Dr Edwards has been performing Prolotherapy for several years and has had excellent results. However, there are some patients that don’t respond as well as we would like and need a little more stimulation of their immune system in order to provide the desired results.
That is where Platelet Rich Plasma (PRP) Therapy comes in.
PRP has been around for several years and has more support in the medical literature. The rational for this is quite simple. The machines & systems used in order to obtain the platelet rich plasma portion of the blood are proprietary and there is money in selling the machines and kits for PRP. Thus, these medical device companies have a vested interest in equipment sales. Therefore, the greater the demand for PRP the more devices they will sell. Any time there is money there can be research studies to back it up!
The procedure for PRP is essentially the same as for prolotherapy. We are stimulating the immune system to heal itself. The primary difference is in the type of proliferant solution. PRP uses the platelet rich portion of plasma once the blood has been ‘spun’ to separate the components.
Platelets are very small cell components that critically contribute to the healing process. As the body’s primary source of bioactive tissue growth factors, platelets include:
- CTGF (Connective Tissue Growth Factor)
- PGDF (Platelet Derived Growth Factor)
- TGF-β (Transforming Growth Factor-beta)
- EGF (Epidermal Growth Factor)
- IGF (Insulin Growth Factor)
- bFGF (basic Fibroblast Growth Factor)
- VEGF (Vascular Endothelial Growth Factor)
By concentrating these growth factors and injecting them at the site of injury, the body’s own stem cells are drawn to the injured area and differentiate to form new healthy and robust regeneration of damaged ligaments and tendons.
PRP does seem to be a bit more potent in stimulating the inflammatory response. The pain after the procedure also seems to be a bit more intense as well.
For those that want to see the process of PRP, here you go…
PRP concentrates Mesenchymal stem cells (MSCs).
MSC’s are multi-potent stem cells that can transform into several of types of cell during the tissue repairing process. The different types of cells that MSC’s have been known to transform into include collagen secreting cells, bone forming osteoblasts and cartilage forming chondrocytes. Collectively, all of these cells can potentially rejuvenate tissues that have been damaged due to injury, osteoarthritis and degenerative changes.
What does it do?
The platelet rich plasma process concentrates fibrin, mesenchymal stem cells and platelets so that each cubic millimeter of the solution consists of 1.5 to 2 million platelets. This results in up to a five-fold increase in the platelets and bioactive growth factors. Platelet Rich Plasma acts as a tissue growth accelerator which amplifies the natural process of the tissue reparation and healing, due to its potency. Studies have revealed that PRP stimulates not only the production of new collagen at the fibroblasts, but bone and cartilage cells at the site of the injection. This strengthens injured ligaments and tendons by rebuilding the joint cartilage. This new, strong, collagen is naturally incorporated into the existing cartilage and ligaments making them thicker and more elastic.
How Does PRP Prolotherapy Compare With Cortisone Shots?
Cortisone injections actually weakens tissue. Although cortisone injections have been known to provide temporary relief and to stop inflammation, they do not provide long-term healing. The process of Platelet Rich Plasma therapy heals and strengthens the tendons and ligaments, in some cases thickening the tissue up to 40%.
How Does PRP Regenerative Injection Therapy compare with regular Dextrose Prolotherapy?
When regular dextrose prolotherapy has provided positive results but recovery has not been ideal, PRP Regenerative Injection Therapy is especially useful. In these types of situations PRP is often the treatment option that will resolve the less responsive or more injured areas. In fact, clinical and anecdotal experience has demonstrated that using PRP as the prolotherapy injection solution creates a deeper healing effect and results in an accelerated healing process in fewer treatments than the regular dextrose prolotherapy..
Frequency Of Treatments
Usually patients feel the benefits of PRP injection therapy after only two treatments. Sometimes satisfactory results may occur even sooner, however this is not absolutely certain. Although individual responses to the treatment do vary, most people require 3-6 sets of injections. Each treatment is spaced four to six weeks apart.
So what conditions are successfully treated with PRP?
Because of the high success of normal Dextrose Prolotherapy, PRP is not something we normally think of as a first line solution. For really, really, bad tears or injuries, especially if someone has had some Prolotherapy elsewhere, it may be used as a first-line therapy. Because of the greater cost of PRP due to the cost of filters and PRP technology as well as preparation it is preferable to begin with regular prolotherapy as it provides excellent results 80% of the time. For those who do get PRP solution as their Prolotherapy solution, we typically see them for follow-up in four to six weeks. Generally, people know by the second PRP Prolotherapy whether it will work or not. Overall the results have been extremely positive. It is very safe. There have been no reactions related to the solution.
When to consider PRP solution as your Prolotherapy Option:
- regular prolotherapy has resulted in some success, you are confident the treatment has been done properly into the appropriate areas, but the results are not optimal.
- Your injury is very severe or complex
- labral or meniscal tears
- high performance athletes who put more demand on joints
- out of town patients who cannot return for visits frequently
- persons who wish to maximize their results with a minimum number of injection visits