We use PRP, platelet-rich plasma, also rich in stem cells from your blood, to literally regrow and repair worn or torn ligaments, tendons, fascia, and meniscus fibrocartilage that are causing pain and damaging movement of your joints. This is a non-surgical process that commonly takes plus or minus 6 once monthly injection procedures to gradually regrow the worn, damaged parts in and around the joint. Exercise, commonly with a physical therapist, usually has to follow in order to strengthen and balance muscles around the joint. Then, the repair can be permanent.
The first step is for you to educate yourself by reading this page carefully. If you are still interested, you can phone 800-702-NMPM to request a preliminary phone meeting with a physician. Our office manager, Tyree, will interview you a bit. Maybe we’ll try to get any imaging you may have had for the painful part. A doctor will call back and discuss your situation with you over the phone and answer your initial questions. Not everyone is a candidate. If you are still a candidate after that preliminary phone conference, a formal evaluation visit is scheduled.
Your face to face initial evaluation may require as much as two hours of discussion, physical examination, ultrasound imaging, education, and more discussion. We make a precise list of what sites in what structures need refurbishing in your painful joint region. Most other doctors evaluate very minimally, with little in the way of physical exam, and usually without ultrasound imaging, or with only minimal, token ultrasound imaging. Their approach results in quick versions of PRP and stem cell therapies, often injecting just one spot, and often just one time. In contrast, our approach is to go further, include more worn structures in the treatment plan, and aim to improve more functions of the joint area over time. That is all explained to you and usually shown to you. If you continue to be a candidate at that point, somewhere around 6 once monthly procedures are usually recommended. All your questions are discussed. If you and the physician are satisfied with this plan, a first procedure is scheduled. Certain medicines are prohibited – see below. Helpful natural medicines are prescribed – see below. Instructions are given.
At each monthly procedure, your blood is drawn by our nurse or one of our paramedics. Key nutrients are infused into the same vein via IV; read about what the nutrients are and what they are meant to do for you. Then you have a snack while your blood is processed in our lab to create a concentrate of your platelets and stem cells. This super cell concentrate is mixed with a specialized local anesthetic. Sometimes additional nerve blocks may be performed. Ultrasound procedure guidance is used by the doctor to see the tiny injection needle inside your body and place the super cell mixture exactly within tears or wear sites in each damaged, degenerated ligament, tendon, and meniscus. The entire process usually takes about 2 hours. You walk out of there, go about your day, and you feel soreness that evening and the next day, less commonly longer than that. After 3-5 days of only limited exercise, most people can return to whatever activity and exercise they tolerate. In worse cases, some sports or activities may need to be avoided longer.
You grow your own. That’s right, for 3-4 weeks, you’ll grow your own brand new, teenage repair tissue at the sites where injury and degeneration have aged your joint. The regrowth in any one month’s crop is partial, so monthly repetition for around 6 months is normally necessary. Usually, you start to feel the difference only late in those months, as new tissue accumulates enough to replace tears and areas of wear, gradually stabilizing the joint. As you start to feel better, and your physician sees objective improvement with physical exam or sonographic imaging, you will likely be instructed to become more active, possibly with referral to physical therapists or other outside experts. Strengthening surrounding muscles in that way will eventually complete the joint transformation process over time.
In summary, it is now possible to turn back the clock on some joint problems, allowing you to become more active again. Read and study the rest of this website carefully and thoroughly. Costs and insurance coverage are detailed on the Finances page. Then, if you’d like, we can discuss at least starting the above described step by step process with you.
No.
No. We get stem cells from your blood, which is effective, less invasive, and safer, as explained here in a slide show of scientific references. A recent study found equivalent results after 2 years when comparing PRP and bone marrow stem cells for knee arthritis.
No. We use them fresh, immediately.
We are very, very experienced. We are very good at what we do. We use unusually thin, acupuncture-like hypodermic needles for most injections. We take lots of time to make you as comfortable as possible. Even with all those positives, and even in areas where we can perform some nerve blocks for partial regional anesthesia, you will nevertheless feel some of the injections, some as pinches, some as sharp sensations, occasionally as hot spots inside. However, you’ll also be surprised at how you hardly feel or don’t feel many of the injections. We think the whole experience is quite reasonable, quite acceptable to most everyone. Many people are anxious to one degree or another initially, but they soon ease up when they feel how reasonable the process is. And, it only gets easier with subsequent sessions. If you are truly phobic about needles, talk to Dr. Skardis about a therapy that can quickly reverse such phobia.
Yes, if you live reasonably nearby, you can drive yourself right home. You might allow some extra time in the waiting room after your first procedure, as some regional anesthesia procedures could leave your leg a bit numb, or the local anesthetic could possibly leave you a bit lightheaded. Our many patients from other states or from far away in New Mexico are usually guided not to drive long distances until the next day or next afternoon, as protracted sitting in the car can make injected areas more sore. Most folks leave our office after a procedure and just go about their daily business, though most are instructed to not return to heavier exercise or heavy work for 3-5 days, depending on what joints in your body are treated.
Most patients experience some post-injection soreness that most commonly begins in several hours and continues for about 18-24 hours. For most people, severity varies between mild and moderate, less with gentle, persistent movement and more with sitting too long. Ice can be used. See the Helpful Natural Medicines heading below for herbs and supplements that we recommend to lessen post-injection soreness. There are also some patients who have little to no soreness at all, and several each year who have greater or longer post-injection soreness. We try to screen for those folks to the best of our ability, as we figure these infrequent greater inflammatory reactions reflect some greater hidden joint inflammation tendency, including possibly some auto-immune problem that needs other kinds of wholistic medical care.
Hardly any. Unlike surgery, after our procedures you just leave and go about your day. Stronger exercise or heavy work need to be put off for 3-5 days.
Yes, our procedures are very safe — much, much safer than even minor surgery. Injections of any kind have good safety profiles, and our injections are clearly safer than corticosteroid injections, as an example. Your doctor will detail risks of any proposed procedure.
It has happened, but that is unlikely. Our injections initially cause some increased inflammation, but then, maybe after a week or so, they may leave the joint less inflamed for another few weeks. This anti-inflammatory effect is usually passing and not the real goal of our method. The main purpose of PRP Stem Cell Joint Repair is to grow new tissue slowly, incrementally rebuilding damaged parts inside of joints, over a half year or more. Our experience tells us that the amount of growth in adults is partial in any one month’s crop, so plus or minus 6 once monthly plantings are usually needed. Decreased pain and increased stability tend to be felt more commonly towards the end of that period of months. Then, your activity needs to be cautiously increased, and some folks will be sent to physical therapy for guidance in strengthening. Your benefits level off a year or more after you are done at NMPM. So, no, for most of what we do, we do not expect you to be better after the first treatment.
Read the answer to the above question. For most of our procedures that regrow damaged tissue, we coach you to not expect any particular relief from any single session. It is a longer, gradual process of building a critical mass of new, healthy, teenage tissue in damaged ligaments, tendons, meniscus structures, and that happens slowly, with results expected to be felt only late in the process, or maybe only after physical therapy strengthening around the joint area. So, the above question is not the right kind of question to be asking.
Sure! Most of what we treat is arthritis, osteoarthritis. Osteoarthritis is wear and tear arthritis that is not a disease that you catch like the flu, but a long-term joint weakening process that begins with little injuries accumulating even from childhood, loosening ligaments that are meant to hold joints together. As years and decades go by, parts within such joints wear and become painful. We regrow damaged tissues in specific structures found to be worn or torn, gradually firming and stabilizing these joints as much as possible. So, actually, we treat arthritis all day, every day.
We do not use PRP Stem Cell Therapy to treat rheumatoid arthritis or the many other arthritis conditions that are first and foremost due to severe inflammation that is systemic, throughout your body.
That term “bone on bone” drives us crazy. It sure is a catchy phrase, it seems to convey a dead end condition – give up and do whatever the surgeon says. However, we feel that this phrase is used very imprecisely, and most people get the wrong impression from its use. We find that most people expect that if they have “bone on bone” it means that there is no cartilage anywhere. Instead, it means that some area, maybe even a very little area, is lacking cartilage, or is coming close to lacking cartilage. That is a serious consideration, however it may not be the end of the world and it may or may not necessarily mean that all such people must go under the knife immediately and have that joint replaced. It might mean that, but it might not. That is what we do evaluations to determine. We would be honored to have a chance to give a second opinion, possibly based on a lengthy evaluation.
Phone 800-702-NMPM and our office manager Tyree will interview you a bit, and he’ll try to see if we can get any X-ray or MRI reports from imaging you’ve had. Then he’ll try to arrange a telephone conference with one of our physicians. If we get past that, a lengthy in-office evaluation is scheduled. Hopefully, by the end of that evaluation, we can answer that question for you to the best of our ability. The last thing we want is to spend our time working on cases unlikely to be successful. Therefore, we accept less than half of the people who contact our office for joint repair.
