Regenexx Platelet Rich Plasma (PRP) in Bellevue and …

PRP Therapy

Regenexx SCP platelet rich plasma (PRP) therapy is being offered by Dr. Attaman in Seattle and Bellevue. Feel free to call us at206-395-4422 (Seattle) or 425-247-3359 (Bellevue), or schedule an appointment online.

We are Washingtons only licensed Regenexx network clinic. Regenexx SCP is the most advanced form of PRP available in the world with the most research to support its use.

Regenexx SCP platelet rich plasma therapy is an injection of a concentrated mixture of the patients own blood. Platelet Rich Plasma injections have been shown to relieve acute and chronic pain and accelerate healing of injured tissues and joints. The injured tissues are oftenhealed by Regenexx SCP platelet rich plasma therapy, in contrast to steroid injections which generally suppress symptoms. Many patient turn to Regenexx SCP platelet rich plasma because it is a way to heal damaged tissue, and because more conventional treatments such as steroid injections and surgery have failed them in the past. However, some physicians and patients believe the best pathway is to treat damaged tissues with Platelet Rich Plasma therapy before steroid injections or surgery are attempted! That said, no treatment is ideal for all conditions, and a comprehensive clinical consultation is required to know whether Regenexx SCP platelet rich plasma is good for your particular issues. If Regenexx SCP platelet rich plasma is not for you, Dr. Attaman has many other treatment options that are likely to be appropriate.

Conditions aided by Regenexx SCP platelet rich plasma include chronic back pain, chronic knee pain, achilles tendonitis,plantar fasciitis, meniscus tears, osteoarthritis of the spine, sacroiliac joint hyper mobility, hip and knee injuries, ligament sprains, rotator cuff tears, lateral epicondylitis (tennis elbow), medial epicondylitis (golfers elbow), and tendon injuries (tendonopathy). Platelet Rich Plasma therapy can also be applied to many other locations in the body.

Regenexx Super Concentrated Platelets vs. Standard PRP

The limited blood supply and poor healing properties of ligaments, cartilage and tendons may make treatment necessary after injury. Unlike medications that dont treat the underlying cause of pain, Platelet Rich Plasma can accelerate the healing process eliminating the cause of pain.

The Platelet Rich Plasma process begins by taking a sample of the patients blood from their vein. Most physicians take a very small sample of 5-10 mL. Such a small sample is easier to obtain and process, but results in a poorly concentrated Platelet Rich Plasma solution. In contrast, Dr. Attaman takes a minimum 60 mL sample up to 240 mL; this allows Dr. Attaman to produces a VERY concentrated Platelet Rich Plasma injectate very dense in platelets and healing factors.The blood sample is then processed using the patentedRegenexx SCP platelet rich plasma protocol in our laboratory. Our laboratory is state of the art and more advanced than almost all others in the state.

We use this laboratory to separate the blood into its primary components platelets and white blood cells, plasma, and red blood cells. Our laboratory includes a clean hood, centrifuges, cell counters and microscopes. Using the patentedRegenexx SCP platelet rich plasma process, we concentrate the platelets to a very concentrated form for re-injection.

A portion of the plasma is removed. The patients concentrated platelets are mixed with the remaining plasma to form a concentrated solution. This platelet rich solution is then injected into and around the injured tissues. Most physicians perform these injections blindly, which means the injections are done without any sort of image guidance. Such physicians will often suggest 5 or more Platelet Rich Plasma injections are required. They require so many injections simply because they are missing the target most of the time.

In contrast, Dr. Attaman performs all Platelet Rich Plasma injections using ultrasound or X-ray image guidance. This allows for much enhanced safety, accuracy, and efficacy. Generally only 1-2 Platelet Rich Plasma injection treatments are needed. Dr. Attaman can directly visualize the damaged tissues under ultrasound, and ensure that 100% of the Platelet Rich Plasma is deposited into injured tissue only. This also allows Dr. Attaman to perform an advanced technique called needle tenotomy, which is when the needle is used to break up scar and calcium deposits in the injured tissue, and prepare the tissue for better healing.

The concentrated platelets release many growth factors that promote a natural immune response. Macrophages specialized white blood cells rush in to remove damaged cells and prepare the tissue for healing.

Stem cells and other cells multiply, repair and rebuild the damaged tissue. This accelerated healing response reduces pain, promotes increased strength, and improves joint function. Healing after Platelet Rich Plasma therapy occurs over a period of many weeks. Generally patients will not see significant changes in their chronic pain until the 6-12 week mark. Some people obtain relief faster than this but this is generally an exception.

The entire Platelet Rich Plasma treatment process takes about an hour the patient will be able to go home the same day. Full recovery from the injection usually occurs within three days of the procedure. Specialized physical therapy is often prescribed after Platelet Rich Plasma injection to accelerate the healing process. Many patients require one to two treatments before the injured tissues are completely healed and they return to a normal active lifestyle. The good news is that some studies indicate that the healing process continues for as long as a year after Platelet Rich Plasma injection therapy, and possibly beyond. This suggests that as time goes on after Platelet Rich Plasma injection therapy, the treated tissues continue to get healthier and stronger.

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Regenexx Platelet Rich Plasma (PRP) in Bellevue and ...

Autologous Blood Injection (ABI) & Platelet Rich Plasma …

Autologous Blood Injection (ABI) and Platelet Rich Plasma (PRP) injections involve injecting a patients blood into a damaged part of the body.

Melbourne Radiology Clinic - Autologous Blood Injection (ABI) Patient & Post Procedure Information Sheet

Melbourne Radiology Clinic - Platelet Rich Plasma (PRP) Injection Patient & Post Procedure Information Sheet

Most commonly at Melbourne Radiology Clinic, this is done into a tendon for the treatment of tendinosis (the medical term for tendinitis), though other applications also include injecting ligaments, muscles and joints. Any tendon in the body may be injected with a patients blood products, with the most frequent clinical uses of ABI or PRP injections used for the plantar fascia (heel), Achilles (ankle), patellar (knee), gluteal (hip), hamstring (buttock), common extensor origin (tennis elbow or lateral epicondylitis) and common flexor origin (golfers elbow or medial epicondylitis). Approximately 80% of patients obtain complete or significant pain relief following this procedure.

