Platelet Rich Plasma (PRP)
and Stem Cell Regenerative Therapy
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What is Platelet Rich Plasma (PRP)?
Platelet Rich Plasma or PRP is derived from the patient’s blood. Processing the patient’s blood specimen in a centrifuge separates the blood components and concentrates the platelets in the plasma. The concentrated platelets found in PRP include growth factors along with bioactive proteins that are vital to initiate and accelerate tissue repair and regeneration. These bioactive proteins increase stem cell production to initiate connective tissue healing, bone regeneration and repair, promote development of new blood vessels, and stimulate the wound healing process.
How Does PRP Therapy Work?
To prepare PRP, a small amount of blood is drawn from the patient. The blood is placed into a centrifuge, which separate the plasma from the blood producing the PRP. This concentrates the platelets and growth factors up to 500 times. This also increases hMSC (human mesenchymal stem cells).
When PRP is injected into the damaged area, it stimulates the surrounding tissue (tendon, ligament or cartilage) causing mild inflammation that triggers the healing cascade. As a result, new collagen begins to develop. As this collagen matures it begins to shrink, causing the tendons and ligaments of the damaged area to tighten and strengthen.
How does PRP Regenerate Tendons and Ligaments?
Tendons connect muscle to bone, making it possible for joints to flex and our bodies to move. Overuse or damage to the tendon over a long period causes the collagen fibers in the tendons to form small tears, a condition called tendonitis. Damage to tendons most often occurs in the knees, ankles, hips, spine, elbows, shoulders and wrists – the joints that move the most.
Ligaments are composed of collagen fibers that hold one bone to another, stabilizing the joint and controlling the range of motion. When a ligament is damaged, it is no longer able to stabilize the bones in the joint, which often leads to pain. This instability does not always show up on high tech imaging equipment. During a thorough evaluation, Dr. Lox can determine which ligaments and tendons are unstable due to injury, wear or tear.
Tendons and ligaments have a poor blood supply and they do not usually heal from damage. Combined with the stress of daily activity, tendons and ligaments become inefficient, causing degeneration of the joint, leading to chronic pain and weakness.
How does Stem Cell Therapy Work?
There are many types of stem cells – fetal, hematopotic (blood) and mesenchymal. Mesenchymal stem cells are able to develop into muscle, bone, tendon and ligamentous tissue. Mesenchymal stem cells are used to regenerate damaged musculoskeletal cells.
How are Stem Cells Obtained?
Stem cells are obtained from:
1. Concentrated blood platelets (platelet rich plasma)
2. Bone Marrow. In a sterile procedure under local anesthetic, a needle is
inserted into a patient’s pelvic bone, and blood and marrow are withdrawn.
Using a centrifuge, this is separated and the stem cells are drawn off.
The stem cells are then injected into the damaged area.
3. From abdominal fat. In a sterile procedure under local anesthetic, a needle
is inserted into the fatty portion of a patient’s abdomen and fat is drawn into
a syringe. This is then processed and the Mesenchymal stem cells are drawn
off and injected into the damaged area.
Is a Bone Marrow Draw Painful?
Because we extensively numb the area, patients say that the marrow draw was not uncomfortable and would do it again.
How Does PRP Compare with Cortisone Shots?
For many people, cortisone or steroid injections provide temporary relief from pain and inflammation, but may not provide long term healing. The healing and growth factors present in PRP heal and strengthen damaged tendons and ligaments, in some cases thickening the tissue up to 40 percent.
What are the Potential Benefits of Treatment?
Patients can see a significant improvement in symptoms, as well as a remarkable return of function. This may eliminate the need for more aggressive treatments such as long-term medication use or surgery.
How many PRP Therapy Treatments are Needed?
While response to the therapy will vary, most people will require 2-5 injections. Each injection procedure is spaced approximately four to six weeks apart. There is no limit to the number of treatments a person can have. The risks and side effects do not change with the number of injections.
Is PRP Right for Me?
If you have a tendon or ligament injury and traditional methods have not provided lasting relief, then PRP therapy may be the solution. The procedure is less aggressive and less expensive than surgery. It will heal tissue with minimal or no scarring and alleviates further degeneration of the tissues. At the conclusion of your initial evaluation with Dr. Lox, he will discuss your treatment options, including if PRP therapy is right for you.
Who is not a candidate for PRP or Stem Cell therapy?
- Patients with active cancers and/or infections.
- Anyone who consistently uses NSAIDs, since we require their suspension a
week before the injection and two weeks afterwards.
What Can Be Treated with PRP?
Since Platelet Rich Plasma injections help regenerate tendons and ligaments, practically any damaged area of the body’s muscular-skeletal system can benefit from PRP. Our clinic treats patients with sports injuries, arthritic and degenerative joints and degenerative disc disease. More specific injuries including tennis elbow, knee injuries and arthritis, ACL tears, chronic wrist pain, rotator cuff tears, shoulder and hip arthritis, and avascular necrosis may all be effectively treated with PRP.
Special Instructions.
Patients scheduled for PRP therapy are restricted from the use of non-steroid anti-inflammatory medications (NSAIDs), one week prior to the procedure and for two weeks after treatment. Initially the procedure may cause some localized soreness and discomfort at the injection site. Most patients only require some extra-strength Tylenol to help with the pain. Ice may be applied to the area as needed.
How Soon Can I Go Back Regular Activities?
PRP and stem cell therapy help regenerate tendons and ligaments, but it is not a quick fix. This therapy is stimulating the growth of new tissue, requiring time and rehabilitation. Under Dr. Lox’s supervision, patients will begin an exercise program immediately following the first procedure. During the treatment process, most people are able to resume normal activities and exercise. If you have a marrow draw, you will want to take it easy for 1-2 days. At the marrow draw site, watch for redness and if the skin becomes warm to the touch; contact the office if it does.
Will My Insurance Cover PRP or Stem Cell Therapy?
Although platelet rich plasma has been used in surgeries since the early 1990s, and despite the publicized success some professional athletes have had with PRP, most insurance companies, including Medicare, view the procedure as “experimental and investigational” and therefore do not cover the service nor reimburse for it. Therefore, we collect $750.00 from the patient for the procedure. Financing arrangements can be made if needed.
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For more information on Platelet Rich Plasma and Stem Cell therapy, please visit www.plateletrichplasmaflorida.com .
