tissue remodeling to occur. Physical therapy and proper nutrition can aid in healing. Platelet rich plasma is a powerful new tool that uses the patients own biological factors to aid in tissue recovery and repair. Multiple research studies and thousands of procedures have been performed nationwide since its inception.

Is All PRP the Same? At Houston Spine and Sports Medicinewe are leaders in non-surgical musculoskeletal treatments including platelet rich plasma in Houston. Our training and experience in PRP is exceptional. With our experience in diverse cases, post PRP rehabilitation, PRP based nutrition and advanced PRP/ultrasound training, we are committed to providing the best non-surgical musculoskeletal treatment options to you and your family.

See what information is being published on the web about Platelet-Rich Plasma:

The use of platelet-rich plasma in arthroscopy and sports medicine: optimizing the healing environment.

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Houston Platelet Rich Plasma - houstonsportsmedicine.com

Platelet Rich Plasma Therapy (PRP) : Dr. Jonathon …

Similar in theory to prolotherapy in terms of creating a healing inflammatory response, PRP therapy involves injecting a patients own concentrated platelets to initiate healing in damages tissues and joints.

Although a relatively new therapy, studies are showing excellent results in using platelet rich plasma to heal damaged ligaments, tendons and muscles. Platelets are often thought of as clotting cells, causing blood to thicken and form scabs after injury; however, platelets serve many other important functions. These small cells are responsible for attracting white blood cells into injured areas to clean up damaged and dead cells, which often produce non-productive stagnant swelling and lead to chronic inflammation or tendonitis. This chronic damage, once thought to be an active inflammatory problem, hence tendonitis, has recently been renamed tendonosis because of the lack of inflammation found. Thus, the area is prevented from healing because the swelling is non-productive and must be resolved for recovery to proceed. Platelets injected into the area not only draw white blood cells in to clean up, they also release growth factors that are directly responsible for tissue regeneration.

PRP is not a new therapy as it has been used for years in surgical centers to improve the success of bone grafting, dental surgery and cosmetic surgery. More recently, doctors began to use PRP in athletic injuries to speed healing. The results were so promising that the technique caught on not just for acute injuries but also for chronic pain as well. All joints, ligaments and tendons are treatable areas whether the problem is acute or chronic. Conditions such as tennis elbow, chronic low back pain, unstable ACL/PCL, pubic symphysis strains, Achilles tendonitis, rotator cuff tears, meniscal tears, osteoarthritis, and neck pain are responding where other therapies have plateaued or failed.

Platelet rich plasma, or PRP, is concentrated blood plasma containing a very high number of platelets. These platelets release growth factors that are vital to initiate and accelerate tissue repair and regeneration. The growth factors increase stem cell production that are vital to repair connective tissues such as tendons and ligaments, help bone regeneration, promote the formation of new blood vessels and stimulate the healing process. The normal concentration of platelets in blood is between 150,000 and 400,000 per micro liter. In PRP, where platelets have been concentrated, the count can exceed 2 million platelets per micro liter. To be considered PRP, the count of platelets must be at least 4x greater than baseline measurements.

Normal Platelet Count

Concentrated Platelet Count

Depending on which area is to be injected, 15-60cc of blood will be drawn from the patients arm. This blood is then spun down to separate the red and white blood cells from the platelets and plasma. The concentrated platelets are then injected into the area that requires healing.

Dr. Berghamer is skilled in using both the Harvest SmartPReP2 Platelet Concentrate System and the Arthrex Angel System.

The PRP process concentrates fibrin, mesenchymal stem cells, and platelets so that each cubic millimeter of solution contains 1.5 to 2 million platelets, resulting in up to a five-fold increase in platelets and bioactive growth factors. Because it is so concentrated, PRP acts as a potent tissue growth stimulant, amplifying the natural process of tissue repair and healing. Studies show that PRP induces the production of new collagen by the fibroblasts, bone and cartilage cells at the site of the injection, rebuilding the joint cartilage and strengthening injured ligaments and tendons. This new collagen is naturally incorporated directly into your existing cartilage and ligaments, making them thicker, stronger and more elastic.

Although cortisone shots may temporarily provide pain relief and reduce inflammation, studies have shown that cortisone can actually weaken tissue. This occurs because cortisone blocks all inflammation, and some inflammation is required for healing. PRP therapy introduces healing factors that promote healthy inflammation that leads to healing. PRP can strengthen tendons and ligaments, in some instances up to 40%.