PRP therapy has also recently found use in treating osteoarthritis. By injecting PRP into joints, it is felt that the healing factors may stimulate cartilage and surrounding soft tissue regeneration, as well as dampen the main symptoms associated with arthritis, that being pain and stiffness. Even if joint surgery, such as joint replacement, is delayed for a year or two, then this is considered a win.

Blood contains many nutrients and substances which are thought to promote healing. Platelets are tiny cells in blood which stick to each other when we cut ourselves to result in the formation of a clot to stop any further bleeding. Platelets contain many powerful growth factors, in particular PDGF (Platelet Derived Growth Factor) which has been shown to promote healing of many types of tissues, including bone, teeth, skin and the tissue lining our eyes. PDGF also promotes healing of tendons which are damaged due to excessive use and/or the ageing process.

Patients who suffer from tendinosis usually require a correct diagnosis prior to any procedure. This usually involves an ultrasound and/or an MRI (Magnetic Resonance Imaging) scan. Following diagnosis and if not already done so, the initial line of treatment is to undergo a period of rehabilitation for 6 weeks supervised by a suitable health care provider. This might be your rehabilitation physician, physiotherapist, podiatrist, chiropractor or osteopath to name a few. If pain persists, then the patient is a candidate for an ABI or PRP injection.

The procedure of ABI takes approximately 5 minutes and involves the use of an ultrasound machine to guide the needle into the correct location and safely.

First the skin is cleansed and prepared. Local anaesthetic is then injected into the skin overlying the tendon. Blood withdrawn from one of the arm veins is then injected directly into the tendon. The amount of blood injected depends on the size of the tendon. The procedure is at this point over and the needle injection site is then dressed with a small bandage.

A PRP injection is similar to an ABI, with the only difference being that a larger amount of blood is withdrawn from an arm vein. The blood is then placed into a tube, which in turn is placed into a machine called a centrifuge, which spins many thousand times a minute. The blood is left to spin for 15 minutes. At this point, the cells in the blood have separated from the fluid component of blood (plasma) into the three main cell types: red blood cells, white blood cells and platelets. The platelets are then selectively removed and used for injection. In this way, the theoretical benefit is that a greater concentration of platelets is delivered into the damaged body part than if whole blood was given alone (approximately 8-10 times greater concentration). There is, however, no scientific research documenting this benefit at the time of writing.

Following the procedure you will be provided with clear, written instructions on when to re-commence your rehabilitation. [See the PDF information sheets above]. If your pain persists after 4 weeks following injection, then a repeat injection is strongly recommended. If your pain remains unchanged following a second injection then no further ABI/PRP injection will be offered and you may instead be offered an alternative injection that is available, or otherwise you may wish to pursue surgery. A third injection is rarely offered.

As with all medical procedures, there are risks. The staff at Melbourne Radiology Clinic have performed this procedure hundreds of time with the only complication being a single minor skin infection which was successfully treated with antibiotics. An infection of the deep soft tissues is also a risk. No recorded tendon ruptures have been documented in the scientific literature, nor has this been our experience to date. Patients consistently report a flare up of their pain in the first week following the procedure, however in most cases, this is controlled with some paracetamol and/or an anti-inflammatory medication. Codeine is rarely required.

A radiologist, a medical doctor specialised in interpreting medical images for the purposes of providing a diagnosis, will then provide a formal written report to your referring doctor or health care professional detailing the procedure and providing some recommendation for your after-care. If medically urgent, or you have an appointment immediately after the scan to be seen by your doctor or health care provider, Melbourne Radiology Clinic will instantly have this report ready. Otherwise, the report will be received by your doctor or health care provider within the next 24 hours.

Whilst every effort is made to keep your appointment time, the special needs of complex cases, elderly and frail patients can cause unexpected delays. Your consideration and patience in these circumstances is appreciated.

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Autologous Blood Injection (ABI) & Platelet Rich Plasma ...

Platelet Rich Plasma Injections, PRP Injections …

Platelet Rich Plasmainjections are used to helpa variety of common conditions including: tennis elbow, achilles tendinitis and knee osteoarthritis. Find Relief with Platelet Rich Plasma Injections:

Sometimes, rest, ice, rehabilitation and other treatments fail to provide relief. If you aredealing with chronic joint pain, tendinitis and osteoarthritis, you may want to consider this new treatment option now available. Louisville sports medicine physician Dr. Stacie Grossfeld is offering Platelet Rich Plasmainjectionsat her office to give patients anew, innovativeform of pain relief.

PRP Injections: $380 Charge Cash Only This treatment option covers a blood draw and PRP related processes. After collecting 10 cc from the arm, it will be spun in a centrifuge and then the platelet rich plasma is injected into the affected joint or area. In total, this fee includes the blood draw, materials used to create the PRP substance, and the actual PRP injection.

For more information about this treatment option, or to make an appointment, callOrthopaedic Specialists at a (502)212-2663. Follow along for more information about platelet rich plasma injections.

PRP or Platelet Rich Plasma is plasma with more platelets.Plasma is the liquid part of our blood that transports our platelets, and red and white blood cells. Platelets generally comprise about 10% of our blood. In order to prepare the injection, the physician must draw blood from the patient. Then the platelets are separated from the red and white blood cells to increase their concentration through centrifugation. This is then combined with the remaining blood to be used as an injection.

Typically, PRP is injected directly into theinjuredarea.Forexample, for tendinitis in the knee, the physician will inject a local anesthetic and the PRP directly into the inflamed tissue. Depending on the level of discomfort, most patients do not require more than two injections to find relief. After the injection, the patient may have residual pain for a day, and up to a week. The swelling and stiffness will decrease and the outcome is positive.

PRP injections have been known to treat chronic tendon injuries, acute ligament and muscle injuries, knee arthritis, fractures and even offer relief post-operatively. Some of the best athletes have used PRP injections to treat their injuries. This includes Alex Rodriguez, Brian Urlacher, Kobe Bryant and Tiger Woods. These injections have helped many athletesreturn to the court, green and fields faster than other forms of treatment.

In the June 2013 issue of American Journal of Sports Medicine, researchers reported some interesting results using PRP injections to heal competitive athletes. According to the study, 30 out of 34 throwing athletes with MRI documented partial ulnar collateral ligament tears got better and were able return to play after receiving platelet rich plasmainjections. (The ulnar collateral ligament is situated on the inner side of the elbow). All the throwing athletes had failed a comprehensive course of conservative treatment prior to receiving PRP injections. Based on these orthopedic research findings, this would be another area in orthopedic medicine where PRP can be useful.