Death and taxes are guaranteed. Medicine is not guaranteed – human bodies are too complex and variable. However, we do not accept patients lightly. We study you carefully. And we detail what we think will be your particular prognosis for success. That prognosis may be a bit complicated, with some joint structures having excellent prognosis and other parts having cautious prognosis.
Maybe, maybe not. Generally speaking, we have extra caution in treating areas that have had surgery. We have a general policy of not injecting in areas where there are metal or other implanted materials. Even without such materials in the way, a post-surgical area is generally harder to help than a natural area that has not been cut and altered. But, phone and arrange a preliminary phone conference to start discussing your particular post-surgical needs.
- Surgical hardware, even sutures & anchors, in the joint to be treated: we would not treat that joint.
- Rheumatoid arthritis, psoriasis with psoriatic arthritis, or other inflammatory disease: we probably would not accept you as a patient. Gout is an inflammatory joint disease and would have to very clearly be under control for us to proceed with PRP Stem Cell Joint Repair.
- Some sorts of chronic infection: we might not accept you as a patient.
- Diabetes: we accept patients with diabetes, but very poorly controlled diabetes could slow your repair.
- Use of prohibited medicines: see that section below.
- Other reasons: we turn away more than half of the people who inquire about becoming patients.
See the Finances section of this website.
See the Finances section of this website.
During the many months of our Joint Repair process, you must never use common oral or topical anti-inflammatory drugs, any oral, topical, or inhaled drugs with corticosteroids, certain particularly destructive antibiotics like Cipro and Levaquin, chemotherapy, and other immune system suppressing drugs. Read further for details.
NSAID means Non-Steroidal Anti-Inflammatory Drug. This includes many over the counter drugs you can purchase at many kinds of stores without a prescription: Ibuprofen, Advil, Aleve, Motrin, aspirin and many others. It also includes prescription medicines such as Celebrex, Vioxx and many others. Note that NSAIDs are also present in some topical crèmes and ointments. NSAIDs chemically shut down natural inflammation that is part of the way your body heals. While in some ways these medicines are clearly not as damaging as the others in this prohibited drug list, they do abort our repair processes, and they have some other negative side effects. Tylenol (acetaminophen) is not an NSAID anti-inflammatory. It is not on the prohibited list. But, read about its problems in the below section Think Twice About These Drugs.
Click here for some more reading about the problems with NSAID’s.
Aspirin deserves some additional commentary. It is also an NSAID. It stops valuable natural inflammation that is needed for healing. The FDA has now taken the position that using aspirin for primary prevention of cardiovascular disease is currently proven to be more dangerous than helpful. Here is a 5/21/22 New York Times article about the current state of aspirin research and medical guidelines. Unfortunately, it may still be recommended by many doctors, despite strong scientific evidence showing it is now counter-indicated and even dangerous for most people. Click here for articles by physicians who believe there is scientific evidence not to take aspirin and that there are natural substances that are healthy and more effective alternatives to daily use of aspirin. Click here for a massive study in the Journal of the American Medicine Association that concluded that aspirin is a risk factor for heart disease. Also, read about a large study that showed no benefit of aspirin in preventing a first heart attack or stroke. Several additional recent studies have further reinforced the need for millions of people to avoid aspirin.
The most significant recent major aspirin research was the publication of a massive study in the Journal of the American Medical Association on January 22nd, 2019. This huge study of 164,225 participants concluded that “there is insufficient evidence to recommend routine aspirin use in the prevention of heart attacks, stroke, and cardiovascular deaths in people without cardiovascular disease.” As a result, the FDA changed its position to be against preventive use of aspirin. And, new research in October of 2021 further warned about aspirin use.
We require that NSAID anti-inflammatory drugs be stopped at least one week prior to beginning PRP Stem Cell Therapy or any other regenerative procedures. Then NSAIDs need to be fully avoided during the months of PRP therapy, and for at least one month after the last procedure. And, you’re probably best off never taking these drugs.
This is a more serious category of drugs. Not only would drugs in this category abort our tissue regeneration procedures, but these drugs can commonly have even more serious and dramatic adverse effects. In injectable form it might be called a cortisone injection, or a steroid injection, or it might be spoken of by specific drug names such as DepoMedrol, Celestone, or others. Orally, it might be called Prednisone or Prednisolone. Corticosteroid use outside of the amounts normally made by the body suppress your own production in the adrenal glands, and in effect turns off your immune system, increasing infection risk, literally putting stem cells to sleep, and posing a threat of damaging connective tissues, weakening and damaging ligaments and tendons. Injection of corticosteroid into a knee has been proven to increase the severity of subsequent osteoarthritis in that knee, and to increase the likelihood of having the knee replaced. Because of this, doctors in the past decade have mostly backed off of injecting it into the Achilles’ tendon, as such injection too often led to rupture of the Achilles’ tendon. But, sadly, injections in other structures continue, perhaps because the damage done is not so clearly seen as with Achilles’ rupture. But note that even plain over the counter cortisone creme is a corticosteroid, as are some nasal sprays and asthma inhalers. All of them need to be stopped.
Because of how much stronger corticosteroids are than NSAIDs, corticosteroids need to be stopped at least 6 or ideally 8 weeks prior to beginning PRP Stem Cell Joint Repair. Some surgeons demand that corticosteroid injections be stopped for 6 months prior to some surgeries.
This should scare you. If you read about these antibiotics, look at the studies and articles below, and watch the Canadian TV documentary, it would be reasonable to be horrified that such damaging medicines are given out so freely, and without explanation of the risks.
Fluoroquinolones are a family of antibiotics that include the following:
- Cipro (ciprofloxacin)
- Levaquin (levofloxacin)
- Avelox (moxifloxacin)
- Factive (gemifloxacin)
- Noroxin (norfloxacin)
- Floxin (ofloxacin)
- NegGram (nalidixic acid)
- Baxdela (delafloxacin)
These are among the most powerful broad-spectrum (kill everything) antibiotics, and they are supposed to be used for more serious infections, but are used too widely. They may be given in women’s urinary infections, even though other antibiotics or even supplements and herbs may be effective. If you are traveling to Africa or Asia a travel doctor or your family doctor may give these to you. They can also be found in some eye drops.
The United State Food and Drug Administration – the FDA – has put “Black Box Warnings” on these antibiotics, in 2008 warning consumers that fluoroquinolones cause spontaneous complete rupture of tendons, and, in 2013, that fluoroquinolones cause nerve damage called neuropathy. Here is their 2016 additional warning. Patients of ours have reported having had psychotic events taking fluoroquinolone antibiotics, and in an early 2018 FDA communication, mental health issues and hypoglycemic coma are added as warnings. Late in 2018, the FDA announced that fluoroquinolones may cause deadly rupture of the aorta.
You’d think that this would change standard medical prescribing patterns, and it may have somewhat, but these are still too commonly prescribed.
Taking these particular antibiotics can weaken, loosen ligaments throughout your body. This resultant widespread tissue damage is permanent, potentially making some joints in your body unstable to one extent or another. Many patients don’t notice new joint pain right away, but in time the loosening of joints leads to gradually increasing damage of parts inside the joint.
In some patients’ cases, we can trace their joint damage to times of taking these antibiotics. Click here for one such case. In this case a heavier amount of Cipro and Levaquin were taken, and the patient suffered spontaneous ruptures of one Achilles’ tendon and rotator cuff tendons in both shoulders. What is often missed in the medical literature is that folks like these also have weakening of many other areas of ligament, tendon, cartilage, muscle, and nerve, setting them up for broad chronic pain. While the above link tells one very dramatic story, understand that we also see damage in patients who only took Cipro or Levaquin briefly, like the patient interviewed on this newsletter on the topic.
We normally require that patients have at least 2 months between consumption of fluoroquinolones and the beginning (or resumption) of PRP Stem Cell procedures. And, we require rehabilitation through IV therapy with magnesium and glutathione, and perhaps other nutrients. Oral magnesium and oral antioxidants will be of some help, but the IV nutrients are dramatically stronger. There are trails of evidence in the medical literature for key roles for magnesium and anti-oxidants in limiting damage from fluoroquinolones, and then also remediating such damage. Click here to read the abstract of a 2011 review article, in a peer reviewed journal, regarding musculoskeletal damage from fluoroquinolone antibiotics. Healthcare professionals may want to purchase the full text and study this well written review article.
Click here to watch this 14 minute documentary from Canadian TV called “Bitter Pill: The Dangerous Side Effects of Fluoridated Antibiotics”.
