Archive for category Regenerative Pain Center
An experimental treatment offered for sale is not the same as a clinical trial.
Posted by Mitchell B. Sheinkop, M.D. in knee, Osteoarthritis, Platelet Rich Plasma, Regenerative Pain Center, Stem Cells on February 6, 2012
Musculoskeletal Care of the Mature Athlete
As I move closer to actually starting up the Bone Marrow Concentrate Stem Cell Pilot Study, I will continue to educate the perspective patient seeking to enjoy relief from arthritis of the hip and knee without a joint replacement. The delay is based on our having to wait for Institutional Review Board approval of our clinical trial. The fact that a procedure is experimental does not automatically mean that it is part of a research study or clinical trial. A responsible clinical trial can be characterized by a number of key features. There is preclinical data supporting that the treatment being tested is likely to be safe and effective. Before starting, there is oversight by an independent group such as an Institutional Review Board or medical ethics committee that protect patients’ rights, and in many countries the trial is assessed and approved by a national regulatory agency, such as the European Medicines Agency (EMA) or the U.S. Food and Drug Administration (FDA). The study itself is designed to answer specific questions about a new treatment or a new way of using current treatments, often with a control group to which the group of people receiving the new treatment is compared. While historically, the cost of the new treatment and trial monitoring is defrayed by the company developing the treatment or by local or national government funding; to date that has not occurred with stem cell trials in the United States. It takes an average of seven years and $750,000,000 to develop a new pharmaceutical therapy. With the rapidity in evolution of regenerative medicine, so far, no company has been identified that is willing to underwrite the expenses of a stem cell Trial. At the same time, beware of expensive treatments that have not passed successfully through clinical trials.
Responsibly conducted clinical trials are critical to the development of new treatments as they allow us to learn whether these treatments are safe and effective. I believe there is enough clinical experience to support a Pilot Study with Adult, Autogenous, Bone Marrow Derived Stem Cells. First no harm and a then reasonable chance of restoring function. To find out if you would qualify for the Pilot Study, contact Jennifer at 312-475-1893 ext.15
Stem Cell Crier
Posted by Mitchell B. Sheinkop, M.D. in Regenerative Pain Center, Stem Cells on January 30, 2012
Musculoskeletal Care of the Mature Patient
I’m back from a short Blog sabbatical, refreshed and with much to discuss. During the time away, I spent a week skiing in Colorado with my wife, read a book, The Immortal Life of Henrietta Lacks, a must read for anyone interested in or considering regenerative medical care, and kept up on issues that I believe would be of interest to readers. While I was gone, my staff continued to work and both finalized and submitted the request to The Institutional Review Board that will enable us to begin The Bone marrow Aspirate Concentrate Stem Cell (BMAC) management of osteoarthritis. I will share with you what I read, watched and observed.
From the American Medical Association Morning Rounds of Tuesday, January 24, Leading the News “Stem cell treatment may help patients with macular degeneration”
On NBC’s The Doctors-Jan 25, a Regenexx stem cell procedure is featured for a patient with a failed microfracture in a woman with an arthritic knee seeking return to an active life style.
The Immortal Life of Henrietta Lacks , written by Rebecca Skloot is the fascinating biography of a woman whose cells were harvested without her knowledge in 1956 at Johns Hopkins; and ultimately became responsible for the world of regenerative medicine today. Along with the factual history of how the first cell cultures of human cells has evolved into the practice of medicine as we know it today, one learns about the evolution of medical ethics, government mandated patient protection and informed consent processes that govern contemporary medicine. You will better understand my approach to regenerative medicine when you finish this book named by more than 60 critics as one of the best books of 2010.
We arrived in Vail on Saturday afternoon, January 21, just as a snowstorm was starting. By time we ventured out on Sunday morning, there was 12 inches of fresh powder at the top of Rivas Ridge. It snowed again two more times during the week with another 14 inches of fresh powder by time we headed down Shangri-La in China Bowl. During the week, a friend came over from Breckenridge with his snow- board. By the end of our Wednesday skiing, I needed regenerative care for my entire body; almost no one was on the slopes besides us.