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Platelet Rich Plasma Injections, PRP Injections ...

What Are Platelet Rich Plasma (PRP) Injections?

Platelet rich plasma (abbreviated PRP) is a treatment used for a variety of common orthopedic conditions. PRP is a concentration of platelet cells taken from your blood, and these platelets have growth factors that may help in the healing process of chronic injuries. Growth factors are chemicals that signal the body to initiate a healing response. By injecting PRP into areas of an injury, the hope is to stimulate and optimize your body's ability to heal the chronic conditions. PRP contains a high concentration of platelets, other blood cells important in healing, and growth factors.

PRP has been used in operating rooms for several decades to help with wound healing, and to stimulate bone formation in spinal fusion surgery. Recently, PRP has been used in outpatient settings for treatment of common overuse conditions including:

PRP injections can be done in a physician's office. The procedure takes about 30 minutes in order to withdraw the blood, spin the blood in the centrifuge, and inject the PRP into the injured area.

Finding a physician who provides PRP injections can be a challenge, but most commonly these are offered by orthopedic physicians who specialize in the care of chronic sports injuries.

PRP is obtained from the patient who is being treated. Blood is withdrawn from a vein in the patient's arm and the blood is placed in a centrifuge, a machine that spins at a high speed to separate the different types of blood cells. The physician extracts the platelet-rich portion of the blood, and injects this into the area of injury. There is not just platelets in the concentrated layer of the "spun" blood, but also other important growth factors, plasma, and some red blood cells.

PRP injections are given as soon as the blood has been spun and the platelets separated. Some physicians may choose to add an "activating agent," usually either thrombin or calcium chloride, while some inject just the platelets. Studies have shown that the tendons being injected can also activate the PRP, so the activating agent may not be necessary.

There is no clear science to justify a particular quantity of PRP and number of injections needed. Most physicians perform one injection, although sometimes PRP injections are given as a series of injections over a span of several weeks.

We know from laboratory studies that PRP can help increase certain growth factors that are important in the healing process. What we do not know is if this makes any difference in healing when PRP is injected into an injured part of the body.

Clinical studies that have been done so far do not clearly demonstrate if PRP is more effective than other treatments. While there are reports of cases of success, it is not known if these successes are better, or worse, than other standard treatments. Currently, investigations are underway to determine if PRP is more helpful than other treatments for chronic tendonitis.

PRP has been shown to have some beneficial effects for tennis elbow, Achilles injuries, and even knee arthritis. Unfortunately, these are relatively small studies that follow the patients for a relatively short duration. Because of this, most doctors, and definitely most insurance companies, consider PRP to be experimental. However, talk to any patient who has found success with PRP, and they will tell you about how successful this treatment can be! It is important to remember, the even though there are some success stories and small studies that show benefit, we really don't know if PRP is worth the expense of this treatment.

Side effectsare uncommon, but they are possible. Whenever a needle is inserted through the skin, infection can occur. The other more common side effect of PRP injections is an increase in inflammation and pain after the injection.

PRP injections are not recommended in individuals with bleeding disorders, those taking anti-coagulation medications (e.g.Coumadin), or those who have cancer, active infections, or are pregnant.

PRP injections are not covered by most insurance plans, so there is usually a fee for providing this service. If your insurance does not cover these injections, you can try to appeal to the insurance provider, but because there is little scientific evidence to support PRP use, the likelihood of coverage may be low.

Most physicians charge between $500 and $1,000 per injection, although I have also heard of fees up to $2,500. Fees for PRP injections vary widely, and you may be able to work out a payment with your physician. While there are many different costs to obtain PRP, most physician offices use disposable kits offered by some of the major orthopedic supply companies. These kits cost a few hundred dollars, so there is certainly flexibility in payment, and you should negotiate the best possible rate if you are paying out of pocket.

PRP injections have been a subject ofsignificant interest for orthopedic surgeons and for their patients. Trying to stimulate a healing response within the body can be a challenge, and PRP injections may be an effective way to achieve that goal. While there is some data to support the use of PRP injections in certain clinical situations, there is other datathat questions whether this is more beneficial than traditional treatment. There is little harm in PRP injections, and they are certainly a reasonable option, but the cost of these injections is often not covered by insurance plans. I think it is reasonable to consider a PRP injection, however it certainly should not be viewed as a mandatory treatment, and this should only be consideredwhenother simpler,and more proven treatments are attempted first.

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What Are Platelet Rich Plasma (PRP) Injections?

Platelet-Rich Plasma (PRP) – OrthoInfo – AAOS

Platelet-Rich Plasma (PRP)

During the past several years, much has been written about a preparation called platelet-rich plasma (PRP) and its potential effectiveness in the treatment of injuries.

Many famous athletes Tiger Woods, tennis star Rafael Nadal, and several others have received PRP for various problems, such as sprained knees and chronic tendon injuries. These types of conditions have typically been treated with medications, physical therapy, or even surgery. Some athletes have credited PRP with their being able to return more quickly to competition.

Even though PRP has received extensive publicity, there are still lingering questions about it, such as:

Although blood is mainly a liquid (called plasma), it also contains small solid components (red cells, white cells, and platelets.) The platelets are best known for their importance in clotting blood. However, platelets also contain hundreds of proteins called growth factors which are very important in the healing of injuries.

PRP is plasma with many more platelets than what is typically found in blood. The concentration of platelets and, thereby, the concentration of growth factors can be 5 to 10 times greater (or richer) than usual.

To develop a PRP preparation, blood must first be drawn from a patient. The platelets are separated from other blood cells and their concentration is increased during a process called centrifugation. Then the increased concentration of platelets is combined with the remaining blood.

Although it is not exactly clear how PRP works, laboratory studies have shown that the increased concentration of growth factors in PRP can potentially speed up the healing process.

To speed healing, the injury site is treated with the PRP preparation. This can be done in one of two ways:

Research studies are currently being conducted to evaluate the effectiveness of PRP treatment. At this time, the results of these studies are inconclusive because the effectiveness of PRP therapy can vary. Factors that can influence the effectiveness of PRP treatment include:

According to the research studies currently reported, PRP is most effective in the treatment of chronic tendon injuries, especially tennis elbow, a very common injury of the tendons on the outside of the elbow.

