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In this episode of the Sarasota Neurology Podcast, Dr. Kassicieh discusses Platelet Rich Plasma  and Regenerative Medicine.

Regenerative medicine is a new, exciting branch of medicine which deals with healing injured or damaged tissue with the body’s own natural healing mechanism. To do this, Platelet Rich Plasma (PRP) is extracted from the patient’s own blood. Using blood from the patient eliminates the risk of transmission of blood born disease, viruses and other infectious agents. PRP is then injected into the area of the body that needs intensive healing and tissue regeneration.

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PRP therapy works especially well for injured tendons and ligaments, and is uniquely suited for those difficult knee and shoulder injuries. Even patients who have had knee or shoulder surgery but still have pain can have dramatic benefit and pain relief from PRP therapy.

PRP is revolutionary therapy in that it avoids surgery. It is done as an outpatient procedure, so there is no recovery time or rehabilitation to deal with. If you have joint pain, you may be an excellent candidate for PRP therapy. Call now to schedule an evaluation to see if you would benefit from PRP therapy.

To schedule an appointment, please call (941) 955-5858 or you may request an appointment here.


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How I Avoided Knee SurgeryI remember it like it was yesterday. While playing racquetball in December 2011, I felt a sudden click in my right knee. I just knew that I had torn my right knee medial meniscus. The knee MRI  proved it. The pain was excruciating, and it was compounded by the thought that this happened 9 weeks before my annual Rocky Mountain ski trip.

The misery did not last long though. I’ve been through this scenario before. I did the exact same thing to my left knee in 2010. (I have the MRI for that one, too!) So, I turned to the revolutionary treatment that got me back up on my feet and on the slopes last time this happened.

If I had gone the surgery route, my trip would have been cancelled, as surgery and rehab can take 3-6 months – with no guarantee of outcome. But I was on the slopes as planned! — Not just any slopes, but the “Expert” slopes! I skied for three gorgeous days in a row without pain or problems! No surgery. No downtime. No rehabilitation. Just a simple injection and then my body did the rest.  I was completely healed, completely pain free by the time I left for my trip. All this only eight weeks after treating my right knee.

Sound too good to be true? Well it’s not…it’s PRP – platelet rich plasma. PRP is the cutting-edge therapy that even professional athletes have turned to when faced with career-limiting injuries.

PRP is short for platelet rich plasma. With PRP, a patient’s own blood is drawn and the platelets are extracted into a small amount of your own blood plasma. Platelets contain numerous beneficial, natural growth factors and chemical messengers that initiate and aid in healing and tissue regeneration. As the PRP is derived from the patient’s own blood, there is no risk for rejection or disease transmission. The PRP is then injected into the injury site. In my case, my knee. It’s that simple. Still not convinced? Let’s compare PRP therapy versus traditional arthroscopic knee surgery, which would be the usual prescribed course of treatment for an MRI proven torn meniscus.

Risks associated with Surgery may include:

  • Possible complications due to anesthesia
  • The surgical procedure itself – with no guarantee of pain relief
  • Increased knee pain during recovery process
  • 3-6 months rehabilitation after surgery
  • 3 hours or more of lost work per week due to therapy plus drive time to appointment
  • Use of narcotics to manage pain
  • Possible risk of addiction to pain killers

Risks associated with PRP:

  • Essentially zero

Pretty startling contrast between the two, don’t you think? Oftentimes, patients may complain PRP is not covered by traditional insurance and therefore too expensive to pay out-of-pocket.  If you look at it a different way: Add up the co-payments associated with both the surgery and 3-6 months of rehabilitative therapy plus the missed time at work, you could have easily covered the cost of PRP therapy. That does not even include the downtime that you will have before and following surgery.

Remember, with PRP therapy there is no recovery time, no anesthesia, no narcotics, no downtime. You have one shot on Friday and are back to work on Monday.