Over the next two weeks, I am scheduled to do site visits to observe and compare notes with centers involved in BMAC. If you want to move forward with learning whether you might be a candidate for regenerative medical care of your arthritis before scheduling that joint replacement, make an appointment or make a call. While no authority can promise success, there is an accumulating body of global information suggesting autogenous, autologous, adult bone marrow derived mesenchymal cells my be an effective, long term, anti-inflammatory and perhaps alter the natural history of degenerative arthritis.
Mitchell B. Sheinkop
1565 N. LaSalle Street
Chicago, Illinois 60610
847-390-7666
FDA Warning on Stem Cells
Posted by Mitchell B. Sheinkop, M.D. in Osteoarthritis, Regenerative Pain Center, Stem Cells on January 12, 2012
Because of the 60 Minute Television program exposing fraud in the marketing of Stem Cells last Sunday, I feel it necessary to preempt the previously announced blog for this week with a word or more of caution. Sometimes called the body’s “master cells,” stem cells are the precursor cells that develop into blood, brain, bones and all of your organs. When used as a medical treatment, there is the potential to repair, restore, replace and regenerate cells and thereby treat many medical conditions and diseases including arthritis.
But the Food and Drug Administration (FDA) is concerned that the hope, which patients have for cures not yet available, may leave them vulnerable to unscrupulous providers of stem cell treatments that are illegal and potentially harmful. Witness the Sunday night episode of 60 Minutes.
FDA cautions consumers to make sure that any stem cell treatment they are considering has been approved by FDA or is being studied under a clinical investigation that has been submitted to and allowed to proceed by FDA.
Regulation of Stem Cells
FDA regulates stem cells in the U.S. to ensure that they are safe and effective for their intended use.
Stem Cells that come from bone marrow or blood are routinely used in transplant procedures to treat patients with cancer and other disorders of the blood and immune system.
Why my Pilot Study and then Clinical Trial? As part of these studies, I must show how the product will be harvested and prepared so that FDA can make certain appropriate steps are being taken to help assure the product’s safety, purity and potency.
Consumers need to be aware that at present—other than cord blood for certain specified indications—there are no approved stem cell products.
Advice for Consumers
- If you are considering stem cell treatment in the U.S., ask your physician if the necessary FDA approval has been obtained or if you will be part of an FDA-regulated clinical study. This also applies if the stem cells are your own. Even if the cells are yours, there are safety risks, including risks introduced when the cells are manipulated after removal.“There is a potential safety risk when you put cells in an area where they are not performing the same biological function as they were when in their original location in the body. Cells in a different environment may multiply, form tumors, or may leave the site you put them in and migrate somewhere else.
- If you are considering having stem cell treatment in another country, learn all you can about regulations covering the products in that country. Exercise caution before undergoing treatment with a stem cell-based product in a country that—unlike the U.S.—may not require clinical studies designed to demonstrate that the product is safe and effective. FDA does not regulate stem cell treatments used solely in countries other than the United States and typically has little information about foreign establishments or their stem cell products. China has recently announced a governmental mandated regulation of a prior free for all in the stem cell market.
- To reemphasize my approach to realizing the promise of stem cell management of arthritis; treatment at the Regenerative Pain Center will only be offered via Pilot Study or Clinical Trial under FDA governance and IRB regulation. Your cells will be harvested from your own bone marrow, concentrated, and administered to your arthritic joint.
Mitchell B. Sheinkop, M.D.