Hyaluronic injections are very effective at increasing comfort and range of motion in injured joints. It does not, however, provide a mechanism of regeneration and it is necessary to continue injections on a regular basis to maintain benefit. PRP is regenerative, which means it causes the body to grow new ligaments, tendons and joint tissues. Ultimately, this healing will last and the tissues will function like normal healthy tissues.

Compared to dextrose prolotherapy, clinical and anecdotal experience is demonstrating that using PRP as the regenerative injection method creates a much more profound healing effect and results in increased healing in less treatments. Prolotherapy is a very effective and useful therapy, but PRP is especially useful when regular prolotherapy has provided positive results, but recovery has not been ideal. In these cases PRP is often the treatment that will resolve these less responsive or more injured areas.

Original post:
Platelet Rich Plasma Therapy (PRP) : Dr. Jonathon ...

Platelet-Rich Plasma For Arthritis | Dr. Colin MacLeod ND

Platelet-rich plasma (PRP) is a therapy which uses a component of a persons own blood to treat their osteoarthritis. PRP is a safe treatment which often gives significant benefit to people suffering from osteoarthritis including improvements in stiffness, pain and mobility.

PRP injections contain a high concentration of your own platelets. These platelets contain a large amount of growth factors, including platelet-derived growth factor (PDGF), transforming growth factor beta (TGF-), insulin-like growth factor (IGF), epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF)1.

Table 1. Growth factors involved in tissue repair2.

These growth factors trigger tissue repair in our natural healing and recovery process. When a high concentration of these growth factors is introduced into the area of an injured or arthritic joint the healing process is jump-started.

Some research has suggested that PRP improves the integrity of the joint cartilage by increasing the amount of cartilage producing cells (chondrocytes) and by decreasing their rate of cell death (apoptosis)3. This would conceivably lead to a larger number of chondrocytes actively producing healthy cartilage within the joint and a healthier joint as a result.

PRP is prepared by drawing and centrifuging a small sample of your own blood on the day of treatment. A centrifuge is a device which rapidly rotates, spinning a blood sample at a high speed causing it to separate into layers based on weight. After centrifugation the blood sample separates into a top layer of plasma which is transparent yellow in color (mostly water with some dissolved proteins) and a bottom thick, red layer (red blood cells). At the junction of the plasma and red blood cell layers sits a dense concentration of platelets. This platelet-rich layer of the plasma is the portion of the blood which is collected and used for injection.

PRP is given by injection into the affected site or the site of injury. For example, in cases of tennis elbow the PRP injection is made at the site of the affected common extensor tendon on the elbow and in plantar fasciitis the injection is given at the site of the damaged plantar fascia insertion on the heel of the foot. In the case of osteoarthritis the injury includes two entire joint surfaces. An osteoarthritic joint is treated by injecting PRP into an affected joint space. Since a joint is a closed compartment the PRP fluid stays within the joint, coating the affected joint surfaces and exerting its effect on them through its rich concentration of growth factors.

Many studies have been performed on PRP injections for osteoarthritis and the results have been near-unanimously positive, showing a reduction in pain and improvement in mobility among the people receiving the treatment. In total, 54 studies have investigated PRP as a treatment for osteoarthritis and all 54 of these studies have found that this treatment was beneficial4-57.

Some research has found that 3 PRP injections, with 1 month between each injection, is more effective and gives longer lasting results than only one or two injections33.

Platelet-rich plasma vs hyaluronic acid

Most PRP for osteoarthritis research has been on the knee. To date 44 studies have examined PRPs effect on knee osteoarthritis while the hip has 4 studies, the temporomandibular joint has 3 studies, the ankle has 2 studies and the thumb has 1 study.

Figure 1. Number of studies (by joint) examining platelet-rich plasma for osteoarthritis. Most research performed on knee joint. Although the studies have yet to be done I have also seen good results with osteoarthritis of other joints including the shoulder, wrist and other hand joints.

PRP injection treatments are quite safe, having very little in the way of reported adverse effects58. While most treatments for pain involve a synthetic medication-based therapy, PRP simply uses a component of a persons blood. PRP therefore carries very little risk of causing an allergic reaction. The most common adverse effect of PRP is discomfort at the site of treatment for 1-3 days. This is a common reaction as the mechanism of action of PRP involves a short-term inflammatory phase after treatment which can contribute to discomfort temporarily. As with any injection there is a small chance of infection. There is also a small chance of allergic reaction to the local anesthetic (numbing agent) which is used at the site of the injection.

