Platelet rich plasma (PRP) has been used medically since the late 1990’s. Dentists were the first to use this natural healing mechanism to improve outcomes of dental procedures. PRP has been used since 2000 for intraoperative (in the course of surgery) therapy following orthopedic, thoracic and cardiac surgical procedures. PRP has found wide use in non-surgical orthopedic treatment of knee pain and other joint injuries.
Platelet rich plasma also can heal injured tendons, ligaments, muscle, cartilage and bone. Major league sports has discovered the incredible natural healing effects of PRP. Many national and international sports leagues have adopted PRP therapy as one of the first line treatments of their injured athletes. Professional sports has recognized the economic value of PRP in that one PRP treatment costs $1500-2000 as compared to the typical orthopedic surgery which can range from $20,000 – 40,000. Additionally PRP has virtually no down time and does not require months of physical rehabilitation. Platelet rich plasma has become an early treatment option in the treatment of professional athletes that have suffered muscle, joint, tendon and ligament injures.
NFL Players Who Have Received PRP
Hines Ward, the Pittsburgh Steelers wide receiver, has use platelet rich plasma therapy on at least two occasions for a torn medial collateral ligament — a knee injury. The use of PRP allowed him to go on and win two Super Bowls. Mr. Ward has attributed his ability to play to receiving PRP.
Other NFL players have successfully been treated with PRP for various injuries. Troy Polamalu, a Steeler’s defensive safety, has had his share of traumatic injuries. As one of the top defensive players, Polamalu has had repeated trauma to his knees. He had one significant MCL injury for which he had PRP therapy.
Donald Jones of the Buffalo Bills and Andre Dixon of the Hartford Colonials have also had PRP therapy for their injuries -all with excellent success. Houston Texans wide receiver Andre Johnson suffered a high ankle sprain. To expedite the recovery process, Johnson underwent platelet rich plasma therapy.
These professional athletes were able to get back to playing football in only a few short weeks, instead of the normal 2-4 months of healing and rehabilitation time it take for more conventional therapies. Surgical treatment would sideline these highly trained athletes for a whole season. NFL physicians have discovered that PRP is the answer to getting these players healed quickly, with needing to resort to surgery. Platelet rich plasma regenerates new, stronger tissue in these injured players.
Major League Baseball and PRP
Alex Rodriguez, one of Major League Baseball’s most famous players used five PRP treatments to accelerate healing and recovery following hip surgery that left him in pain. His trainers were amazed to see how much faster A-Rod was able to get back into playing baseball.
Takashi Saito suffered an elbow injury in his pitching arm while playing as a Pitcher for the LA. At 38, surgery was not a good option, as recovery could have taken as much as 9 months. He had PRP therapy and was able to resume pitching in only a few weeks. Saito credited his unlikely recovery from a partially torn ulnar collateral ligament to PRP therapy.
In one year, Major League Baseball’s 30 teams had 519 players who spent 28,602 days on the disabled list for injuries sustained while playing baseball. This represented $455 million in total salary sitting idle, as these athletes were sidelined. PRP therapy can and does have a major effect in reducing recovery and down time.
National Basketball Association and PGA
One of the most famous basketball players, Kobe Bryant, has had several arthroscopic knee surgeries for right knee pain. He went to Germany to receive platelet rich plasma therapy. Being in his 30’s, he did not see more surgery as a good alternative. The promise of non-surgical, more rapid improvement with PRP therapy for his knee pain convinced this basketball legend to undergo therapy. Similarly professional golf star, Tiger Woods has undergone platelet rich plasma therapy more than once following ACL reconstructive surgery. His knee pain continued after surgery and he went with PRP with beneficial results.
National Tennis and World Soccer
Other major national and international sports have recognized PRP therapy as an outstanding alternative to “standard” conservative therapy and certainly its benefits over surgical intervention. World tennis star, Rafael Nadal underwent PRP therapy after injuring his knee. His physician, Dr. Mikel Sanchez, described platelet rich plasma as a miraculous regenerative treatment. Indeed, that is what PRP does, regenerates new tissue. Major League Soccer players have also discovered the potential for better, rapid healing with PRP therapy.
Jonathan Bornstein, one of the top new young stars in soccer, twisted his knee resulting in a torn ligament. Facing the prospect of being out of playing soccer for 10 weeks, Bornstein elected to have PRP for his knee injury. He was back to running in 3 weeks and was ready to resume playing soccer only 2 weeks later. The list of professional athletes in a broad range of Major League sports, who have undergone platelet rich plasma therapy is growing every week. This list is beyond the scope of this article. The conclusion though is that PRP therapy is here to stay in the treatment of these injured, highly trained athletes.