1565 N. LaSalle Street
Chicago, Illinois 60610
847-390-7666
On Proteins, PRP, Bone Marrow Concentrate, Stem Cells and Orthokine
Posted by Mitchell B. Sheinkop, M.D. in Platelet Rich Plasma, Regenerative Pain Center, Stem Cells on January 4, 2012
The difference between platelet-rich plasma therapy, also known as PRP, and the Orthokine treatment that Alex Rodriguez, Kobe Bryant and other athletes have received in recent months in Germany is fairly straight forward. I personally treat athletic injuries and arthritis with PRP; but, do not use the Orthokine procedure because it is not approved in the United States or Canada.
With PRP, I withdraw 20 cc blood, spin it in a special kit and inject plasma that is rich in platelets and lymphocytes into joints, thereby introducing growth factor and hopefully helping the body to heal itself. In the Orthokine procedure, 20 ccs of a patient’s blood are mixed in a tube with ‘factors,’ incubated for a time , the blood is spun down, and the substance is injected much in the same way as PRP.
The theory of Orthokine, which has also been used by Alex Rodriguez, Kobe Bryant and golfers Vijay Singh and Fred Couples, among other athletes, is that Orthokine addresses one of the possible triggers of joint disease; thought to be the protein interleukin. The theory is an attack on one of the culprits behind arthritis. The protein is an important part of the body’s immune system and has the ability to alter the function of other cells. IL-1 can be positive when it allows the body’s ‘repair troops’ to move in quickly to fight infection or other kinds of damage; but it can also trigger inflammatory processes that lead to degeneration and breakdown of cartilage. These negative effects are primarily responsible for the pain and stiffness of osteoarthritis.
The Germans say that another protein that counteracts the effects of IL-1 is a ‘good protein’ in the body called anti-IL(1) produced by blood cells that protects cartilage by keeping the pro-inflammatory proteins in check. It is the body’s own natural anti-inflammatory and that is what gets mixed in prior to incubation.
In none of these treatments, PRP, stem-cell therapy Yankee pitcher Bartolo Colon had performed in the Dominican Republic. Is there good published research readily available that confirms they are effective, although it could turn out to be so. Individual anecdotes suggest they work. The procedures are not banned by the World Anti-Doping Agency or by Major League Baseball. However, Rodriguez was given the go-ahead by MLB and the Yankees to have it done in Germany. While PRP is available throughout the United States, the Regenerative Pain Clinic Bone Marrow Concentrate Stem Cell Pilot is now open for enrollment. Bone Marrow Concentrate has all the right proteins but does it work? Why am I advocating Bone Marrow Concentrate?
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What’s in Bone Marrow Concentrate: Both pro- and anti-inflammatory cytokines and the factors: Fibroblast Growth Factor-b, PDGF-AB, TGF-B, and VEGF. |
Call to see if you might qualify for the clinical pilot trial.
Mitchell B. Sheinkop, M.D.
1565 N LaSalle Street
Chicago, Illinois 60622
847-390-7666
From Anecdote to Clinical Trial
Posted by Mitchell B. Sheinkop, M.D. in Regenerative Pain Center on December 28, 2011
If you watched the Los Angeles Lakers play the Chicago Bulls over the Christmas weekend, you would have heard the story repeated many times during the broadcast of how Kobe Bryant had traveled to Germany for a Platelet Rich Plasma treatment for his arthritic knee and how PRP is not available in the United States. My congratulations to Kobe Bryant and his doctors, it looks like the treatment worked although the Bulls did win. He played well and there was no visible sign of the bone-on-bone arthritic knee affecting him. To correct the announcers though, you should be aware that platelet rich plasma injection, not unlike that used in the case of Kobe Bryant, is widely available in the United States and FDA approved. Since April of this year, I have personally treated 28 patients with Platelet Rich Plasma including the knee, hip and shoulder. Improvement in arthritic symptoms and increased function has been observed in about 70% of those patients so far. That’s a reasonable improvement for arthritic impairment but is there something better? Might a non-surgical stem-cell treatment for people suffering from knee pain due to common injuries or other degenerative problems be a substitute treatment for arthroscopy or total knee replacement?