PRP treatment can provide lasting results for people with osteoarthritis including reduced pain and improved mobility. Typically 3 treatments will be required to attain maximum benefit from PRP. PRP injections can be done 2-4 weeks apart without issue.

PRP injections are a long-term solution for osteoarthritis. While this treatment gives long term benefit some people may experience discomfort following treatment for 1-3 days. In order to deal with this possible discomfort it is best to reduce physical activity after a PRP injection to avoid additional discomfort of the region which was treated. Applying ice to the affected area will not inhibit the effectiveness of the PRP treatment and may help if the treated area is achy or sore.

The treated body part should be rested on the day of treatment and if discomfort remains then 2-3 days of avoiding heavy activity may be required to assist in recovering. Anti-inflammatories such as aspirin, ibuprofen and naproxen in general should not be taken for 2-7 days after a PRP treatment as they could theoretically dampen its effectiveness. Generally acetaminophen (Tylenol) is preferable to anti-inflammatories in this short term to manage any discomfort or pain which may be present.

People with active cancer or active infection are not candidates for PRP treatment. People with thrombocytopenia (low platelets) and people on blood thinners can have PRP treatment but some changes to the treatment may be required.

Naturopathic Doctor at MacLeod Naturopathic

Dr. Colin is a naturopathic doctor practicing in Upper Tantallon in the Halifax Area. He was born and raised in rural Cape Breton and returned to Nova Scotia to practice after finishing his naturopathic education in Toronto. His practice focuses on pain management and maintaining health through physical activity and diet. He utilizes platelet-rich plasma, neural prolotherapy and acupuncture to keep his patients pain-free so that they can stay physically active, social and healthy.

Last updated October 9, 2018

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Platelet-Rich Plasma For Arthritis | Dr. Colin MacLeod ND

PRP Injections as Treatment for Pain – AAOM

PRP injections (or platelet rich plasma therapy) is a new treatment method that relieves pain by promoting long lasting healing of musculoskeletal conditions. This rapidly emerging technique is showing exciting potential with osteoarthritis of the knee, shoulder, hip and spine, rotator cuff tears, chronic plantar fasciitis, anterior cruciate ligament (ACL) injuries, pelvic pain and instability, back and neck injuries, tennis elbow, ankle sprains, tendonitis, and ligament sprains.

How do PRP injections help?The bodys first response to soft tissue injury is to deliver platelet cells. Packed with growth and healing factors, platelets initiate repair and attract the critical assistance of stem cells. Platelet Rich Plasma therapys natural healing process intensifies the bodys efforts by delivering a higher concentration of platelets. To createplatelet rich plasmatherapy, a small sample of your blood is drawn (similar to a lab test sample) and placed in a centrifuge that spins the blood at high speeds, separating the platelets from the other components. The concentrated PRP injection is then delivered into and around the point of injury, jump-starting and significantly strengthening the bodys natural healing signal. Because your own blood is used, there is no risk of a transmissible infection and a very low risk of allergic reaction.

How long does it take to get PRP Injections?The Platelet Rich Plasma therapy takes approximately one to two hours, including preparation and recovery time. Performed safely in a medical office,PRP injections relieve pain without the risks of surgery, general anesthesia, or hospital stays and without a prolonged recovery. In fact, most people return to their jobs or usual activities right after the procedure.

How often should PRP injections be given?Up to three PRP injections may be given within a six-month time frame, usually performed two to three weeks apart. You may, however, gain considerable to complete relief after the first or second injection.

What are the expected results of PRP Injections?Because the goal of platelet rich plasma therapy is to resolve pain through healing, it could prove to have lasting results. Initial improvement may be seen within a few weeks, gradually increasing as the healing progresses. Research studies and clinical practice have shown PRP injections to be very effective at relieving pain and returning patients to their normal lives. Both ultrasound and MRI images have shown definitive tissue repair after PRP therapy, confirming the healing process. The need for surgery can also be greatly reduced by treating injured tissues before the damage progresses and the condition is irreversible.

