Use of platelet-rich plasma (PRP), along with ultrasound-guided needle tenotomy, was shown in a study to be an effective treatment for chronic, recalcitrant tendinopathy.  The study was conducted by the Department of Physical Medicine and Rehabilitation at the Mayo Clinic College of Medicine, Rochester, MN.  Study results were published in the October 2011 journal of PM&R (www.pmrjournal.org)

Tendinopathy is a broad term for a common, painful problem occurring in and around tendons, in response to overuse.  Recent basic science research suggests little or no inflammation is present in these conditions, although many treatment options are aimed at reducing inflammation.  Today, tendinopathy is thought to be a degenerative process.

In the Mayo Clinic study, 51 patients with chronic, recalcitrant tendinopathy received ultrasound-guided needle tenotomy and an injection of autologous platelet-rich plasma.  The mean follow up visit was 14 months postprocedure, and maximum benefits occurred four months postprocedure.

Although no tendons demonstrated a normal sonographic appearance, 83 percent of the subjects were satisfied with the outcome and would recommend the procedure to a friend.

These study results are consistent with what our patients with similar conditions have experienced.  This study adds support to the growing body of evidence that indicates that platelet-rich plasma is effective in treating musculoskeletal injuries and conditions. 

Information contained in this blog is intended for educational purposes only and not for medical diagnosis or treatment.  If you have a medical concern or issue, please consult with your physician.

For patients with severe chronic plantar fasciitis not manageable with traditional non-operative treatments, injections with platelet-rich plasma (PRP) is significantly more effective than using cortisone.  This is according to a study presented by Raymond R. Monto, M.D., from the Nantucket Cottage Hospital in Massachusetts at the annual meeting of the American Academy of Orthopaedic Surgeons, held recently in San Francisco.

Dr. Monto compared PRP with cortisone injections for the treatment of 36 patients with plantar fasciitis that was resistant to traditional non-operative management.  Patients underwent pretreatment magnetic resonance imaging and ultrasound studies.  Group 1, with an average age of 59 years, an average of 5.4 months of failed standard non-operative treatment, and an average pretreatment American Orthopaedic Foot & Ankle Society (AOFAS) score of 52, was treated with a single injection of methylprednisolone at the injury site.  Group 2, with an average age of 51 years, an average of 5.7 months of failed standard non-operative treatment, and an average pretreatment AOFAS score of 37, was treated with a single injection of un-buffered autologous PRP.

Monto found that, in Group 1, the average post-treatment AOFAS score improved to 81 at three months, decreased to 74 at six months, and then decreased to 58 at 12 months. In Group 2, the average post-treatment AOFAS score improved to 95 at three months, and remained at 94 at six and 12 months (P = 0.001).

Based on the improved AOFAS score, platelet-rich plasma injection was more effective and durable than cortisone injection for the treatment of severe chronic plantar fasciitis.

While there are still no large-scale studies of PRP’s effectiveness, this study does support the growing body of antidotal evidence that indicates that PRP is effective in treating musculoskeletal injuries and conditions.  It is used widely and openly in professional sports, the veterinary world, and we have seen patients have positive results following PRP treatment in this office.

If you weren’t aware, plantar fasciitis is a common source of foot pain.  The pain may sometimes be diffuse and confused with ankle pain.  The plantar fascia is a fibrous aponeurosis (a thick cord-like tissue).  It originates off the calcaneus or heel bone and fans out to attach to the plantar surfaces of the phalanges bones (foot bones). 

Plantar fasciitis is a common source of foot pain in athletes, especially ones who compete in running athletics.  However, plantar fasciitis may also been seen in over-weight non-athletes

The plantar fascia may either be caused by an inflammatory process or there may be an underlying degenerative process, such as seen in tendinopathies where there is thickening, scarring and abnormal collagen formations.  Rupture of the plantar fascia may occur with an extremely forceful injury, usually in the mid portion of the fascia. 

Information contained in this blog is intended for educational purposes only and not for medical diagnosis or treatment.  If you have a medical concern or issue, please consult with your physician.

An interesting article came out online over the past few days in the current issue of Practical Pain Management, entitled Advances in Regenerative Medicine:  High-Density Platelet-rich Plasma and Stem Cell Prolotherapy for Musculoskeletal Pain.

It provides a detailed, yet readable, view of this cutting-edge procedure that is growing in use and acceptance.

Information contained in this blog is intended for educational purposes only and not for medical diagnosis or treatment.  If you have a medical concern or issue, please consult with your physician.

Blood injections, especially of platelet-rich plasma, into the affected area help relieve the pain associated with "tennis elbow" where other treatment methods have failed, according to a Greek study.  Reuters article here.

Information contained in this blog is intended for educational purposes only and not for medical diagnosis or treatment.  If you have a medical concern or issue, please consult with your physician.