PRP may not be right for every situation, but if you have an injury or condition that you’ve been told requires surgery, it’s definitely worth checking out! This is true not only for knee problems (not limited to a torn meniscus) but also for shoulder pain, rotator cuff injuries, hip pains, ankle injuries and plantar fasciitis (foot pain.) Remember: surgery is irreversible and narcotics are addictive. Surgery never comes with a guarantee and frequently patients have more pain after the surgical procedure. Avoid them if at all possible! For more information on the non-surgical treatment of joint pains and learn more about Sarasota PRP here.

I remember discussing my knee with my physical therapist friend who marveled at my rapid, complete recovery. He looked at me and said, “Why isn’t there a line out your door right now of patients waiting to get PRP instead of surgery?”  I thought to myself, “He’s right. Too many patients are getting knee, shoulder and foot surgery who could do extremely well with PRP therapy.”

Ready to make your appointment today and start living pain free?


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Patients are being treated currently at Sarasota Neurology with PRP (platelet rich plasma) for a wide variety of joint pain and other pain issues. Among the more common uses for PRP are knee pain, shoulder pain and other painful conditions such as plantar fasciitis, tennis elbow, some types of low back pain. PRP can also be used in patients that have residual joint pain from having had orthopedic arthroscopic knee or shoulder surgery.

PRP works to heal painful joints by using the patients’ own natural biological healing mechanism. The injured or damaged tissue in the joints, ligament and tendons or muscle send out chemical signals that there is injury or incomplete healing. PRP has receptors on the active platelets that seek out these damaged tissues. The PRP graft then biologically and molecularly attach to the damage tissue and trigger the natural healing process of making new collagen. This process takes six weeks to have a full effect although actual healing can continue for up to three months.

PRP may be used in some patients as an alternative to having surgery on their knees, rotator cuffs or in cases of plantar fasciitis (foot pain). Beginning in early 2011, Sarasota Neurology will be offering a new and innovative uses for PRP. This highly effective treatment is ideal for patients who would prefer to avoid the cost, pain and time involved in having surgery for the same problem. Check back with us in February to get more details of this exciting treatment with PRP in Sarasota.


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As a neurologist who sees many patients with neck, back and various joint pains, I practice an area of medicine known as neuro-orthopedics. As such, I treat patients for their pain without surgical intervention. Many patients with neck, back and joint pain (knee pain, shoulder pain, elbow pain, etc.) can be successfully treated without invasive surgery and the many risk that go along with this. With surgery there is also a prolonged recovery time and need for extensive rehabilitation. The area of medicine that applies to successfully treating patients without surgery or use of narcotic medications is known as regenerative medicine. In this field, platelet rich plasma is injected into the affected joint, tendon, ligament or soft tissue area that has pain and is failing to heal completely. Tendons attach muscle to bone and ligaments attach bones to bones. Platelet rich plasma (PRP) is the concentrated healing components of the blood. Only one percent of the blood contains the bioactive proteins and platelets that are involved in healing. Through a specialized process, we can take the patient’s own blood and concentrate the platelets and bioactive proteins up to 500%. This small amount of concentrated PRP is then injected into the joint or other body area, that needs regeneration, after local anesthetic is administered. The PRP graft is then activated with thrombin and the healing process begins. Using the patient’s own blood eliminates the risk of transmitting disease and prevents graft rejection. PRP also has the benefit of being antimicrobial, killing off bacteria thereby limiting the risk of infection. David Crane, MD published an excellent overview of platelet rich plasma.

Platelet rich plasma works by first being injected into the affected area and activated. The activated platelets attach themselves to the damaged tissue, whether that be tendons, ligaments, muscle or bone. The platelets release alpha granules and dense particles. The small packets contain powerful bioactive proteins that begin the healing process. The alpha granules contain clotting factors, growth factors, cytokines and adhesion molecules. These substances allow the PRP graft to attach to the damaged tissue and start recruiting other healing cells to migrate into the area. The dense particles contain proteins that allow the platelets to clump together, forming the structural matrix of the PRP graft.

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