It was already mentioned above that corticosteroids are immune suppressive. In the above section we were mostly referring to situations where patients are given corticosteroids temporarily. In unusual other situations, Prednisone may be given permanently, or for protracted lengths of time, for some severe or life-threatening illnesses, or to suppress immune system rejection of an organ transplant. There are other drugs in this category as well.
Psoriasis, rheumatoid arthritis, and other inflammatory conditions are treated with a newer category of drugs called TNF inhibiters. Examples include Embrel, Humira and others. Since these powerful drugs turn off parts of your immune system, and since our tissue regeneration procedures depend on a functional immune system, we see these medicines as contraindicated with PRP Stem Cell Therapy and our related methods.
Much of chemotherapy works with a mechanism similar to the fluoroquinolone antibiotics discussed above. Chemo drugs cause severe oxidation which breaks down cancer cells much like oxidation breaks down iron to iron oxide (rust). Unfortunately, this means that various other tissues in the body may break down as well. This break down environment is the opposite of the build up environment that we seek. If you are getting chemotherapy, PRP Stem Cell Therapy should wait.
The following are drugs that we do not formally prohibit with PRP Stem Cell Therapy, however we list them here as significant concerns you should at least know about, IF you are using these drugs.
Tylenol (acetaminophen)
Because Tylenol is not an NSAID anti-inflammatory, it is not prohibited during the months of PRP Stem Cell Therapy. But, at least know that it is also very risky for your liver. In fact, Tylenol (acetaminophen) is the #1 cause of liver failure in the US. And, other, new side-effects of Tylenol continue to be discovered. As of early 2020, we have news that California regulators are considering taking this drug off the market because of cancer concerns. Take less than the upper limit noted on the bottle, checking that there is no acetaminophen in other of your meds. Do not consume alcohol while taking Tylenol. If you feel you must take Tylenol (acetaminophen), then also take the nutritional supplement NAC with it, as NAC is the antidote recommended by the FDA to save your liver in cases of acetaminophen overdose. Better than that, use the natural medicines we recommend below.
Statins – Cholesterol Suppressing Drugs
We do not prohibit use of statin drugs during PRP Stem Cell Therapy, but maybe we should. What is scientifically clear is that at least in some partial percentage of patients, statin drugs damage muscle tissue, as well as nerve, ligament, and tendon tissue. Click here for articles and studies that discuss that effect. This article cites research that arguably shows that statins increase the risk of knee replacement, and this article is a newer version. Statins trigger brain changes with potentially severe consequences. These cholesterol drugs double or triple your chances of developing diabetes. The latest study in the journal Diabetes, showed statin users have 38% greater chance of getting diabetes. Statin drugs also cause deficiency of CoQ10, a critical nutrient for cell and heart health; if you do take cholesterol suppressing drugs, at least supplement with CoQ10 or the more absorbable form called ubiquinol. And, unfortunately, research has found that “Physicians seem to commonly dismiss the possibility of a connection” of statins to these proven detrimental side effects. Recent research that firmly links statin drugs, and the whole strategy of lowering cholesterol, to dementia and Alzheimer’s disease. But don’t you need to take drugs to lower your cholesterol? Recent research says that high cholesterol means a longer life!
Blood Thinners
We can work with patients on blood thinners like Warfarin (Coumadin), Plavix and others. The doctor who prescribes the blood thinner is welcome to phone to speak with your doctor here at NMPM. We explain to them that our injections are generally not near major vessels, and most commonly ultrasound guided. As such, it is our experience that our injections are generally safe for patients on blood thinners. In recent years, the most common conclusion of the doctors monitoring these blood thinners for our patients is to have patients go forward with the injections without interrupting their daily regimen of taking that drug.
While we do commonly work with patients on blood thinners, it may be that blood thinners could make our PRP Stem Cell Procedures take a bit more time.
Birth Control Pills and Some Hormone Medicines
Birth control pills can be gradually damaging to ligaments and tendons, as may some pharmaceutical manufactured hormone drugs. Instead, we recommend compounded (not manufactured) natural bioidentical hormones that are balanced in an ongoing manner with a healthcare provider, such as Dr. Celeste Skardis, willing to meet with you often and ideally educate you in making small day to day adjustments in hormone crèmes applied to your skin.
Other Antibiotics
Fluoroquinolone antibiotics like Cipro and Levaquin are listed above as clearly prohibited drugs that fully negate our use of PRP Stem Cell Therapy. They are grossly damaging to tendons, ligaments, cartilage, nerves, etc. But we also recommend caution whenever possible in use of other antibiotics as well. For example, many people experience fatigue following antibiotic use, and we can only infer that your response to our healing process may be somewhat slowed or weakened by consumption of antibiotics. We can usually proceed with our process when a patient is on antibiotics, but in an ideal world it would be great to avoid the weakening antibiotics entirely, if it were safe to do so.
We understand that most of you will tend to want to do what your doctor says, and any infection can have serious consequences. We are not telling you to ignore you doctor’s recommendations. One option is to establish a standing relationship with a wholistic doctor as your primary doctor, or as an additional doctor. The key is to establish a relationship and to plan ahead with them on what to do with any future infection. Hopefully, you can arrange to have some natural medicines in your medicine cabinet, and enough knowledge of what to use as soon as there is any worry of an infection, together with established access by phone to your wholistic doctor. Many infections can be handled without antibiotic drugs, but you have to work very quickly with a knowledgeable doctor to be safe and effective.
Drugs for Anxiety, Depression, Sleep
Benzodiazepines and related drugs can have much worse consequences than many people realize. There are dozens of these drugs with various names such as Valium and Ativan. Sleep drugs like Ambien have similar concerns, as do drugs for depression, and anti-psychotic drugs in general. They all have somewhat similar actions of altering the nervous system. These drugs are extremely addictive within a very short time period of usage, they have many side-effects, including sometimes paradoxically amplifying the very symptoms they are meant to treat. Since they effect the nervous system, they sometimes may add to your pain, and possibly make you more anxious about your pain.
Most physicians prescribe such drugs very freely, usually with no explanation of the risks, and possibly with an under appreciation of the risks. However, some physicians argue that psychoactive meds have unusual, difficult withdrawal symptoms, may eventually amplify existing pain and may cause many unpleasant symptoms that may complicate any pain patient’s life. Often such symptoms lead physicians to simply increase dosage, deepening the problem. The complexity of the withdrawal process is well described in this interview of a psychology doctor. Some argue that healing and recovery are delayed and complicated because of benzodiazepine withdrawal both before and after stopping the medication.
There is also another similar class of drugs used primarily as antidepressants such as Prozac, Paxil, and many others in this class, described as selective serotonin re-uptake inhibitors (SSRIs). We do not turn away patients just because they are on SSRIs, but the science says that SSRIs do impair platelet function and thus likely increase the required number of monthly PRP Stem Cell procedures. 95% of serotonin is produced and located in the gut. Even research financed by Merck, a manufacturer of SSRI drugs, admits to numerous gastrointestinal side-effects from the drugs. Drug treatment centers who actually work in the trenches to help people who have severe symptoms from taking and from withdrawing from SSRIs and benzodiazepine drugs report even more torturous gastrointestinal problems.
A strong FDA warning has been issued about severe dangers of combining benzodiazepines and opiates.
New research shows that taking such psychotropic drugs worsens outcomes from hip replacement. This new research should provide concern that other types of healing may be impaired by these drugs, including the healing we initiate with PRP Stem Cell Therapy. But, at this point, more research is needed.
Beware: if you take drugs for anxiety, sleep, depression, or other psychiatric conditions, they may be adding another confusing layer of chemically induced pain. It is possible that this drug effect would amplify pain where you have localized mechanical joint problems. We can’t help you with that added layer of pain from the drugs.
See the website http://benzo.org.uk. This extensive website has long been run by a British medical doctor who has tried to increase consciousness about the complex hidden negatives of benzos and related sleep and depression meds. Also, read accounts about these problems from the recovery community in the US – grass roots groups of people who have succeeded in the difficult task of getting off these prescription drugs. The withdrawal from these drugs can be very protracted and confusing. If you are on these anxiety, sleep, or depression drugs, or have had these drugs recommended, study this information and think twice about these drugs. They may make your pain worse.
Vitamin D increases growth of new repair tissue. Bromelain, curcumin, boswellia, ginger, astaxanthin help pain, swelling and inflammation and thus replace Advil, Aleve, Ibuprofen, etc.
PRP Stem Cell Joint Repair is a natural process that depends fully on the natural ability of your body to heal. This section is about compatible natural medicines to make the healing more effective, and to reduce swelling and inflammation without impairing the healing process. With the limitations of the above section Prohibited Medicines, you need to educate yourself and migrate to using the below natural medicines.