PRP therapy is considered to be acceptable medical therapy by the International Olympic Committee, World Anti-Doping Agency and most professional sports association. Platelet rich plasma therapy is distinctly not blood doping and has been ruled on by the IOC and WADA as well as professional athletic associations.
Platelet rich plasma is a novel, non-surgical therapy to heal injured tissue. The platelets contain growth factors, cytokines and other agents that trigger the healing cascade. The difference is, is that with PRP therapy, a massively concentrated amount of platelets and supporting proteins are injected directly into the damage tissue. The body uses the same natural healing process for injuries but not in this high concentration. With this high concentration of healing platelets and growth factors, injured tissues can be regenerated and healed in only a few weeks. Many patients can have pain relief in 3 weeks. Many other painful conditions can be treated with PRP. If you suffer from joint, muscle, tendon or back pain – contact Sarasota Neurology for PRP therapy in Sarasota.
Posted in Back Pain, Pain, Platelet Rich Plasma and tagged Hines Ward, injuries, joint pain, knee pain, Major League Baseball, NFL, olympic, orthopedic, Pain, Pittsburgh Steelers, platelet, Platelet Rich Plasma, PRP, PRP therapy, prp therapy sarasota, rafael nadal, Tiger Woods by Dan Kassicieh, D.O.
A recent report in the Journal of the AMA (De Vos, et al JAMA 2009) reported that platelet rich plasma therapy was no more effective for chronic Achilles tendinopathy than standard, conservative therapy. This study was inherently flawed in its design resulting in incorrect conclusions. Platelet rich plasma is the healing component of blood. It is derived and concentrated from a patient’s own blood and then injected into the affected area. Not all PRP is the same. Blood processing is the key, levels of growth factors are of utmost importance and successful outcomes will vary with the technique, protocol and level of expertise the clinician possesses. Different PRP extraction equipment and how the blood product is handled during this process is also critical.
De Vos et al commented “A limitation of the study was that the amount of platelets and quantity of activated growth factors that were present in the PRP injections were unknown.” This introduces several variables that would invalidate the data and the study’s conclusion:
1. What PRP processing system was used?
2. Were the levels of Growth Factors therapeutic? Therapeutic level ranges are usually 4-5 times the baseline.
3. No levels or PRP concentrations were taken or reported.
All of these are significant study design flaws that will result in invalid study conclusions. Additionally the study stated “Platelets are slow to activate by exposure to tendon collagen, but it might be that therapeutic pressure within the tendon, a large amount of PRP diffused rapidly out of the tendon thereby reducing its effect.” Additionally thrombin – a critical component in PRP therapy – was not used to activate the platelets. PRP and growth factors will not activate or be as effective if thrombin is not used in this procedure.
Perhaps most significant study design error was that only one PRP injection was given. The study patients, by design criteria, were required to have chronic Achilles tendinopathy that had responded poorly to prior therapies. Chronic tendon injuries, particularly those in the Achilles tendon, heal poorly due to inherently poor blood circulation. The standard PRP technique in this type of injury would be a series of three injections over a period of 3-4 months. A study that specifies treating a patient with a chronic tendinopathy with a single PRP injection is setting up the patient unnecessarily for failure. Lastly, the study had a low number of subjects in it to make any clinically significant conclusions. Only 27 subjects were treated, each with a single PRP injection and there were 27 control subjects.
Regenerative medicine – Platelet rich plasma – has been FDA approved for medical use for 20 years. It has been used widely in dental, cardiac, orthopedic medicine to assist in and improve medical outcomes. The professional horse racing associations widely use PRP therapy to heal leg injuries in their million dollar race horses. Major league sports such as the NFL and MLB consider platelet rich plasma therapy an important treatment option to get their elite athletes “back into the game” in as short of time as possible. PRP healing typically takes six weeks, particularly when combined with rehabilitation. In conclusion, PRP is a highly effective medical treatment for ligament, tendon, muscle and other knee/shoulder injuries as well as lower back pain. Even patients with post-operative knee pain or shoulder pain can benefit from PRP therapy. Outcomes are entirely dependent on the preparation and handling of the blood, equipment used and experience as well as skill of the treating physician. Additional information on PRP can be found at PRP Stops Pain. Excellent clinical study references can be found by clicking here.
Posted in Back Pain, General Medicine, Pain, Platelet Rich Plasma and tagged Achilles, Achilles tendinopathy, Back Pain, blood, FDA approved, growth factors, JAMA, joint pain, knee pain, ligament, lower back pain, MLB, NFL, Pain, platelet, Platelet Rich Plasma, platelets, PRP, PRP stops pain, shoulder pain, tendon, thrombin by Dan Kassicieh, D.O.