The use of PRP for other chronic tendon injuries such as chronic Achilles tendonitis or inflammation of the patellar tendon at the knee (jumper's knee) is promising. However, it is difficult to say at this time that PRP therapy is any more effective than traditional treatment of these problems.

Much of the publicity PRP therapy has received has been about the treatment of acute sports injuries, such as ligament and muscle injuries. PRP has been used to treat professional athletes with common sports injuries like pulled hamstring muscles in the thigh and knee sprains. There is no definitive scientific evidence, however, that PRP therapy actually improves the healing process in these types of injuries.

More recently, PRP has been used during certain types of surgery to help tissues heal. It was first thought to be beneficial in shoulder surgery to repair torn rotator cuff tendons. However, the results so far show little or no benefit when PRP is used in these types of surgical procedures.

Surgery to repair torn knee ligaments, especially the anterior cruciate ligament (ACL) is another area where PRP has been applied. At this time, there appears to be little or no benefit from using PRP in this instance.

Some initial research is being done to evaluate the effectiveness of PRP in the treatment of the arthritic knee. It is still too soon to determine if this form of treatment will be any more effective than current treatment methods.

PRP has been used in a very limited way to speed the healing of broken bones. So far, it has shown no significant benefit.

Treatment with PRP could hold promise, however, current research studies to back up the claims in the media are lacking. Although PRP does appear to be effective in the treatment of chronic tendon injuries about the elbow, the medical community needs more scientific evidence before it can determine whether PRP therapy is truly effective in other conditions.

Even though the success of PRP therapy is still questionable, the risks associated with it are minimal: There may be increased pain at the injection site, but the incidence of other problems infection, tissue damage, nerve injuries appears to be no different from that associated with cortisone injections.

If you are considering treatment with PRP, be sure to check your eligibility with your health insurance carrier. Few insurance plans, including workers' compensation plans, provide even partial reimbursement.

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Platelet-Rich Plasma (PRP) - OrthoInfo - AAOS

Platelet Rich Plasma (PRP) Injection Therapy & Treatments

share Helping Patients Across the US, including Northern Virginia, Washington, DC, and Maryland

Platelet rich plasma, commonly referred to as PRP, is a non-operative, permanent solution for conditions such as arthritis and ligament/tendon sprains and tears. Utilizing the bodys natural healing process, PRP therapy is a concentration of platelets that are injected into the damaged ligaments, tendons, and joints to promote tissue repair and accelerate healing. Platelets are rich in growth and healing factors which means, on average, an injured individual can get back to a pain-free life in four to six weeks.

PRP was made popular by professional athletes and weekend warriors through its treatment of season-ending symptoms including swelling, stiffness, inflammation, tenderness, and pain.

Platelet rich plasma injections are most effective for the following conditions:

Additionally, PRP can be effective for many cases of osteoarthritis by stimulating healing of cartilage and reducing pain and disability. This includes:

PRP presents patients with a long lasting, permanent solution that will not wear off over time as with a traditional pain injection. For this reason, the use of PRP could help a patient avoid joint replacement surgery, and potentially back surgery. With any treatment option, the effectiveness of the treatment depends upon the severity of the injury.

Many traditional, non-operative treatment options concentrate on relieving pain, without fixing the underlying cause. Get to the root of your problem today -- schedule an initial consultation with a specialist at Virginia Spine Institute.

Creation of PRP is simple, painless, and conveniently done at an office visit. The entire process of drawing blood to solution preparation only takes approximately 25-30 minutes. A small amount of blood is drawn from the patient, just like a routine blood test. Once the blood is drawn it is then placed into a centrifuge. The centrifuge is a machine that spins the blood at high speeds in order to separate the blood into red blood cells and concentrated platelets. Once the blood is separated the red blood cells are discarded, and we are left with concentrated platelet rich plasma (PRP) which is ready to be used in the treatment process.

The injection process does not take more than an hour, which includes the creation of the PRP as explained above. The platelet-rich portion is collected and injected back into the injured tendon, ligament, muscle, joint, or disc that has been determined to be a source of pain and is not-healing appropriately. When structures around the spine are being injected, x-ray (i.e. fluoroscopy) guidance is used to assure safe and proper placement of PRP at the affected site. In the extremities, ultrasound-guidance is commonly used to inject PRP into the appropriate tendon, ligament or joint that is being targeted. Injections are performed under image guidance to assure precise placement of PRP. The number of injections varies based on each patients individualized condition but typically range anywhere from two to six injections done over time. Patients typically experience significant reduction in pain after the first or second injection.

Generally speaking PRP injections are not painful; however the discomfort level depends on the part of the body being treated.Injections into the joint are of minimal discomfort.There is sometimes a small amount of pain after the procedure; however this does not last more than a few days and can be minimized with over the counter Tylenol.It is critical to avoid anti-inflammatory medications such as Aleve, Motrin, Celebrex, Naprosyn, and Mobic. These drugs may impede the healing process.

The benefit to PRP therapy is that unlike other treatments it has a sustained outcome and is categorized as a permanent fix. The timeframe for experiencing results is dependent upon the area of injury and the extent of the injury. On average, most patients start to see signs of improvement in the form of reduced pain or increased function within four to six weeks. Continuing a well-designed course of physical therapy and avoidance of aggressive physical activity or overloading the injected tissues is advised in the weeks that follow the injections. This is done to allow the tissues to heal best.

Overall, PRP is an especially safe treatment option with no risk of allergic reaction because it is your own blood. However, anytime a needle is placed in the body, there is a risk of infection, bleeding, and nerve damage. These risks do not happen often, and are very rare. Other risks depend on the area being treated. If you are unsure of the risks of your specific condition, consult your physician. In general, PRP is not considered a first line treatment and is usually considered after other more traditional treatments have failed.

If you will benefit from Platelet Rich Plasma treatment? Give us a call at (703) 709-1114 or schedule your initial consultation online.

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Platelet Rich Plasma (PRP) Injection Therapy & Treatments

Top Six Reasons Why Platelet-Rich Plasma Injections Fail …

The other day we received an email from a person who had Platelet-Rich Plasma (PRP) Injection that failed to produce any results. Not impressed, did not work for me. Had it done for my back, she said. Comments like these are charged with emotions as almost all of these patients have paid for PRP injections out of their own pockets. Thats why the same patient also added later but did empty my wallet. For us, her comment was one of the kinder ones. Others, who were really mad at seeing their money wasted, called it a sham, quackery, and ways for doctors to make money. We understand this sentiment. And we cant argue with the fact that these treatments may have been failures.