Synthetic pharmaceutical drugs commonly have doses of a single small pill or capsule. Natural medicines are closer to food and often need to be taken in larger volume each time, in more frequent doses, and for a longer time before they build up in your blood enough to have their effect. The benefit? You get the intended therapeutic effect, plus good side-effects. Dosage should be discussed with your doctor at NMPM.
We try to carry most of the below mentioned natural medicines for the convenience of just our patients. We are not a store for people off the street. We try to check Amazon.com periodically, and we aim to meet or beat their prices for the below listed natural medicines we carry as a convenience to you. We periodically study the available products to find those with the best absorption, the best ingredients, no harmful fillers, and the best potency to price ratio. You are very welcome to get the same products on your own from Amazon or elsewhere, but don’t just get any product or you may be getting a weak product with far less therapeutic effect.
Read our longer Vitamin D page.
To summarize that page quickly, our joint repair is increasingly effective if we can quickly get your Vitamin D3 blood level to between 60 and 80, or even to 100. We prescribe 15,000 IU every single day, with Vitamin K2-7 (MK7), with a meal, ideally a meal with some oil in it. We carry this product, recommending 3 small gel caps per dose. Read our longer, dedicated Vitamin D page for more information.
Enzymes are natural substances, commonly in foods, that help you digest. Proteolytic enzymes are those that digest proteins. They can be taken with food to help digest the protein in that meal. If they are taken apart from food, such as 20 or more minutes before a meal, 1 to 1.5 hours after a meal, or at any other time on an empty stomach, ingested proteolytic enzymes go into your blood stream and look for proteinous debris to digest. There will be such debris in inflamed, sore joint areas. The enzymes will gradually digest that debris and help such areas drain, reducing swelling and pressure, and making any such sore, inflamed area feel more comfortable. It is not anti-inflammatory, but it helps inflamed areas feel better and heal more quickly.
An analogy we use often is to compare the above effect to the use of an enzyme product called Rid-X. It may be recommended that homes with septic systems put Rid-X into their toilet once a month to digest any excess residual waste in their septic tank, thus letting the tank safely drain into the leach field and not back up sewage into the house.
The simple, inexpensive protein digesting enzyme that we most commonly recommend is bromelain, which is an enzyme from pineapple. We make recommendations on an individualized basis for each patient, but a common dose is 500 mg (one capsule), 0 to 3 times per day, apart from food. But, it is even more appealing to take this around each PRP Stem Cell procedure, sometimes up to 1000 mg (two capsules), as frequently as every 2-4 hours, for a couple of days before each procedure, the day of each procedure, and for at least a couple of days after each procedure. Ask your physician here for individualized dosage advice.
If you wish to study the science about bromelain more in-depth, you may review this journal article.
There are many, many enzyme supplements on the market. Many are good. One goal is to compare them well. Compare the potency (GDU) and the amount (milligrams) per capsule. You’ll have to sort out what enzymes in a given commercial formula are protein digesting (proteolytic), and not digestive enzymes for fat, starch, dairy, etc. We recommend against formulas that are “proprietary”, not divulging such potency and volume information. Interestingly, enzymes are the main category of medicines sold in Europe, prescription or non-prescription!
We currently carry this high potency, high value bromelain product.
Inflammation is good. Inflammation is the natural ability of your body’s immune system to rally and bring blood and various useful natural bodily chemicals to an area to help with repair. We need inflammation throughout the time that we work with your body to grow new tissue to repair your joints. Corticosteroids, Advil, Aleve, Ibuprofen, Motrin, and aspirin stop inflammation, which aborts the repair process in your joints. Instead, the following natural medicines regulate or balance inflammation, ameliorating excess inflammation without suppressing all inflammation. We encourage you, now and over time, to get to know many versions of the following healthy natural medicines.
At minimum, we recommend taking some or all of these natural medicines for for a few days before and after each PRP Stem Cell intervention. Some of you might want to take these natural substances daily, throughout the time we’re working together to repair your joints. Talk to your NMPM physician.
Curcumin is an extract of the culinary herb turmeric that makes curry yellow. It helps moderate any excess inflammation in joints, and many other systems of your body. Read this 2022 research study about its use in musculoskeletal pain. It has many good side-effects. Read this article about UCLA research into how curcumin and Vitamin D may actually reverse plaques in the brain associated with Alzheimer’s disease. We recently did a review of available curcumin extraction methods, deciding to carry this product.
Omega 3 is a category of oil that most people don’t get enough of, creating a more inflamed condition. Ideally, one’s Omega 3 should be at least 8% of the fats you consume in your diet. A recent research study showed that to get to that percentage, it is recommended to consume 1900 mg combined of the two types of Omega 3’s, DHA and EPA. You can get these from fish oil, krill oil, or vegan marine algae Omega 3’s. There is some controversy about fish oil sometimes being rancid or having toxins, though not all fish oil is bad. Krill oil may have a bit of an absorption advantage, but it is more expensive. This vegan Omega 3 product is arguably a good choice, and to get 1900 mg of DHA and EPA combined, the dose is 4 capsules with breakfast and 4 capsules with dinner. There is some question about how quickly you get the reduction in inflammation, but it is probably gradual. It has been shown to reduce joint inflammation, including muscle soreness after activity. It has been shown to help prevent chronic migraine headaches. Besides helping with your pain, many systems in your body will benefit. Increasing Omega 3 may help counter obesity and depression, besides the more well known effect of reducing inflammation. Here is an impressive article about the value of Omega 3 with migraine prevention.
Astaxanthin, pronounced az-ta-zan-thin, is a red substance that comes from algae in the ocean. Astaxanthin is what makes salmon pink. Astaxanthin is a very potent anti-inflammatory, making it useful for virtually any inflammatory condition, including joint problems such as rheumatoid arthritis, carpal tunnel syndrome and tennis elbow. Astaxanthin has 550 times stronger antioxidant power than vitamin E, and is 6,000 times more potent than vitamin C. Astaxanthin acts on at least five different inflammation pathways, making it a very potent anti-inflammatory, and maintains balance within the system. It has broad versatility and exceptional safety, even at extremely high doses. Well over 100 studies demonstrate the safety of astaxanthin, even at mega-doses as high as 500 milligrams (mg) per day.” It is the only antioxidant that crosses into the brain and directly into the retina at the back of your eyes. Astaxanthin may slow brain aging. Taking astaxanthin orally even acts like applying sunscreen to your skin. We recommend 10-12 mg per day, though you may take more. Here is an example of a cost-effective brand available at Amazon.com. Here is another astaxanthin product that may be even better absorbed.
Boswellia is the biblical herb frankincense. Read more about boswellia here. Read this 2022 research study about its use in musculoskeletal pain. Here is an example of a cost-effective brand available at Amazon.com.
Ginger may be a very valuable medicine for you. Get this ginger juice and this lime juice and mix into bubble water to make your own ginger ale. Sprinkle inexpensive ginger powder on food during or after cooking. Use half a teaspoon to make a cup of tea. Or, buy it in capsules at any natural food store. A double-blind randomized placebo-controlled clinical trial showed that ginger objectively changes the blood of knee osteoarthritis patients to be less inflammatory, and another such study had similar results. Ginger reduces cartilage wear. Ginger reduces pain of osteoarthritis. Ginger reduces inflammatory blood markers in well-trained male endurance runners. Muscle soreness after exercise is reduced by ginger. Thigh pain during cycling is reduced by ginger. Exercise endurance is increased with ginger use. A medical journal article entitled The Amazing and Mighty Ginger collects a vast number of scientific references about the valuable actions of ginger.
After your blood is drawn for PRP Stem Cell Joint Repair, our nurse or one of our paramedics starts an IV of nutrients that are powerful contributors to the repair process. If you are interested, click here for more details about those particular IV nutrients.
Food. There is great power in what you eat and how you eat it. Sure, this is a huge discussion, and there are numerous points of view. Just let it be said that your experience of PRP Stem Cell Joint Repair will at some background level be influenced by your food choices and how you eat.
Vitamin D, discussed more thoroughly on our full Vitamin D page, is itself anti-inflammatory, though mostly through gradual, long-term increase of the Vitamin D level in your blood. A study of nearly ten thousand people confirmed that Vitamin D reduces inflammation in 25 different diseases.
Meditation is not a pill or capsule, but it is very healing. This research study shows meditation increases stem cells in the blood. Meditation can also help pain. Here is a book on a very simple version of meditation. Here is a free book that claims to even make that simple method even simpler. Much of religion based prayer is meditative, particularly contemplative prayer. If you want to go deeper, click here and here. Make meditation your medication!
