PRP, Platelet Rich Plasma Regenerative Injection Therapy, for the treatment of back pain, neck pain, tendonitis, shoulders, elbows, wrists, fingers, hips, knees, ankles, feet, all joints of the body.
PRP Regenerative Injection Therapy (Prolotherapy) A new treatment for pain is becoming popular among orthopedic and pain specialists: the injection of platelet rich plasma (PRP). Almost everyone thinks of blood platelets as being responsible for blood clotting after injury which is true. What many people do not know is that blood platelets serve two other important functions. Blood platelets are responsible for bringing white blood cells to the injured area to clean up the remains of dead and injured cells. Most importantly, blood platelets release growth factors that are directly responsible for tissue regeneration. PRP has been used for years in surgical centers around the US and abroad to improve the success of bone grafting (especially in dental surgery) and also by cosmetic surgeons for speeding healing time and decreasing the risk of infection after surgery. Only in the last few years have doctors and surgeons been experimenting with injecting PRP for the treatment of chronic pain. Tennis elbow, plantar fasciitis, Achilles tendonitis/tendonosis, rotator cuff tears, meniscal tears, osteoarthritis and chronic low back and neck pain are are all being treated with the prolotherapy injection of PRP with the goal of regenerating degenerated connective tissue with reports of great success at a magnitude greater than regular dextrose prolotherapy.
What is Platelet Rich Plasma (PRP)?
Platelet Rich Plasma or PRP is blood plasma with concentrated platelets. The concentrated platelets found in PRP include growth factors among the huge reservoirs of 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.
While a normal concentration of platelets circulating in your blood is 200,000 per micro liter, the platelet count in Platelet Rich Plasma can exceed 2 million platelets per micro liter. To be considered PRP, the platelet count must be 4x or greater above baseline.
How is Platelet Rich Plasma made?
The process of creating Platelet Rich Plasma begins by drawing 20 - 60 cc of blood (500 cc is taken in blood bank donations). The blood is then put into the Harvest SmartPReP®2 Platelet Concentrate System and spun down separating the red blood cells, plasma and concentrating the platelets.
Here’s how it works:
All injuries result in tissue damage. The body’s natural response to injury is an organized process of regeneration and remodeling of damaged cells, ultimately returning the injured tissues to their normal state. Collectively this process is known as the healing cascade. This healing cascade is primarily controlled by bioactive tissue growth factors found in platelets. With PRP prolotherapy, these growth factors are concentrated and injected directly into the site of injury.
Growth Factor Biology
The response of living tissue to injury forms the foundation of all surgical practice:
All surgery results in tissue and cellular damage
The body's natural response to this injury is a series of regeneration and remodeling steps collectively referred to as the "Healing Cascade"
The steps are initiated and controlled by bioactive proteins found in platelets, plasma, and white blood cells
Cellular regeneration, remodeling, and proliferation requires a combination of:
Scaffold (structure or matrix)
Undifferentiated Cells (Mesenchymal stem cells)
Signal Proteins (platelets, plasma and white blood cells)
Increasing the concentration of the bioactive proteins acts as a catalyst for accelerating the wound healing process and forms the foundation of tissue engineering
Bioactive proteins replace, repair, and regenerate tissue. These proteins are natural components found in the body and are considered by many to be a “new frontier” of clinical treatment. Increasing the bioactivity at the wound site takes medicine one step closer toward its ultimate goal of naturally accelerating the body's normal healing process.
The bioactive proteins carried by platelets are already being used succesfully for hemostasis, wound sealing, and wound healing in surgical disciplines such as: oral and maxillofacial, orthopaedic, neurology, otolaryngology, cardiovascular, vascular, general, plastic and reconstructive, non-healing wounds, and pediatrics.
Why use your own platelets?
Platelets are tiny cells that are critical to healing. They are the body’s primary source of bioactive tissue growth factors, including CTGF (Connective Tissue Growth Factor) PGDF (Platelet Derived Growth Factor), TGF-β (Transforming Growth Factor-beta), EGF (Epidermal Growth Factor), IGF (Insulin Growth Factor), bFGF (basic Fibroblast Growth Factor), and VEGF (Vascular Endothelial Growth Factor. By concentrating these growth factors and injecting them at the site of injury, the body's own stem cells are drawn to the injured area and differentiate to form new healthy and robust regeneration of damaged ligaments and tendons.
PRP provides a fibrin matrix graft. : Fibrin matrix provides the scaffolding for new collagen to form along damaged ligaments and tendons. With a fibrin matrix graft, even severely damaged tissues can re-organize and heal.
PRP concentrates Mesenchymal stem cells (MSCs).
MSCs are multi-potent stem cells that can differentiate into a variety of cell types during tissue repair processes. Cell
types that MSCs have been shown to differentiate into include collagen secreting cells, bone forming osteoblasts and cartilage forming chondrocytes. Together these cells have the potential of rejuvenating tissues damaged by injury, degenerative changes, and osteoarthritis.
What does it do?
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.
How Does PRP Prolotherapy Compare With Cortisone Shots?
Studies have shown that cortisone injections may actually weaken tissue. Cortisone shots may provide temporary relief and stop inflammation, but may not provide long term healing. PRP therapy is healing and strengthening these tendons and ligaments and in some cases thickening the tissue up to 40%.
How Does PRP Regenerative Injection Therapy compare with regular Dextrose Prolotherapy?
Clinical and anecdotal experience is demonstrating that using PRP as the prolotherapy solution creates a much deeper healing effect and results in improved results in less treatments. It 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.
Frequency Of Treatments
While responses to treatment vary, most people will require 3 to 6 sets of injections of PRP. Each set of treatments is spaced 4 to 6 weeks apart. Usually positive development is evident after 2 treatments. Often satisfactory results may occur even sooner, but cannot be determined with certainty