But the thing is very few people, including some expert physicians understand why these PRP injections fail.

In the 1990s, there were about 150 new research articles on Platelet-Rich Plasma every year. At least in the Pubmed database. Back then, only a select group of physicians who really understood the treatment actually offered it to their patients. Now, just this year alone, there were more than 600 new articles. The trend line has gone from a gradual climb to a U curve or exploding popularity.

And so did the number of physicians offering this treatment.

Certainly, money wasnt the objective for those physicians for if it were, the best ways to do it wouldve been to prescribe a battery of tests, drugs and surgeries approved by insurance companies. Instead, the physicians started offering it once they knew well the inherent benefits of an interventional autologous medicine like Platelet-Rich Plasma.

The problem is, not all physicians were that passionate about it.

Some did it because patients asked for it. Some did it because everyone else was doing it. Still others just wanted to experiment with it casually.

And so not all Platelet-Rich Plasma injections worked. Thats why, as the treatment exploded in popularity, we saw a small portion of those treatments end up being a waste of the patients money and that gets talked about a lot because, as I mentioned above, the patient usually has huge emotional response to the outcome.

But on the other hand, majority of the patients are happy about their results.

Thats another response we got on the SAME DAY that this women told us it didnt work for her. Another physician also told us the very same day, PRP works great. We have had fantastic results on patients in the office.

So whats making the difference?

Why do some PRP treatments work spectacularly while some others turn out to be a dud?

Thats what well explain in the rest of this post here. There are six main reasons why it can fail. Plus a seventh no-so-common reason. Lets look at them one by one.

As much as the Platelet-Rich Plasma injection enthusiasts would like beat the drum of its universality of application, there are certain instances where a PRP injection may be unnecessary. The classic case is demonstrated in the 2015 Double-Blind Randomized, Placebo-controlled Study that showed that PRP injections are NOT beneficial at all.

According to expert researchers we subscribe to, it is clear that this study had selected the WRONG PATIENTS!!!

Heres what that means. This study, conducted by researchers at Cooper Medical School of Rowan University, New Jersey, was done in the emergency care department where patients whod just had a ankle sprain were given a Platelet-Rich Plasma Injection.

First of all, ankle sprains are relatively acute medical condition, commonly occurring due to over-stretching and tearing of the muscle or tendon. And theyre usually healed on their own. The thing that emergency care physicians usually do for this condition is to put ice packs or local anesthetic to numb the pain so the patient can rest. For patients whore very active, their body is able to heal itself from most of these types of ankle sprains very rapidly. For them, a PRP injection might not accelerate healing. On the other hand, because injections break up the tissue and poke holes, it can actually cause unnecessary complications.

Thats why successful studies on Platelet-Rich Plasma Injections are almost always done on chronic wounds and injuries that wouldnt heal on its own. If youre out to test PRPs efficacy, the untreated-by-PRP control group should be non-healable so we can determine clearly the effects of PRP.

So definitely, Platelet-Rich Plasma injections are not ideal for emergency care.

The same is true for patients on the other end of the spectrum. That is the category of patients whod been on steroids and drugs for a long time and are in the very advanced stages of the disease. Although there might be hope, Platelet-Rich Plasma might not be enough to reverse course here.

The ideal candidate for Platelet-Rich Plasma injection is a patient who has a relatively new, chronic musculoskeletal condition and whose only other option is surgery or heavy steroid/drug use.

2. Use of certain drugs

One of the other reasons why Platelet-Rich Plasma may not be ideal for emergency care patients is that when patients come in with intense pain, its a common practice for the ER physician to administer powerful local anesthetics and/or steroids in high dose. The problem with both of them is that they are are known to be toxic to stem cells and growth factors as shown here here, here and here. So if youre using these steroids, anesthetics or drugs, it is recommended to wait till the patient can get off of them before applying Platelet-Rich Plasma. Otherwise, the toxicity of the chemicals may limit Platelet-Rich Plasmas ability to recruit stem cells to the area.

For example, the local anesthetic Marcaine is found to be extremely harmful to stem cells even in small quantities. So as a general practice, the patient has to avoid harmful steroids, anesthetics and drugs at the time or up to 48 hours prior to PRP injections.

3. Lack of Rehab

Its been reported that PRP injection works well when combined with the physical therapy for sports injuries. However, some physicians mistakenly see PRP injections as an alternative to physical therapy. Hence the comparisons like these where PRP is pitted as a rival to physical therapy. The fact is Platelet-Rich Plasma can only supplement the effects of a proper rehabilitation program as illustrated in this study which demonstrated that PRP + physiotherapy is more effective than Dry Needling + Physiotherapy for patellar tendonisis.

There is one thing we need to add to that though. Most PRP injections are done in a way that breaks up scar tissue and triggers new healing response to which the platelets can respond. So the best post-Platelet-Rich Plasma treatment rehab program is one which treats the patients as if they just had an acute injury. Meaning, the physiotherapy regimen following a PRP injection has to aim at square one stimulation of blood flow to the injured area to provoke the inflammatory response. This is a different approach than the usual where the PT tries to attenuate the inflammatory response.

4. Under dosing

Under-dosing is a serious problem in this field. If youre using PRP with below 3X platelet concentration, youre under-dosing your patients. An example is the PT vs PRP study we highlighted earlier. Not only did they mistakenly conclude that Platelet-Rich Plasma could be an alternative to Physiotherapy, they were severely under dosing the patients by using PRP with 2.1-2.5X concentration of platelets.

Studies have shown that a concentration of at least 1,000,000 platelets/l is needed for optimal therapeutic benefits. That is 5X the concentration of platelets in normal whole blood. Here is one such study.

That is the very reason why we advocate not using Gel-based PRP Kit for PRP separation. The problem with gel-based kit is that most of the platelets will get trapped in the gel. Instead a kit like DrPRP kit gives you 5X-9X platelets because it uses a mechanical separation process while giving the same 1-step convenience of gel separators.

5. Using PRP as just another injectate

There is a fundamental difference between Platelet-Rich Plasma based orthopedic intervention and typical modern surgical and drug-based treatment. And that is surgery and the drugs are designed to eliminate symptoms of diseases. For example, pain is one of many symptoms that occur when a certain part of the body is out of balance. By taking a drug, steroid, NSAID or even undergoing surgical correction, the physician hopes that the pain goes away. This approach has led to all the problems that we face in modern orthopedic medicine. Because when we treat symptoms, the underlying problems usually dont go away.