Chinese herbal medicine. Thousands of years of written medical experience have made Chinese herbal medicine a special resource, far more advanced than other traditions of herbology. If you have qualified practitioners of Chinese herbal medicine in your area, they may be able to help regulate your inflammation, improve circulation, reduce stagnation responsible for soreness after inactivity, etc. The complex formulas of Chinese herbal medicine may be in pills, capsules, powders, or loose, dried herbs that you must cook on your own. An interesting quality is that some formulas send the herbs more to certain areas of the body. Another interesting quality is that pain in a joint might be diagnosed to be from different causes, such as dampness, cold, heat, wind, and other causes that are different than in modern Western medicine. Most of all, Chinese herbal medicines can be very effective, IF well chosen for your particular needs. And, those needs change from time to time in your body and thus need to be monitored and updated by a qualified practitioner.
Hemp oil, CBD oil, or THC oil may be useful at topicals in your painful joint area.
Scroll through the below listed 122 research studies that have already proven PRP effectiveness in repairing joints, including randomized controlled trials, meta-studies, and systemic reviews. Appreciate the diversity and length of the below list of research already supporting our use of PRP.
Lin MT, Wei KC, Wu CH. Effectiveness of Platelet-Rich Plasma Injection in Rotator Cuff Tendinopathy: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Diagnostics (Basel). 2020 Mar 28;10(4):189. doi: 10.3390/diagnostics10040189.
Oeding J, Varady N, Fearington F, Pareek A, Strickland S, Nwachukwu B, Camp C, Krych A. Platelet-Rich Plasma Versus Alternative Injections for Osteoarthritis of the Knee: A Systematic Review and Statistical Fragility Index–Based Meta-analysis of Randomized Controlled Trials. Am J of Sports Medicine 2024 Jan 29.
Thomas J, Jayaditya DP, Al Dallal W, Athanasiou A. Evaluating the Effectiveness of Intra-articular Platelet Rich Plasma Injections for the Treatment of Knee Osteoarthritis: A Systematic Review. SVOA Orthopaedics April 03, 2023
Ho-Won L, Kyung-Ho C, Jung-Youn K, Ik Y, Kyu-Cheol N. Prospective Clinical Research of the Efficacy of Platelet-rich Plasma in the Outpatient-based Treatment of Rotator Cuff Tendinopathy. Shoulder Elb. 2019 Jun 1;22(2):61-69. doi: 10.5397/cise.2019.22.2.61. eCollection 2019 Jun.
Rossi LA, Piuzzi N, Giunta D, Tanoira I, Brandariz R, Pasqualini I, Ranalletta M. Subacromial Platelet-Rich Plasma Injections Decrease Pain and Improve Functional Outcomes in Patients With Refractory Rotator Cuff Tendinopathy. Arthroscopy. 2021 Sep;37(9):2745-2753. doi: 10.1016/j.arthro.2021.03.079. Epub 2021 Apr 20.
Tahririan MA, Moezi M, Motififard M, Nemati M, Nemati A, Ultrasound guided platelet-rich plasma injection for the treatment of rotator cuff tendinopathy. Adv Biomed Res. 2016 Dec 27;5:200. doi: 10.4103/2277-9175.190939. eCollection 2016.
Long P, Yang X, Tao L, Yinghao L, Jing Z, Xin T. Platelet-Rich Plasma Injection Can Be a Viable Alternative to Corticosteroid Injection for Conservative Treatment of Rotator Cuff Disease: A Meta-analysis of Randomized Controlled Trials. Arthroscopy. 2023 Feb;39(2):402-421.e1. doi: 10.1016/j.arthro.2022.06.022. Epub 2022 Jul 8.
Yang Xu, Tao Li, Li Wang, Lei Yao, Jian Li, Xin Tang. Platelet-Rich Plasma Has Better Results for Long-term Functional Improvement and Pain Relief for Lateral Epicondylitis: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Am J Sports Med. 2024 Feb 15:3635465231213087. doi: 10.1177/03635465231213087.
Kia C, Baldino J, Bell R, Ramji A, Uyeki C, Mazzocca A. Platelet-Rich Plasma: Review of Current Literature on its Use for Tendon and Ligament Pathology. Curr Rev Musculoskelet Med. 2018 Dec;11(4):566-572. doi: 10.1007/s12178-018-9515-y.
Prodromos CC, Finkle S, Prodromos A, Chen JL, Schwartz A, Wathen L, Treatment of Rotator Cuff Tears with platelet rich plasma: a prospective study with 2 year follow-up. C Musculoskelet Disord. 2021 May 29;22(1):499. doi: 10.1186/s12891-021-04288-4.
Dyson-Hudson TA, Hogaboom NS, Nakamura R, Terry A, Malanga GA. Ultrasound-guided platelet-rich plasma injection for the treatment of recalcitrant rotator cuff disease in wheelchair users with spinal cord injury: A pilot study. J Spinal Cord Med. 2022 Jan;45(1):42-48. doi: 10.1080/10790268.2020.1754676. Epub 2020 May 7.
Pritem AR, Abraham VT, Krishnagopal R. Early Clinical and Functional Outcome of Rotator Cuff Tendinopathy of the Shoulder Treated with Platelet Rich Plasma Injection. lays Orthop J. 2021 Jul;15(2):55-61. doi: 10.5704/MOJ.2107.009.
Bezuglov E, Zholinsky A, Chernov G , Khaitin V, Goncharov E , Waśkiewicz Z, Barskova E, Lazarev A. Conservative Treatment of the Fifth Metatarsal Bone Fractures in Professional Football Players Using Platelet-Rich Plasma. Foot Ankle Spec. 2022 Feb;15(1):62-66.
Singh H, Knapik DM Polce EM, Eikani CK, Bjornstad AH, Gursoy S, Perry AK, Westrick JK, Yanke AB, Verma NN, Cole BJ, Chahla JA. Relative Efficacy of Intra-articular Injections in the Treatment of Knee Osteoarthritis: A Systematic Review and Network Meta-analysis. Am J Sports Med. 2021 Aug 17.
Dai WL, Zhou AG, Zhang H, Zhang J. Efficacy of Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis: A Meta-analysis of Randomized Controlled Trials. Arthroscopy. 2017 Mar;33(3):659-670.e1. doi: 10.1016/j.arthro.2016.09.024. Epub 2016 Dec 22.
Shen L, Yuan T, Chen S, Xie X, Zhang C. The temporal effect of platelet-rich plasma on pain and physical function in the treatment of knee osteoarthritis: systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res. 2017 Jan 23;12(1):16. doi: 10.1186/s13018-017-0521-3.
Xing D, Wang B, Zhang W, Yang Z, Hou Y, Chen Y, Lin J. Intra-articular platelet-rich plasma injections for knee osteoarthritis: An overview of systematic reviews and risk of bias considerations. Int J Rheum Dis. 2017 Dec 5. doi: 10.1111/1756-185X.13233. [Epub ahead of print]
B Ghaia, V Guptab, A Jainc, N Goela, D Chouhane, YK Batrad. Effectiveness of platelet rich plasma in pain management of osteoarthritis knee: double blind, randomized comparative study. Refista Brasieira de Anestesiologia, 14 September 2019.
Chen X, Jones IA, Park C, Vangsness CT Jr. The Efficacy of Platelet-Rich Plasma on Tendon and Ligament Healing: A Systematic Review and Meta-analysis With Bias Assessment. Am J Sports Med. 2017 Dec 1:363546517743746. doi: 10.1177/0363546517743746. [Epub ahead of print]
Laver L, Marom N, Dnyanesh L, Mei-Dan O, Espregueira-Mendes J, Gobbi A. PRP for Degenerative Cartilage Disease: A Systematic Review of Clinical Studies. Cartilage. 2016 Sep 1:1947603516670709. doi: 10.1177/1947603516670709. [Epub ahead of print]
Chen Z, Wang C, You D, Zhao S, Zhu Z, Xu M. Platelet-rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis: A meta-analysis. Medicine (Baltimore). 2020 Mar;99(11):e19388. doi: 10.1097/MD.0000000000019388.
Lin KY, Yang CC, Hsu CJ, Yeh ML, Renn JH. Intra-articular Injection of Platelet-Rich Plasma Is Superior to Hyaluronic Acid or Saline Solution in the Treatment of Mild to Moderate Knee Osteoarthritis: A Randomized, Double-Blind, Triple-Parallel, Placebo-Controlled Clinical Trial. Arthroscopy. 2019 Jan;35(1):106-117. doi: 10.1016/j.arthro.2018.06.035.
Belk JW, Kraeutler MJ, Houck DA, Goodrich JA, Dragoo JL, McCarty EC. Platelet-Rich Plasma Versus Hyaluronic Acid for Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Am J Sports Med. 2020 Apr 17:363546520909397. doi: 10.1177/0363546520909397. [Epub ahead of print]
Patel S, Dhillon MS, Aggarwal S, Marwaha N, Jain A. Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double-blind, randomized trial. Am J Sports Med. 2013 Feb;41(2):356-64. doi: 10.1177/0363546512471299. Epub 2013 Jan 8.