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PRP Injections as Treatment for Pain - AAOM

Regenexx Platelet Rich Plasma (PRP) in Bellevue and …

PRP Therapy

Regenexx SCP platelet rich plasma (PRP) therapy is being offered by Dr. Attaman in Seattle and Bellevue. Feel free to call us at206-395-4422 (Seattle) or 425-247-3359 (Bellevue), or schedule an appointment online.

We are Washingtons only licensed Regenexx network clinic. Regenexx SCP is the most advanced form of PRP available in the world with the most research to support its use.

Regenexx SCP platelet rich plasma therapy is an injection of a concentrated mixture of the patients own blood. Platelet Rich Plasma injections have been shown to relieve acute and chronic pain and accelerate healing of injured tissues and joints. The injured tissues are oftenhealed by Regenexx SCP platelet rich plasma therapy, in contrast to steroid injections which generally suppress symptoms. Many patient turn to Regenexx SCP platelet rich plasma because it is a way to heal damaged tissue, and because more conventional treatments such as steroid injections and surgery have failed them in the past. However, some physicians and patients believe the best pathway is to treat damaged tissues with Platelet Rich Plasma therapy before steroid injections or surgery are attempted! That said, no treatment is ideal for all conditions, and a comprehensive clinical consultation is required to know whether Regenexx SCP platelet rich plasma is good for your particular issues. If Regenexx SCP platelet rich plasma is not for you, Dr. Attaman has many other treatment options that are likely to be appropriate.

Conditions aided by Regenexx SCP platelet rich plasma include chronic back pain, chronic knee pain, achilles tendonitis,plantar fasciitis, meniscus tears, osteoarthritis of the spine, sacroiliac joint hyper mobility, hip and knee injuries, ligament sprains, rotator cuff tears, lateral epicondylitis (tennis elbow), medial epicondylitis (golfers elbow), and tendon injuries (tendonopathy). Platelet Rich Plasma therapy can also be applied to many other locations in the body.

Regenexx Super Concentrated Platelets vs. Standard PRP

The limited blood supply and poor healing properties of ligaments, cartilage and tendons may make treatment necessary after injury. Unlike medications that dont treat the underlying cause of pain, Platelet Rich Plasma can accelerate the healing process eliminating the cause of pain.

The Platelet Rich Plasma process begins by taking a sample of the patients blood from their vein. Most physicians take a very small sample of 5-10 mL. Such a small sample is easier to obtain and process, but results in a poorly concentrated Platelet Rich Plasma solution. In contrast, Dr. Attaman takes a minimum 60 mL sample up to 240 mL; this allows Dr. Attaman to produces a VERY concentrated Platelet Rich Plasma injectate very dense in platelets and healing factors.The blood sample is then processed using the patentedRegenexx SCP platelet rich plasma protocol in our laboratory. Our laboratory is state of the art and more advanced than almost all others in the state.

We use this laboratory to separate the blood into its primary components platelets and white blood cells, plasma, and red blood cells. Our laboratory includes a clean hood, centrifuges, cell counters and microscopes. Using the patentedRegenexx SCP platelet rich plasma process, we concentrate the platelets to a very concentrated form for re-injection.

A portion of the plasma is removed. The patients concentrated platelets are mixed with the remaining plasma to form a concentrated solution. This platelet rich solution is then injected into and around the injured tissues. Most physicians perform these injections blindly, which means the injections are done without any sort of image guidance. Such physicians will often suggest 5 or more Platelet Rich Plasma injections are required. They require so many injections simply because they are missing the target most of the time.

In contrast, Dr. Attaman performs all Platelet Rich Plasma injections using ultrasound or X-ray image guidance. This allows for much enhanced safety, accuracy, and efficacy. Generally only 1-2 Platelet Rich Plasma injection treatments are needed. Dr. Attaman can directly visualize the damaged tissues under ultrasound, and ensure that 100% of the Platelet Rich Plasma is deposited into injured tissue only. This also allows Dr. Attaman to perform an advanced technique called needle tenotomy, which is when the needle is used to break up scar and calcium deposits in the injured tissue, and prepare the tissue for better healing.

The concentrated platelets release many growth factors that promote a natural immune response. Macrophages specialized white blood cells rush in to remove damaged cells and prepare the tissue for healing.