But scores of physicians look at Platelet-Rich Plasma with that same attitude. They inject Platelet-Rich Plasma expecting the symptoms to go away.

Thats NOT what Platelet-Rich Plasma is for.

Platelet-Rich Plasma is a HEALING AGENT. Its different. Its not designed to eliminate symptoms like a drug. The only thing that PRP can do is use the body to heal itself.

So the first task, if youre an orthopedic surgeon or someone treating a musculoskeletal issue, is to IDENTIFY precisely whats producing the symptoms. This means looking at the connection between various muscles, tendons and ligaments. Understanding how they work in unison and finding out whats causing stress in the system. All the muscles and ligaments and tendons are like different pieces of the puzzle pulling weights in sync with their functions. So if theres a anomaly in the whole picture, chances are one of the pieces of the puzzle is not able to carry out its job.

For an easy example, a tightness in the hamstring might be a result of a twisted ligament or bone in the back caused by a bad sitting posture. So in addition to injecting PRP to the hamstring, you might also need to inject to the ligament or bone on the back. And advise the patient to change posture.

This is the definition of Interventional Orthopedics.

And it requires extensive experience on the anatomy AND delivering precise injections into the weaker links in the musculoskeletal system to improve overall function of the body. This means using image guidance technologies like fluoroscopy (Ultrasound guidance isnt enough) to accurately place Platelet-Rich Plasma on areas which require healing. These type of injections enable efficient tissue regeneration and healing, and is usually not taught in medical school, residency, or fellowship.

Thats why we encourage physicians whore offering PRP injections to get certified by taking one of the courses at the non-profit Interventional Orthopedics foundation.

Getting certified in Advanced Injection practices will make your Platelet-Rich Plasma results more consistent. There is a must-have for all physicians offering PRP Injections. It will also educate you on all the different ways regenerative medicine is being used right now.

6. Thinking only about relieving pain

We touched on it a little on the section above, but this is a broad topic that deserves an explanation on its own. Platelet-Rich Plasma as a healing tool is not something that you should make use of when your patients are in pain. Instead, PRP is used for a wide variety of issues that doesnt involve pain including wound healing, skin aging reversal, wrinkle correction, dry eye syndrome, nerve regeneration, bone union, hair regeneration and even womens fertility restoration and strengthening the uterus.

The bottom line is Platelet-Rich Plasma isnt just a tool for containing pain due to sports injuries. That days are far behind us now. Today, every physician, from the family physicians to neurologists and cardiologists, to fertility specialists and optometrists, to dermatologists and hair restoration experts everyone uses Platelet-Rich Plasma.

Plus, more and more applications are discovered every day.

Platelet-Rich Plasma, on its own without funding by Big Pharma or the government, has become an integral part of modern medicine.

BONUS: The 7th Reason Why PRP Injections Fail

We know all analogies are imperfect but we like to use the expresso shot analogy when it comes to platelets. Platelets are like expresso shots for healing. But like expresso shots, your body cant function using expresso shots alone. It needs food. Thats why studies like this one by Giusti has shown that super concentrating the Platelets may not only be useless, it can actually be harmful. What they did was completely isolate Platelets and platelets alone and applied it in different concentrations on tendon cells to see if higher concentrations hurt or helped. Thats not Platelet-Rich Plasma. Thats just platelets.

And Platelets alone cant do the job. In fact, it has nothing to support the survival of cells.

Instead, Platelet-Rich Plasma, is rich in Platelets while also including a small portion of RBC, WBC and the plasma serum which contains the nutrients the cells needed to survive.

Thats why research shows that taking the concentration above 1,000,000 platelets/l doesnt necessarily increase therapeutic benefits and as the Giusti study pointed out, it can actually have a detrimental effect.

This may not be an issue for the average physician, but it is possible to make this mistake thinking that higher concentration is better. Thats why we believe choosing the right Platelet-Rich Plasma kit plays an important role.

Because the kit has to produce Platelet-Rich Plasma in the ideal concentration not just Platelets so it can work every single time you administer it on patients.

Speaking of the composition of Platelet-Rich Plasma, the famed Stanford researcher and Platelet-Rich Plasma pioneer Allan K. Mishra has recently filed a patent application titled PLATELET RICH PLASMA FORMULATIONS which can be found here. In it, Mishra claims hes identified specific concentration of platelets, red blood cells, and white blood cells for treating treating connective tissue and/or cardiac tissue damage. Its worth a look if youre curious.

If you need help in getting started with Platelet-Rich Plasma, dont hesitate to give us a call at (844) 377-7787 for a quick consultation. We can support you not only in supplying all the necessary equipment, but also provide you with the information you need to be a confident pioneer in this field. Were looking forward to having you as part of our family.

You can also email us via hello@drprpusa.com or visit our shop to order directly.

Thank you for reading our blog. We love you.:)

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Top Six Reasons Why Platelet-Rich Plasma Injections Fail ...

Platelet-Rich Plasma For Arthritis | Halifax Naturopathic …

Platelet-rich plasma (PRP) is a therapy which uses a component of a persons own blood to treat their osteoarthritis. PRP is a safe treatment which often gives significant benefit to people suffering from osteoarthritis including improvements in stiffness, pain and mobility.

PRP injections contain a high concentration of your own platelets. These platelets contain a large amount of growth factors, including platelet-derived growth factor (PDGF), transforming growth factor beta (TGF-), insulin-like growth factor (IGF), epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF)1.

Table 1. Growth factors involved in tissue repair2.

These growth factors trigger tissue repair in our natural healing and recovery process. When a high concentration of these growth factors is introduced into the area of an injured or arthritic joint the healing process is jump-started.

Some research has suggested that PRP improves the integrity of the joint cartilage by increasing the amount of cartilage producing cells (chondrocytes) and by decreasing their rate of cell death (apoptosis)3. This would conceivably lead to a larger number of chondrocytes actively producing healthy cartilage within the joint and a healthier joint as a result.