Lisi C, Perotti C, Scudeller L, Sammarchi L, Dametti F, Musella V, Di Natali G. Treatment of knee osteoarthritis: platelet-derived growth factors vs. hyaluronic acid. A randomized controlled trial. Clin Rehabil. 2017 Aug 1:269215517724193. doi: 10.1177/0269215517724193. [Epub ahead of print]
Fitzpatrick J, Bulsara M, Zheng MH. The Effectiveness of Platelet-Rich Plasma in the Treatment of Tendinopathy: A Meta-analysis of Randomized Controlled Clinical Trials. Am J Sports Med. 2016 Jun 6. pii: 0363546516643716. [Epub ahead of print]
Raeissadat SA, Rayegani SM, Hassanabadi H, Fathi M, Ghorbani E, Babaee M, Azma K. Knee Osteoarthritis Injection Choices: Platelet- Rich Plasma (PRP) Versus Hyaluronic Acid (A one-year randomized clinical trial). Clin Med Insights Arthritis Musculoskelet Disord. 2015 Jan 7;8:1-8. doi: 10.4137/CMAMD.S17894. eCollection 2015.
Dallari D, Stagni C, Rani N, Sabbioni G, Pelotti P, Torricelli P, Tschon M, Giavaresi G. Ultrasound-Guided Injection of Platelet-Rich Plasma and Hyaluronic Acid, Separately and in Combination, for Hip Osteoarthritis: A Randomized Controlled Study. Am J Sports Med. 2016 Jan 21. pii: 0363546515620383. [Epub ahead of print]
Forogh B, Mianehsaz E, Shoaee S, Ahadi T, Raissi GR, Sajadi S. Effect of single injection of Platelet-Rich Plasma in comparison with corticosteroid on knee osteoarthritis: a double-blind randomized clinical trial. J Sports Med Phys Fitness. 2015 Jul 14. [Epub ahead of print]
de Almeida AM, Demange MK, Sobrado MF, Rodrigues MB, Pedrinelli A, Hernandez AJ. Patellar tendon healing with platelet-rich plasma: a prospective randomized controlled trial. Am J Sports Med. 2012 Jun;40(6):1282-8. doi: 10.1177/0363546512441344. Epub 2012 Apr 2.
Angoorani H, Mazaherinezhad A, Marjomaki O, Younespour S. Treatment of knee osteoarthritis with platelet-rich plasma in comparison with transcutaneous electrical nerve stimulation plus exercise: a randomized clinical trial. Med J Islam Repub Iran. 2015 Jun 27;29:223. eCollection 2015.
Dragoo JL, Wasterlain AS, Braun HJ, Nead KT. Platelet-Rich Plasma as a Treatment for Patellar Tendinopathy: A Double-Blind, Randomized Controlled Trial. Am J Sports Med. 2014 Jan 30. [Epub ahead of print]
Scarpone M, Rabago D, Snell E, Demeo P, Ruppert K, Pritchard P, Arbogast G, Wilson JJ, Balzano JF. Effectiveness of Platelet-rich Plasma Injection for Rotator Cuff Tendinopathy: A Prospective Open-label Study. Glob Adv Health Med. 2013 Mar;2(2):26-31. doi: 10.7453/gahmj.2012.054.
Gosens T, Peerbooms JC, van Laar W, den Oudsten BL. Ongoing positive effect of platelet-rich plasma versus corticosteroid injection in lateral epicondylitis: a double-blind randomized controlled trial with 2-year follow-up. Am J Sports Med. 2011 Jun; 39(6):1200-8.
Peerbooms JC, Sluimer J, Bruijn DJ, Gosens T. Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up. Am J Sports Med. 2010 Feb;38(2):255-62. doi: 10.1177/0363546509355445.
Mishra AK, Skrepnik NV, Edwards SG, Jones GL, Sampson S, Vermillion DA, Ramsey ML, Karli DC, Rettig AC. Efficacy of Platelet-Rich Plasma for Chronic Tennis Elbow: A Double-Blind, Prospective, Multicenter, Randomized Controlled Trial of 230 Patients. Am J Sports Med. 2013 Dec 12. [Epub ahead of print]
Thanasas C, Papadimitriou G, Charalambidis C, Paraskevopoulos I, Papanikolaou A. Platelet-rich plasma versus autologous whole blood for the treatment of chronic lateral elbow epicondylitis: a randomized controlled clinical trial. Am J Sports Med. 2011 Oct;39(10):2130-4. doi: 10.1177/0363546511417113. Epub 2011 Aug 2.
A Hamid MS, Mohamed Ali MR, Yusof A, George J, Lee LP. Platelet-Rich Plasma Injections for the Treatment of Hamstring Injuries: A Randomized Controlled Trial. Am J Sports Med. 2014 Jul 29. pii: 0363546514541540. [Epub ahead of print]
Meheux CJ, McCulloch PC, Lintner DM, Varner KE, Harris JD. Efficacy of Intra-articular Platelet-Rich Plasma Injections in Knee Osteoarthritis: A Systematic Review. Arthroscopy. 2015 Sep 29. pii: S0749-8063(15)00659-3. doi: 10.1016/j.arthro.2015.08.005. [Epub ahead of print]
Laudy AB, Bakker EW, Rekers M, Moen MH. Efficacy of platelet-rich plasma injections in osteoarthritis of the knee: a systematic review and meta-analysis. Br J Sports Med. 2015 May;49(10):657-72. doi: 10.1136/bjsports-2014-094036. Epub 2014 Nov 21.
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. PubMed PMID: 26834369; PubMed Central PMCID: PMC4713808.
Campbell KA, Saltzman BM, Mascarenhas R, Khair MM, Verma NN, Bach BR Jr, Cole BJ. Does Intra-articular Platelet-Rich Plasma Injection Provide Clinically Superior Outcomes Compared With Other Therapies in the Treatment of Knee Osteoarthritis? A Systematic Review of Overlapping Meta-analyses. Arthroscopy. 2015 May 29. pii: S0749-8063(15)00353-9. doi: 10.1016/j.arthro.2015.03.041. [Epub ahead of print]
Lubowitz JH. Editorial Commentary: Platelet-Rich Plasma Improves Knee Pain and Function in Patients With Knee Osteoarthritis. Arthroscopy. 2015 Nov;31(11):2222-3. doi: 10.1016/j.arthro.2015.08.022.
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. Am J Phys Med Rehabil. 2018 Apr;97(4):248-254. doi: 10.1097/PHM.0000000000000874.
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.
Wetzel RJ, Patel RM, Terry MA. Platelet-rich plasma as an effective treatment for proximal hamstring injuries. Orthopedics. 2013 Jan;36(1):e64-70. doi: 10.3928/01477447-20121217-20.
Fader RR, Mitchell JJ, Traub S, Nichols R, Roper M, Dan OM, McCarty EC. Platelet-rich plasma treatment improves outcomes for chronic proximal hamstring injuries in an athletic population. Muscles Ligaments Tendons J. 2015 Feb 5;4(4):461-6.
Mautner K, Colberg RE, Malanga G, Borg-Stein JP, Harmon KG, Dharamsi AS, Chu S, Homer P. Outcomes after ultrasound-guided platelet-rich plasma injections for chronic tendinopathy: a multicenter, retrospective review. PM R. 2013 Mar;5(3):169-75. doi: 10.1016/j.pmrj.2012.12.010. Epub 2013 Feb 9.
Chang KV, Hung CY, Aliwarga F, Wang TG, Han DS, Chen WS. Comparative effectiveness of platelet-rich plasma injections for treating knee joint cartilage degenerative pathology: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2014 Mar;95(3):562-75. doi: 10.1016/j.apmr.2013.11.006. Epub 2013 Nov 27.
Halpern B, Chaudhury S, Rodeo SA, Hayter C, Bogner E, Potter HG, Nguyen J. Clinical and MRI outcomes after platelet-rich plasma treatment for knee osteoarthritis. Clin J Sport Med. 2013 May;23(3):238-9. doi: 10.1097/JSM.0b013e31827c3846.
Kon E, Buda R, Filardo G, Di Martino A,Timoncini A, Canacchi A, Fornasari PM, Giannini S, Marcacci M. Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 2010; 18 (4):472-479.
Filardo G, Kon E, Buda R, Timoncini A, Di Martino A, Cenacchi A, Fornasari PM, Giannini S, Marcacci M. Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2011 Apr;19(4):528-35. doi: 10.1007/s00167-010-1238-6. Epub 2010 Aug 26.
Wang-Saegusa A, Cugat R, Ares O, Seijas R, Cuscó X, Garcia-Balletbó M. 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. doi: 10.1007/s00402-010-1167-3. Epub 2010 Aug 17.