Stem cells and other cells multiply, repair and rebuild the damaged tissue. This accelerated healing response reduces pain, promotes increased strength, and improves joint function. Healing after Platelet Rich Plasma therapy occurs over a period of many weeks. Generally patients will not see significant changes in their chronic pain until the 6-12 week mark. Some people obtain relief faster than this but this is generally an exception.

The entire Platelet Rich Plasma treatment process takes about an hour the patient will be able to go home the same day. Full recovery from the injection usually occurs within three days of the procedure. Specialized physical therapy is often prescribed after Platelet Rich Plasma injection to accelerate the healing process. Many patients require one to two treatments before the injured tissues are completely healed and they return to a normal active lifestyle. The good news is that some studies indicate that the healing process continues for as long as a year after Platelet Rich Plasma injection therapy, and possibly beyond. This suggests that as time goes on after Platelet Rich Plasma injection therapy, the treated tissues continue to get healthier and stronger.

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Regenexx Platelet Rich Plasma (PRP) in Bellevue and ...

Autologous Blood Injection (ABI) & Platelet Rich Plasma …

Autologous Blood Injection (ABI) and Platelet Rich Plasma (PRP) injections involve injecting a patients blood into a damaged part of the body.

Melbourne Radiology Clinic - Autologous Blood Injection (ABI) Patient & Post Procedure Information Sheet

Melbourne Radiology Clinic - Platelet Rich Plasma (PRP) Injection Patient & Post Procedure Information Sheet

Most commonly at Melbourne Radiology Clinic, this is done into a tendon for the treatment of tendinosis (the medical term for tendinitis), though other applications also include injecting ligaments, muscles and joints. Any tendon in the body may be injected with a patients blood products, with the most frequent clinical uses of ABI or PRP injections used for the plantar fascia (heel), Achilles (ankle), patellar (knee), gluteal (hip), hamstring (buttock), common extensor origin (tennis elbow or lateral epicondylitis) and common flexor origin (golfers elbow or medial epicondylitis). Approximately 80% of patients obtain complete or significant pain relief following this procedure.

PRP therapy has also recently found use in treating osteoarthritis. By injecting PRP into joints, it is felt that the healing factors may stimulate cartilage and surrounding soft tissue regeneration, as well as dampen the main symptoms associated with arthritis, that being pain and stiffness. Even if joint surgery, such as joint replacement, is delayed for a year or two, then this is considered a win.

Blood contains many nutrients and substances which are thought to promote healing. Platelets are tiny cells in blood which stick to each other when we cut ourselves to result in the formation of a clot to stop any further bleeding. Platelets contain many powerful growth factors, in particular PDGF (Platelet Derived Growth Factor) which has been shown to promote healing of many types of tissues, including bone, teeth, skin and the tissue lining our eyes. PDGF also promotes healing of tendons which are damaged due to excessive use and/or the ageing process.

Patients who suffer from tendinosis usually require a correct diagnosis prior to any procedure. This usually involves an ultrasound and/or an MRI (Magnetic Resonance Imaging) scan. Following diagnosis and if not already done so, the initial line of treatment is to undergo a period of rehabilitation for 6 weeks supervised by a suitable health care provider. This might be your rehabilitation physician, physiotherapist, podiatrist, chiropractor or osteopath to name a few. If pain persists, then the patient is a candidate for an ABI or PRP injection.

The procedure of ABI takes approximately 5 minutes and involves the use of an ultrasound machine to guide the needle into the correct location and safely.

First the skin is cleansed and prepared. Local anaesthetic is then injected into the skin overlying the tendon. Blood withdrawn from one of the arm veins is then injected directly into the tendon. The amount of blood injected depends on the size of the tendon. The procedure is at this point over and the needle injection site is then dressed with a small bandage.

A PRP injection is similar to an ABI, with the only difference being that a larger amount of blood is withdrawn from an arm vein. The blood is then placed into a tube, which in turn is placed into a machine called a centrifuge, which spins many thousand times a minute. The blood is left to spin for 15 minutes. At this point, the cells in the blood have separated from the fluid component of blood (plasma) into the three main cell types: red blood cells, white blood cells and platelets. The platelets are then selectively removed and used for injection. In this way, the theoretical benefit is that a greater concentration of platelets is delivered into the damaged body part than if whole blood was given alone (approximately 8-10 times greater concentration). There is, however, no scientific research documenting this benefit at the time of writing.