PRP is prepared by drawing and centrifuging a small sample of your own blood on the day of treatment. A centrifuge is a device which rapidly rotates, spinning a blood sample at a high speed causing it to separate into layers based on weight. After centrifugation the blood sample separates into a top layer of plasma which is transparent yellow in color (mostly water with some dissolved proteins) and a bottom thick, red layer (red blood cells). At the junction of the plasma and red blood cell layers sits a dense concentration of platelets. This platelet-rich layer of the plasma is the portion of the blood which is collected and used for injection.

PRP is given by injection into the affected site or the site of injury. For example, in cases of tennis elbow the PRP injection is made at the site of the affected common extensor tendon on the elbow and in plantar fasciitis the injection is given at the site of the damaged plantar fascia insertion on the heel of the foot. In the case of osteoarthritis the injury includes two entire joint surfaces. An osteoarthritic joint is treated by injecting PRP into an affected joint space. Since a joint is a closed compartment the PRP fluid stays within the joint, coating the affected joint surfaces and exerting its effect on them through its rich concentration of growth factors.

Many studies have been performed on PRP injections for osteoarthritis and the results have been near-unanimously positive, showing a reduction in pain and improvement in mobility among the people receiving the treatment. In total, 47 studies have investigated PRP as a treatment for osteoarthritis and all 47 of these studies have found that this treatment was beneficial4-50.

Some research has found that 3 PRP injections, with 1 month between each injection, is more effective and gives longer lasting results than only one or two injections31.

Platelet-rich plasma vs hyaluronic acid

Most PRP for osteoarthritis research has been on the knee. To date 37 studies have examined PRPs effect on knee osteoarthritis while the temporomandibular joint has 4 studies, the hip has 3 studies, the ankle has 2 studies and the thumb has 1 study.

Figure 1. Number of studies (by joint) examining platelet-rich plasma for osteoarthritis. Most research performed on knee joint. Although the studies have yet to be done I have also seen good results with osteoarthritis of other joints including the shoulder, wrist and other hand joints.

PRP injection treatments are quite safe, having very little in the way of reported adverse effects50. While most treatments for pain involve a synthetic medication-based therapy, PRP simply uses a component of a persons blood. PRP therefore carries very little risk of causing an allergic reaction. The most common adverse effect of PRP is discomfort at the site of treatment for 1-3 days. This is a common reaction as the mechanism of action of PRP involves a short-term inflammatory phase after treatment which can contribute to discomfort temporarily. As with any injection there is a small chance of infection. There is also a small chance of allergic reaction to the local anesthetic (numbing agent) which is used at the site of the injection.

PRP treatment can provide lasting results for people with osteoarthritis including reduced pain and improved mobility. Typically 3 treatments will be required to attain maximum benefit from PRP. PRP injections can be done 2-4 weeks apart without issue.

PRP injections are a long-term solution for osteoarthritis. While this treatment gives long term benefit some people may experience discomfort following treatment for 1-3 days. In order to deal with this possible discomfort it is best to reduce physical activity after a PRP injection to avoid additional discomfort of the region which was treated. Applying ice to the affected area will not inhibit the effectiveness of the PRP treatment and may help if the treated area is achy or sore.

The treated body part should be rested on the day of treatment and if discomfort remains then 2-3 days of avoiding heavy activity may be required to assist in recovering. Anti-inflammatories such as aspirin, ibuprofen and naproxen in general should not be taken for 2-7 days after a PRP treatment as they could theoretically dampen its effectiveness. Generally acetaminophen (Tylenol) is preferable to anti-inflammatories in this short term to manage any discomfort or pain which may be present.

People with active cancer or active infection are not candidates for PRP treatment. People with thrombocytopenia (low platelets) and people on blood thinners can have PRP treatment but some changes to the treatment may be required.

If you are interested in having PRP treatment contact MacLeod Naturopathic at 902-820-2727 to book an initial consultation with Dr. MacLeod. PRP treatment is also available at Dr. MacLeods location in Port Hood which can be reached at the phone number above.

Naturopathic Doctor at MacLeod Naturopathic

Dr. Colin is a naturopathic doctor practicing in Upper Tantallon in the Halifax Area. He was born and raised in rural Cape Breton and returned to Nova Scotia to practice after finishing his naturopathic education in Toronto. His practice focuses on pain management and maintaining health through physical activity and diet. He utilizes platelet-rich plasma, neural prolotherapy and acupuncture to keep his patients pain-free so that they can stay physically active, social and healthy.

Last updated August 31, 2017

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Platelet-Rich Plasma For Arthritis | Halifax Naturopathic ...

Platelet Rich Plasma Therapy for Osteoarthritis …

What is the role of PRP in Stem Cell Therapy?

PRP stands for Platelet Rich Plasma, which isa main component of a PRP stem cell injection. The term is used very loosely to include anything that has growth factors and cytokines derived from blood (Platelets). When cells talk to each other, they make proteins and peptides that are the messages that pass from one cell to another and determine how the cell will respond. These are called cytokines and include growth factors. PRP stem cell injections for the knee, hip and spine use these cytokines to control the actions of surrounding cells. Platelets store granules of these cytokines that can be harvested and used.

The process of obtaining cytokines begins with a sample of blood being collected and centrifuged. The red blood cells collect at the bottom, while the plasma containing platelets can be taken from the top. This plasma with platelets can be used as is or can be centrifuged a second time to concentrate the platelets at the bottom of the tube.

We then have Platelet Rich Plasma (PRP) at the bottom and Platelet Poor Plasma (PPP) at the top. Collecting the PRP from the bottom, it can be used as is or it can be activated by adding Calcium Gluconate. This causes a clot to form, which excretes the cytokines from the platelets. The clot will slowly shrink as the cytokines are excreted. The platelets are now destroyed, and because the clotting factors have been used up, the plasma is now serum. The end product is cytokines in serum, which is used for stem cell therapy. This is obviously not PRP, as there are no platelets and no plasma.

When the plasma containing platelets are injected into the body, the platelets will be activated by contact with any tissue except endothelial cells (the cells that line arteries and stop platelets clotting). When this happens, the cytokines will be released slowly over 5 or more days. This clot is known as Platelet Rich Plasma Gel (PRPG).

The normal role of platelets in the body is to adhere to any gap in blood vessels, where they form a clot to block the hole and release cytokines to heal the damage. It is this healing power that can be utilised by doctors to heal tendon, joint and other soft tissue injuries.

Macquarie Stem Cells wanted to see if this function of platelets could be used to test if people will be responders or non-responders to stem cell therapy. We have tested this on a large number of patients using various combinations and the test has had some usefulness.

