Regenerative Medicine //
Regnerative therapies have gained much media attention recently due to famous athletes like Kobe Bryant and Tiger Woods undergoing regenerative treatments to maintain their competitive edge and control their pain symptoms while avoiding surgery. You can search online for key words like atheletes and platelet-rich-plasma (PRP) and there are many examples of how regenerative medicine is helping professional and Olympic atheletes around the world. But super athletes are just a small portion of the total patient population who can benefit from regenerative medicine. There is good scientific evidence that patients with sports related injuries, age related degenerative changes, and trauma, have great reduction in pain and improvement in function with regenerative therapies.
However, regenerative medicine should not be viewed as a miracle cure for every ailment. Eventhough there is good scientific evidence that treatments like prolotherapy and PRP works in certain diseases, it does not work in everyone and in every disease.
If you are considering regenerative therapy, please schedule a consultation to discuss in person and in depth if you are a good candidate and what options are available for you.
PRP injection therapy involves autologus transfusion of the patient's own platelets. By injecting a high concentration of platelets that release growth factors and attract circulating stemcells, the body's healing system is activated. It is another natural way to stimulate your body to heal. Unlike prolotherapy, PRP is a superconcentration of cells involved in healing and requires havesting of your blood.
Commonly Treated Conditions with Regnerative Medicine and PRP
- Osteoarthritis of large joints like Shoulder, Hip, and knee.
- Tendinopathies of the elbow (Tennis elbow and Golfer's elbow)
- Tendinitis and Ligament injuries
- Back and Neck pain
- Plantar fascitis
- Rotator cuff tear (partial)
- Ankle sprain
- Sacroiliac joint injury
Platelet-Rich-Plasma (PRP) Injection
How is the procedure done?
PRP injection is a simple, non-surgical procedure that takes about 45 minutes. It is not a painful procedure and most patients are able to return to normal function the next day. The procedure can be divided into three parts. First part is the harvesting of platelets where we draw between 30-60ml of your blood using techniques to minimize damage to the platelets. Second part is the isolation of platelets using a specialized centrifugation system designed to preserve platelet structure while separating the platelets from red blood cells. Lastly, the superconcentrate platelet is injected back into your body into the affected area under image guidance like ultrasound and X-ray.
How can I prepare for the procedure?
The most important part of the preparation is the avoidance of medications that inhibit platelet function. Unfortunately, many over-the-counter pain medications like Aspirin and Nonsteroidal Antiinflammatory Drug (NSAIDs)- Ibuprofen (Motrin, Advil), Naproxen (Aleve, Naprosyn), Celecoxib (Celebrex), and diclofenac (Cambia, Voltaren, Zipsor) inhibit platelet function. Such medications should be stopped for approximately 7-10 days before the procedure.
If you are on a blood thinner like Warfarin (Coumadin), Clopidogrel (Plavix), Rivaroxaban (Xarelto), Apixaban (Eliquis), and Dabigatran (Pradaxa), please consult with your presciber if it is ok to stop it before the injection. The prescriber should provide you with instructions on when to stop and restart the medication.
You may need a driver depending on your need for premedication.
What happens after the procedure?
The majority of patients are able to return to work the next day, if not within 2-3 days. There is minimal discomfort from the injection. Patients are also asked to stop NSAIDs for additional 4-6 weeks after the procedure.
The most important part of the post-procedure period is the first 4 weeks where patients must engage in aggressive physical therapy and rehabilitation. Although injections alone can help the regenerative process, physical therapy augments the healing effects of platelets.
What type of results can I expect?
Unlike steroid injections where significant pain relief is noticed within a week, the best effects of PRP can take several weeks. PRP stimulates natural healing which can take weeks for significant tissue regneration to affect pain symptoms. Studies that have compared steroids to PRP injections consistently show that although initially the pain relief is better with steroids, they are short lived. PRP, on the other hand, takes longer to relieve pain, but the pain relief is sustained for a longer period, often over a year.
There is a strong correlation between physicial therapy and effectiveness of PRP therapy. Effects of regenerative medicine is amplified with exercise and healthy lifestyle.
Does insurance cover PRP?
Eventhough there is very good evidence for PRP therapy, at this time, insurance plans consider PRP experimental or investigational and do not cover it. Unfortunately, your health benefits plan does not pay for everything, even some care that you or your health care provider have good reason to think you need.