Khawaja K, Maher IK, Jatop ZA, Zaur A, Tago IA, Peracha MA, Keerio NH. Efficiency of Intra-Articular Platelet-Rich Plasma Injection in Grade I and Grade II Osteoarthritis in the Knee Joints: A Longitudinal Study. Pakistan Journal of Medical and Health Sciences, Vol.16,No.02,FEB 2022 1019.
Rahimzadeh P, Imani F, Faiz SHR, Ezary SRE, Zamanabadi MNN, Alebouyeh MR. The effects of injecting intra-articular platelet-rich plasma or prolotherapy on pain score and function in knee osteoarthritis. Clinical Interventions in Aging 2018:13 73–79.
Mohammed F, Aggarwal V, Kushwaha SS, Verma A, Khan YA. Role of platelet rich plasma in patients of osteoarthritis knee-a prospective study. Original Research Article. Indian Journal of Orthopaedics Surgery 2017;3(2):171-175.
Raeissadat, SA, Rayegani SM, Babaee M, Ghorbani E. The Effect of Platelet-Rich Plasma on Pain, Function, and Quality of Life of Patients with Knee Osteoarthritis. Pain Research and Treatment, Volume 2013.
Huda N, ul Islam MS, Bishnoi S, Kumar H, Aggarwal S, Ganai AA. Role of Triple Injection Platelet‑Rich Plasma for Osteoarthritis Knees: A 2 Years Follow‑Up Study. Indian Journal of Orthopaedics (2022) 56:249–255.
Thomas J, Jayaditya DP, Al Dallal W, Athanasiou A. Evaluating the Effectiveness of Intra-articular Platelet Rich Plasma Injections for the Treatment of Knee Osteoarthritis: A Systematic Review. SVOA Orthopaedics, April 03, 2023.
Kadam R, Agrawal A, Chhallani A, Pandhre S, Gupta A, Sawant R. To assess the effects of platelet rich plasma application on pain in osteoarthritis knee. Int J Res Orthop. 2017, May;3(3):436-439.
Babu PA, Sekhar AC, Sujin S. Improving Function in Knee Osteoarthritis with Platelet-rich Plasma Therapy: A Functional Outcome Evaluation. International Journal of Pharmacy and Pharmaceutical Sciences, Vol 15, Issue 6, 2023.
Roy S, Bandyopadhyay BK, Bhattacharya D, Biswas P. Evaluation of Intra-Articular Administration of Platelet-Rich Plasma in the Treatment of Knee-Joint Osteoarthritis. J. Evolution Med. Dent. Sci, Vol. 8/ Issue 45/ Nov. 11, 2019 Page 3387.
Nazibullah M, Islam T, Talukder TK, Shaharul Islam AKM. The Role of Platelet-rich Plasma in Osteoarthritis of Knee-joint. © 2020 Scholars Journal of Applied Medical Sciences, 05.08.2020.
Talay Calis H, Tomruk Sutbeyaz T, Guler E, Halici C, Sayan H, Koc A, Konk M, Yazicioglu A. Efficacy of Intra-Articular Autologous Platelet Rich Plasma Application in Knee Osteoarthritis. Arch Rheumatol 2015;30(3):198-20.
Rayegani SM, Ahmad Raeissadat SA, Taheri MS, Babaee M, Bahrami MH, Eliaspour D, Ghorbani E. Does intra articular platelet rich plasma injection improve function, pain and quality of life in patients with osteoarthritis of the knee? A randomized clinical trial. Orthopedic Reviews 2014; volume 6:5405.
Smith J, Sellon JL. Comparing PRP injections with ESWT for athletes with chronic patellar tendinopathy. Clin J Sport Med. 2014 Jan;24(1).
Sánchez M, Anitua E, Azofra J, Aguirre JJ, Andia I. Intra-articular injection of an autologous preparation rich in growth factors for the treatment of knee OA: a retrospective cohort study. Clin Exp Rheumatol. 2008 Sep-Oct;26(5):910-3.
Spaková T, Rosocha J, Lacko M, Harvanová D, Gharaibeh A. Treatment of knee joint osteoarthritis with autologous platelet-rich plasma in comparison with hyaluronic acid. Am J Phys Med Rehabil. 2012 May;91(5):411-7. doi: 10.1097/PHM.0b013e3182aab72.
Sakata R, McNary SM, Miyatake K, Lee CA, Van den Bogaerde JM, Marder RA, Reddi AH. Stimulation of the Superficial Zone Protein and Lubrication in the Articular Cartilage by Human Platelet-Rich Plasma. Am J Sports Med. 2015 Mar 26. pii: 0363546515575023. [Epub ahead of print]
Sakata R, Reddi AH. Platelet-Rich Plasma Modulates Actions on Articular Cartilage Lubrication and Regeneration. Tissue Eng Part B Rev. 2016 Apr 25. [Epub ahead of print]
Cerza F, Carni S, Carcangiu A, Di Vavo I, Schiavilla V, Pecora A, De Biasi G, Ciuffreda M. Comparison Between Hyaluronic Acid and Platelet-Rich Plasma, Intra-articular Infiltration in the Treatment of Gonarthrosis. The American Journal of Sports Medicine, Vol. XX, No. X DOI: 10.1177/0363546512461902, 2012
Gobbi A, Lad D, Karnatzikos G. The effects of repeated intra-articular PRP injections on clinical outcomes of early osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc. 2014 Apr 20. [Epub ahead of print]
Kwon DR, Park GY, Lee SU. The effects of intra-articular platelet-rich plasma injection according to the severity of collagenase-induced knee osteoarthritis in a rabbit model. Ann Rehabil Med. 2012 Aug;36(4):458-65. doi: 10.5535/arm.2012.36.4.458. Epub 2012 Aug 27.
Gosens T, Den Oudsten BL, Fievez E, van ‘t Spijker P, Fievez A. Pain and activity levels before and after platelet-rich plasma injection treatment of patellar tendinopathy: a prospective cohort study and the influence of previous treatments. Int Orthop. 2012 Sep;36(9):1941-6. doi: 10.1007/s00264-012-1540-7. Epub 2012 Apr 27.
Hsu WK, Mishra A, Rodeo SR, Fu F, Terry MA, Randelli P, Canale ST, Kelly FB. Platelet-rich plasma in orthopaedic applications: evidence-based recommendations for treatment. J Am Acad Orthop Surg. 2013 Dec;21(12):739-48. doi: 10.5435/JAAOS-21-12-739.
Sampson S, Reed M, Silvers H, Meng M, Mandelbaum B. 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. doi:10.1097/PHM.0b013e3181fc7edf.
Volpi P, Marinoni L, Bait C, De Girolamo L, Schoenhuber H.Treatment of chronic patellar tendinosis with buffered platelet rich plasma: a preliminary study. Med Sport. 2007;60(4):595-603.
C, Zaoui A, Bellaiche L, Bouyer B. Are Multiple Platelet-Rich Plasma Injections Useful for Treatment of Chronic Patellar Tendinopathy in Athletes?: A Prospective Study. Am J Sports Med. 2014 Feb 11. [Epub ahead of print]
Andriolo L, Altamura SA, Reale D, Candrian C, Zaffagnini S, Filardo G. Nonsurgical Treatments of Patellar Tendinopathy: Multiple Injections of Platelet-Rich Plasma Are a Suitable Option: A Systematic Review and Meta-analysis. Am J Sports Med. 2018 Mar 1:363546518759674. doi: 10.1177/0363546518759674. [Epub ahead of print]
Charousset C, Zaoui A, Bellaiche L, Bouyer B. Are multiple platelet-rich plasma injections useful for treatment of chronic patellar tendinopathy in athletes? a prospective study. Am J Sports Med. 2014 Apr;42(4):906-11. doi: 10.1177/0363546513519964. Epub 2014 Feb 11.
Li M, Zhang C, Ai Z, Yuan T, Feng Y, Jia W. Therapeutic effectiveness of intra-knee-articular injection of platelet-rich plasma on knee articular cartilage degeneration. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2011 Oct;25(10):1192-6.
Kanchanatawan W et al. Short-term outcomes of platelet-rich plasma injection for treatment of osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc. 2015 Sep 19. [Epub ahead of print]
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Finnoff JT, Fowler SP, Lai JK, Santrach PJ, Willis EA, Sayeed YA, Smith J. Treatment of chronic tendinopathy with ultrasound-guided needle tenotomy and platelet-rich plasma injection. PM R. 2011 Oct;3(10):900-11. doi: 10.1016/j.pmrj.2011.05.015. Epub 2011 Aug 26.