Using Platelet Rich Plasma therapy for osteoarthritis has not improved the results when given at the same time as stem cells, but there may be some utility when given two weeks before stem cells, as well as in the healing time after stem cell therapy.

Using the cytokines contained in platelets is like having a burst of stem cell activity. The results can last for one week in some patients whilst in others the results can be much longer, lasting up to a year or more. There will be a group of patients who only need plasma/platelets and others who will need stromal cells (stem cells) to get a lasting and complete effect.

A recently conducted case series has had significant findings relating to PRP stem cell injections. This study focused on knee osteoarthritis, which previously could only be treated with pain medication, anti-inflammatory drugs, or invasive joint replacement surgery.

Four different patients suffering from knee osteoarthritis were investigated to establish the effectiveness of an exercise rehabilitation program combined with Platelet Rich Plasma injections containing autologous StroMed and PRP. Over a 12 month period, each patient received regular PRP stem cell injections, participated in physical function tests, and recorded their symptoms in a questionnaire. At the conclusion of the study, all patients experienced improved outcomes, indicating that injecting a combination of stromal cells and PRP can be beneficial for osteoarthritis.

If youre interested in learning more about the role of Platelet Rich Plasma therapy for osteoarthritis, including PRP injections for the knee, hip or spine, contact Macquarie Stem Cells to arrange a consultation.

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Platelet Rich Plasma Therapy for Osteoarthritis ...

Quick scouting report on Milwaukee Brewers call-up Taylor Williams – Brew Crew Ball

The Milwaukee Brewers announced seven September call-ups yesterday, including one player who was making his first trip to the major leagues: right-handed pitcher Taylor Williams. The Kent State product started his career back in 2013 as a 4th-round pick by the Brewers and quickly began to see his fastball velocity rise along with his stock as a prospect. During Spring Training in 2015, Ryan Braun likened Williams explosive fastball to that of All-Star closer Craig Kimbrels.

Unfortunately for Williams and the Brewers, arm issues started cropping up shortly thereafter. He began the 2015 season on the disabled list with and ultimately was forced to undergo Tommy John surgery after physical therapy and platelet-rich plasma injections couldnt heal his ailing elbow. He wound up missing all of the 2015 and 2016 minor league seasons, returning to action last fall for instructional league. Even after the lengthy layoff, Williams showed enough at instructs to convince Milwaukees front office to add him to the 40 man roster in order to protect him from the Rule 5 Draft.

Williams spent this year with AA Biloxi under very close watch from the organization, and hell now join the big league club for the stretch run as the Milwaukee Nine chases their first postseason berth since 2011. So, what should we be looking for from the hard-throwing righty?

Williams is considered a bit undersized as a pitching prospect, standing at just 511 though he is a stout 195 lbs. Scouts consider his delivery to be rather high effort, featuring a notable leg kick and throwing from a three-quarters arm slot. Williams has lighting-quick arm speed, which helps him consistently generate big velocity on his fastball. Because of his smaller stature and high-effort mechanics, many scouts have had him ticketed to become a reliever since he was drafted.

Williams relies mainly on two power offerings in his arsenal, a fastball and slider. He hasnt shown any issues in finding his pre-injury velocity this season, with his fastball sitting in the mid-90s and touching as high as 99 MPH recently for the Shuckers. The late tail that the pitch features can give batters fits at home plate, and he misses plenty of barrels and bats with his heater. His hard slider features 1-to-7 action that breaks down and away from right-handed batters. He typically uses this as his put-away pitch when hes ahead in the count. Williams also will throw on occasion a below-average changeup that lags a good bit behind of his two other pitches in terms of quality. Williams high-octane stuff leads to plenty of strikeouts, but his two-pitch arsenal and fringy command again support that ultimately hell be better suited for bullpen duty.

Williams only crossed the 200 professional innings threshold this season after he missed so much time with his elbow troubles, but statistically hes had little issue with minor league hitters to this point. After debuting in the Pioneer League in 2013, Williams posted a 2.72 ERA/2.23 DRA in 132.1 innings pitched between A-level Wisconsin and high-A Brevard County in 2014. He struck out 137 batters while walking only 28 and inducing ground balls at a 50% clip.

When Williams finally returned to regular season action in 2017, Milwaukee closely monitored his work load at AA Biloxi. Working mostly in a piggyback with pitching prospect Jon Perrin, Williams started in 14 of his 22 appearances this year but never worked beyond 3.2 innings or threw more than 65 pitches in any of his outings. He had been on the once-every-five-days schedule that is typical of a starting pitcher, but at the end of July the org stopped having him start games and began pitching him every 2 or 3 days while entering later on in games in preparation for a move to the bullpen.

Williams wound up tossing a total of 46.2 innings for Biloxi and registering a 3.09 ERA before getting his first call to The Show. He did strike out 28.6% percent of the batters he faced, 57 whiffs in all. He managed to keep the both ball on the ground (48%) and in the park (2 home runs allowed) very well this season. Opponents were able to hit .237 against him though, which ranked right around the median for Southern League pitchers. He also had a notable difficulty with free passes, issuing them at a rate of 4.05 per nine innings, helping lead to a WHIP of 1.35. Based on these and several other factors, Williams work in AA translated to a Deserved Run Average of 4.19 this season. Thats more than a run worse than his ERA, and in terms of overall production DRA feels his performance was actually a tiny bit worse than the average Southern League pitcher in 2017 (102 DRA-).

Ultimately there appears to be little doubt that the best way for Taylor Williams to produce meaningful value at the major league level will be out of the bullpen. Williams advanced age (he turned 26 in July) and the fact that he missed two full years of developmental time really put him behind the eight-ball in terms of building up the stamina and arm strength needed to pitch 160+ innings on a year-to-year basis. His middling command, lack of a trustworthy third pitch, and diminutive stature work against him as well.

Williams should get some opportunities to showcase his stuff in Milwaukees bullpen this September and he will probably compete for an Opening Day spot as a reliever next spring. His dynamic fastball-slider combination and high strikeout approach should continue to play extremely well out of the bullpen for the next several seasons.

In fact, one might even say that Williams is Taylor-made for a role as a big league setup man.

Statistics courtesy of Baseball Prospectus and Fangraphs

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Quick scouting report on Milwaukee Brewers call-up Taylor Williams - Brew Crew Ball