Following the procedure you will be provided with clear, written instructions on when to re-commence your rehabilitation. [See the PDF information sheets above]. If your pain persists after 4 weeks following injection, then a repeat injection is strongly recommended. If your pain remains unchanged following a second injection then no further ABI/PRP injection will be offered and you may instead be offered an alternative injection that is available, or otherwise you may wish to pursue surgery. A third injection is rarely offered.

As with all medical procedures, there are risks. The staff at Melbourne Radiology Clinic have performed this procedure hundreds of time with the only complication being a single minor skin infection which was successfully treated with antibiotics. An infection of the deep soft tissues is also a risk. No recorded tendon ruptures have been documented in the scientific literature, nor has this been our experience to date. Patients consistently report a flare up of their pain in the first week following the procedure, however in most cases, this is controlled with some paracetamol and/or an anti-inflammatory medication. Codeine is rarely required.

A radiologist, a medical doctor specialised in interpreting medical images for the purposes of providing a diagnosis, will then provide a formal written report to your referring doctor or health care professional detailing the procedure and providing some recommendation for your after-care. If medically urgent, or you have an appointment immediately after the scan to be seen by your doctor or health care provider, Melbourne Radiology Clinic will instantly have this report ready. Otherwise, the report will be received by your doctor or health care provider within the next 24 hours.

Whilst every effort is made to keep your appointment time, the special needs of complex cases, elderly and frail patients can cause unexpected delays. Your consideration and patience in these circumstances is appreciated.

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Autologous Blood Injection (ABI) & Platelet Rich Plasma ...

Platelet Rich Plasma Injections, PRP Injections …

Platelet Rich Plasmainjections are used to helpa variety of common conditions including: tennis elbow, achilles tendinitis and knee osteoarthritis. Find Relief with Platelet Rich Plasma Injections:

Sometimes, rest, ice, rehabilitation and other treatments fail to provide relief. If you aredealing with chronic joint pain, tendinitis and osteoarthritis, you may want to consider this new treatment option now available. Louisville sports medicine physician Dr. Stacie Grossfeld is offering Platelet Rich Plasmainjectionsat her office to give patients anew, innovativeform of pain relief.

PRP Injections: $380 Charge Cash Only This treatment option covers a blood draw and PRP related processes. After collecting 10 cc from the arm, it will be spun in a centrifuge and then the platelet rich plasma is injected into the affected joint or area. In total, this fee includes the blood draw, materials used to create the PRP substance, and the actual PRP injection.

For more information about this treatment option, or to make an appointment, callOrthopaedic Specialists at a (502)212-2663. Follow along for more information about platelet rich plasma injections.

PRP or Platelet Rich Plasma is plasma with more platelets.Plasma is the liquid part of our blood that transports our platelets, and red and white blood cells. Platelets generally comprise about 10% of our blood. In order to prepare the injection, the physician must draw blood from the patient. Then the platelets are separated from the red and white blood cells to increase their concentration through centrifugation. This is then combined with the remaining blood to be used as an injection.

Typically, PRP is injected directly into theinjuredarea.Forexample, for tendinitis in the knee, the physician will inject a local anesthetic and the PRP directly into the inflamed tissue. Depending on the level of discomfort, most patients do not require more than two injections to find relief. After the injection, the patient may have residual pain for a day, and up to a week. The swelling and stiffness will decrease and the outcome is positive.

PRP injections have been known to treat chronic tendon injuries, acute ligament and muscle injuries, knee arthritis, fractures and even offer relief post-operatively. Some of the best athletes have used PRP injections to treat their injuries. This includes Alex Rodriguez, Brian Urlacher, Kobe Bryant and Tiger Woods. These injections have helped many athletesreturn to the court, green and fields faster than other forms of treatment.

In the June 2013 issue of American Journal of Sports Medicine, researchers reported some interesting results using PRP injections to heal competitive athletes. According to the study, 30 out of 34 throwing athletes with MRI documented partial ulnar collateral ligament tears got better and were able return to play after receiving platelet rich plasmainjections. (The ulnar collateral ligament is situated on the inner side of the elbow). All the throwing athletes had failed a comprehensive course of conservative treatment prior to receiving PRP injections. Based on these orthopedic research findings, this would be another area in orthopedic medicine where PRP can be useful.

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Platelet Rich Plasma Injections, PRP Injections ...