Sanli I, Morgan B, van Tilborg F, Funk L, Gosens T. Single injection of platelet-rich plasma (PRP) for the treatment of refractory distal biceps tendonitis: long-term results of a prospective multicenter cohort study. Knee Surg Sports Traumatol Arthrosc. 2014 Dec 11. [Epub ahead of print]
Monto RR. Platelet-rich plasma efficacy versus corticosteroid injection treatment for chronic severe plantar fasciitis. Foot Ankle Int. 2014 Apr;35(4):313-8. doi: 10.1177/1071100713519778. Epub 2014 Jan 13.
Ragab EM, Othman AM. Platelets rich plasma for treatment of chronic plantar fasciitis. Arch Orthop Trauma Surg. 2012 Aug;132(8):1065-70. doi: 10.1007/s00402-012-1505-8. Epub 2012 May 4.
Kumar V, Millar T, Murphy PN, Clough T. The treatment of intractable plantar fasciitis with platelet-rich plasma injection. Foot (Edinb). 2013 Jun-Sep;23(2-3):74-7. doi: 10.1016/j.foot.2013.06.002. Epub 2013 Jul 30.
Martinelli N, Marinozzi A, Carnì S, Trovato U, Bianchi A, Denaro V. Platelet-rich plasma injections for chronic plantar fasciitis. Int Orthop. 2013 May;37(5):839-42. doi: 10.1007/s00264-012-1741-0. Epub 2012 Dec 19.
Kim E, Lee JH. Autologous platelet-rich plasma versus dextrose prolotherapy for the treatment of chronic recalcitrant plantar fasciitis. PM R. 2014 Feb;6(2):152-8. doi: 10.1016/j.pmrj.2013.07.003. Epub 2013 Jul 19.
Peerbooms JC, Lodder P, den Oudsten BL, Doorgeest K, Schuller HM, Gosens T. Positive Effect of Platelet-Rich Plasma on Pain in Plantar Fasciitis: A Double-Blind Multicenter Randomized Controlled Trial. Am J Sports Med. 2019 Oct 11:363546519877181. doi: 10.1177/0363546519877181. [Epub ahead of print]
Singh P, Madanipour S, Bhamra JS, Gill I. A systematic review and meta-analysis of platelet-rich plasma versus corticosteroid injections for plantar fasciopathy. Int Orthop. 2017 Jun;41(6):1169-1181. doi: 10.1007/s00264-017-3470-x. Epub 2017 Apr 10.
Akşahin E, Doğruyol D, Yüksel HY, Hapa O, Doğan O, Celebi L, Biçimoğlu A. The comparison of the effect of corticosteroids and platelet-rich plasma (PRP) for the treatment of plantar fasciitis. Arch Orthop Trauma Surg. 2012 Jun;132(6):781-5. doi: 10.1007/s00402-012-1488-5. Epub 2012 Mar 8.
Shetty SH, Dhond A, Arora M, Deore S. Platelet-Rich Plasma Has Better Long-Term Results Than Corticosteroids or Placebo for Chronic Plantar Fasciitis: Randomized Control Trial. J Foot Ankle Surg. 2019 Jan;58(1):42-46. doi: 10.1053/j.jfas.2018.07.006. Epub 2018 Nov 15.
Shetty VD, Dhillon M, Hegde C, Jagtap P, Shetty S. A study to compare the efficacy of corticosteroid therapy with platelet-rich plasma therapy in recalcitrant plantar fasciitis: A preliminary report. Foot Ankle Surg. 2014 Mar;20(1):10-3. doi: 10.1016/j.fas.2013.08.002. Epub 2013 Aug 16.
Wilson JJ, Lee KS, Miller AT, Wang S. Platelet-rich plasma for the treatment of chronic plantar fasciopathy in adults: a case series. Foot Ankle Spec. 2014 Feb;7(1):61-7. doi: 10.1177/1938640013509671. Epub 2013 Nov 27.
Sánchez M, Guadilla J, Fiz N, Andia I. Ultrasound-guided platelet-rich plasma injections for the treatment of osteoarthritis of the hip. Rheumatology (Oxford). 2012 Jan;51(1):144-50. doi: 10.1093/rheumatology/ker303. Epub 2011 Nov 10.
Battaglia M, Guaraldi F, Vannini F, Buscio T, Buda R, Galletti S, Giannini S. Platelet-rich plasma (PRP) intra-articular ultrasound-guided injections as a possible treatment for hip osteoarthritis: a pilot study. Clin Exp Rheumatol. 2011 Jul-Aug;29(4):754. Epub 2011 Sep 1.
Tietze DC, Geissler K, Borchers J. The effects of platelet-rich plasma in the treatment of large-joint osteoarthritis: a systematic review. Phys Sportsmed. 2014 May;42(2):27-37. doi: 10.3810/psm.2014.05.2055.
Mishra A, Pavelko T.Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. American Journal of Sports Medicine Dec 2006 Volume 34: 1774-1778
Monto RR. Platelet-rich plasma more effective for treatment of chronic hip bursitis than cortisone. Paper #778. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 11-15, 2014; New Orleans.
Fitzpatrick J, Bulsara MK, O’Donnell J, Zheng MH. Leucocyte-Rich Platelet-Rich Plasma Treatment of Gluteus Medius and Minimus Tendinopathy: A Double-Blind Randomized Controlled Trial With 2-Year Follow-up. Am J Sports Med. 2019 Apr;47(5):1130-1137. doi: 10.1177/0363546519826969. Epub 2019 Mar 6.
Fitzpatrick J, Bulsara MK, O’Donnell J, McCrory PR, Zheng MH. The Effectiveness of Platelet-Rich Plasma Injections in Gluteal Tendinopathy: A Randomized, Double-Blind Controlled Trial Comparing a Single Platelet-Rich Plasma Injection With a Single Corticosteroid Injection. Am J Sports Med. 2018 Mar;46(4):933-939. doi: 10.1177/0363546517745525. Epub 2018 Jan 2.
Alsousou J, Handley R, Thompson M, et al. Platelet-rich plasma in accelerated Achilles tendon healing (PATHT): A randomized controlled trial – pilot phase. Presented at the British Orthopaedic Association Congress 2012. Sept. 11-14. Manchester.
Vavken P, Murray MM. The potential for primary repair of the ACL. Sports Med Arthrosc. 2011 Mar;19(1):44-9. doi: 10.1097/JSA.0b013e3182095e5d.
Zhang J,Wang JH. Platelet-Rich Plasma Releasate Promotes Differentiation of Tendon Stem Cells Into Active Tenocytes. Am J Sports Med. 2010 Aug 27.
Osterman C, McCarthy MB, Cote MP, Beitzel K, Bradley J, Polkowski G, Mazzocca AD. Platelet-Rich Plasma Increases Anti-inflammatory Markers in a Human Coculture Model for Osteoarthritis. Am J Sports Med. 2015 Feb 25. pii: 0363546515570463. [Epub ahead of print]
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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 Stem Cell Therapy and other forms of interventional pain management (duration: 14 minutes, 54 seconds).
Slideshow: Microscopic Photos: click here for a slideshow of mostly microscopic images that give you greater insight into how we repair joints by regrowing their damaged tissues.
Slideshow: PRP in the Press: click here for a slide show with press clippings mostly from the time period 2008 through 2010, when PRP was new news. Click on a slide to pause the slideshow and read any one slide fully.
Slideshow: PRP in Sports: click here for a slide show mostly from the time period 2008 through 2010, when PRP was big new news in the sports world. Now, PRP is a regular part of every major league team’s sports medicine tool chest. It is no longer new news in sports. Click on a slide to pause the slideshow and read any one slide fully.
Here is a 2023 article from the Santa Fe New Mexican newspaper.
Video: click here for a video about PRP use at The Hospital for Special Surgery on the Upper East Side of Manhattan, which has for decades been rated among the best orthopedic hospitals in the US. They are advocates for PRP.
Article: click here for a Mayo Clinic article about PRP. Publications of the Mayo Clinic have been supportive of PRP, and PRP is practiced and researched at Mayo Clinic.
Article: click here for an article by the American Academy of Orthopedic Surgeons, showing their relatively conservative but also supportive position on PRP. Many orthopedic surgeons around the United States utilize PRP as a stand-alone procedure as we do, and they may use PRP to augment various surgeries.
PRP Stem Cell Joint Repair is the form of interventional pain management that we are sub-specialized in. But, on rare occasion we may consider utilizing some other interventional pain management methods.
Here are photo credits for the various photos through this website.
We repair your ligaments, tendons, meniscus, etc. When we judge that the repair of those fundamental structural elements is complete or close enough, you get the green light to increase activity and start to strengthen surrounding muscles. There can be significant value to getting specialized guidance in that rehab process from physical therapists or other experts. Read more about our point of view of how to develop fitness around your newly repaired joint.
