PRP Therapy

One of our most powerful methods for growing new tissue is platelet-leukocyte autografting, known in the press as PRP Therapy or platelet-rich plasma injection.

• Platelets are blood components that carry a pouch of growth factors. Growth factors are the complex proteins in our bodies that act as contractors and subcontractors to initiate and organize the growing of tissue.
  
• Leukocytes are white blood cells, several kinds of immune system cells that are also key to tissue growth.
  
• Stem cells are cells that divide to leave one stem cell and another cell of whatever kind may be needed by the growth factor contractors to make new structures.
• By concentrating the blood we are concentrating some amount of stem cells natural to the blood. The injection of this blood cell concentrate has also been shown to attract a large additional amount of stem cells to the repair site.
  
• Grafting is taking tissue or cells from one place and putting it in another place where it is needed.
  
• Autografting is using the tissue or cells from one's own body.

How does it work? Your blood is drawn and processed here on-site over about an hour or more. The resultant platelet, white blood cell and stem cell grafting concentrate is then injected, usually with real time ultrasound imaging guiding the needle to precisely within tears and frayed, porous areas of the damaged tissue. Intelligent regeneration of the broken tissue fibers and fibrils ensues. Growth and repair continue for up to a month. Some series of monthly procedures is usually necessary.

The result is new, healthy, natural young tissue that is permanent. The causes of chronic pain are eliminated permanently.
The reason for consideration of joint surgery or joint replacement are in many cases eliminated.

Click on the above triangle to listen to Dr. Jonas Skardis of New Mexico Pain Management, interviewed on KSFR-FM radio on the subject of PRP therapy, interventional pain management, prolotherapy, and automobile accident care (duration: 14 minutes, 54 seconds).

History of PRP Therapy

The use of this method has its roots in the worlds of surgery and dentistry. For over 20 years platelet-rich plasma has been used as a surgical glue to seal some difficult incisions, such as those of open thoracic surgery, or some large skin flaps in plastic surgery. In dentistry, PRP has been used to build up bone in the jaw. PRP is used in orthopedic surgery as one of several tools to repair bone fractures that are resistant to mending. Dr. Jonas Skardis of New Mexico Pain Management began teaching PRP Injection to US and Canadian physicians in 2006. Since that time there has been an explosion of PRP use in sports medicine, particularly with elite athletes in the NFL, NBA, Major League Baseball, the NHL and among professional golfers. See the following slide show for news of PRP in sports. The slide show also quotes the New York Times as saying that over 500 hospitals utilize PRP, though the slides show mostly East and West Coast hospitals, and the Mayo Clinic. We know of no hospitals in New Mexico or Texas that utilize these methods that are most commonly now referred to as PRP therapy, PRP injection, platelet-rich plasma therapy or platelet-rich plasma injection.

PRP vs Prolotherapy

Both are effective tissue regeneration procedures. PRP therapy uses injection of a concentrate of the patient’s most potent blood cells. Prolotherapy is a strategy of injecting dextrose or other natural substances. Injectable dextrose is an FDA approved medicine that is easily available. PRP must be produced fresh from the patient’s blood for each procedure, requiring time, effort, and greater expense. There are greater limits on the amount of PRP that can practically be produced for any one procedure, without such limits for medicinal dextrose. Thus, in some areas of the body where large volumes of injected substances are required, prolotherapy with dextrose is preferred. On the other hand, there is general consensus that injection of PRP is stronger, more bioactive, expected to require fewer once monthly procedures. Each procedure is substantially longer with PRP therapy.

It should also be noted that tenotomy/fasciotomy, discussed in the section on other interventional pain management procedures, is also a tissue regeneration method.

Tissues Regenerated by PRP

Like prolotherapy injection of dextrose, PRP regenerates, regrows, repairs ligament, tendon, fascial, cartilage, nerve and muscle tissues. Like prolotherapy, and like any medical procedure, there are limits to what PRP can accomplish. Every case must be assessed individually.

FOR MORE INFORMATION:

Click here for additional press clippings from Orthohealing.com

FOR REFERRING PHYSICIANS:

http://harvesttech.com/education/references.html - a useful list of references about PRP therapies in various areas of medicine, up through 2008 only.

www.drreeves.com - this is a site run by K. Dean Reeves, MD, Clinical Associate Professor, Physical Medicine and Rehabilitation, University of Kansas Medical Center. The site reviews available research on a variety of percutaneous tissue regeneration procedures, among them platelet-rich plasma injections.

Orthopedic surgeon Allan Mishra, MD of Stanford maintains several websites related to PRP, such as www.bloodcure.com and www.totaltendon.com,

Dr. Reeves’ chapter, Evidence Based Regenerative Injection Therapy (Prolotherapy) in Sports Medicine.

AAOS Now, a monthly publication of the American Academy of Orthopedic Surgeons, has published a number of articles about PRP therapy.