Original Article
Incidental Meniscal Findings on Knee MRI in Middle-Aged and Elderly Persons
Martin Englund, M.D., Ph.D., Ali Guermazi, M.D., Daniel Gale, M.D., David J. Hunter, M.B.,B.S., Ph.D., Piran Aliabadi, M.D., Margaret Clancy, M.P.H., and David T. Felson, M.D., M.P.H.
N Engl J Med 2008; 359:1108-1115September 11, 2008
Results
The prevalence of a meniscal tear or of meniscal destruction in the right knee as detected on MRI ranged from 19% among women 50 to 59 years of age to 56% among men 70 to 90 years of age. Among persons with radiographic evidence of osteoarthritis, the prevalence of a meniscal tear was 63% among those with knee pain, aching, or stiffness on most days and 60% among those without these symptoms. The corresponding prevalence among persons without radiographic evidence of osteoarthritis was 32% and 23%. Sixty-one percent of the subjects who had meniscal tears in their knees had not had any pain, aching, or stiffness during the previous month.
Conclusions
Incidental meniscal findings on MRI of the knee are common in the general population and increase with increasing age.
Because of the aforementioned scientific study, I have determined the following Inclusion criteria for the Bone Marrow Concentrate Pilot Study
1. Age over 50. For patients with an osteoarthritic defect on MRI
2. Near normal knee alignment
3. Symptoms referable to the cartilage defect:
Swelling
Pain
Giving way
Locking
Crepitation
4. Early OA with no evidence of inflammatory arthritis
5. >2mm residual joint space on X-ray
6. Unicompartmental osteoarthritis
a. ROM >-10 to 110
b. Mechanical axis <12 degrees varus or valgus
c. Minimal involvement of patella femoral joint
d. No >2-3mm laxity in any plane
To find out if you qualify for the study, call and make an appointment. For those who don’t qualify for inclusion in the Pilot Study, you still may be a candidate for Bone Marrow Concentrate treatment of your arthritic joint.
Mitchell B. Sheinkop, M.D.
1565 N. LaSalle Street
Chicago, Illinois 60610
847-390-7666
The Regenerative Pain Center
Posted by Mitchell B. Sheinkop, M.D. in Regenerative Pain Center on December 13, 2011
The Regenerative Pain Center
There is a very unique challenge concerning how to manage the effects of aging and the resulting impact on musculoskeletal well-being and continued participation in sports-from the weekend to the master athlete. Better understanding of the basic science of aging allows for better management of the physiological and biological issues and challenges facing the athletic baby boomer patient. The major problem as we age is weight gain despite a high level of activity and the same nutritional patterns as when we were younger. One must be aware that the body’s Resting Metabolic Rate (RMR) comprises 60-75% of daily energy expenditure and that RMR decreases 20% from childhood to retirement. The second major contribution to athletic decline is degenerative arthritis
The Basic Science of Aging :Implications for the Male and Female Master Athletes
We all must recognize the normal physiologic effects of aging and how our activities of daily living, work related undertakings, recreational enjoyment, and participation in sports are impacted. Are there appropriate non-operative treatment plans for patients with traumatic, degenerative, and arthritic conditions, particularly related to the knee, hip, shoulder and spine that might allow you to postpone or even avoid a joint replacement?
To address these issues, the Regenerative Pain Center (RPC) will open its Chicago doors next week with offices in Lincoln Park and Des Plaines; the sole purpose being an attempt at pain control through regenerative medicine. Is the timing right; is it premature? Last week, Dr. Jon Lapook on CBS NEWS Healthwatch reported on the experimental treatment Platelet Rich Plasma therapy, the procedure that appears to help heal a muscle, tendon or joint injury without surgery. Assessing the value of PRP therapy may be viewed at
http://www.cbsnews.com/video/watch/?id=7390747n&tag=mncol;lst;1
On page 3 of The Chicago Tribune/Business/Section 2/Friday, December 9, 2011 FOCUS STEM CELL THERAPY featured “Investors poised to pounce on a commercial breakout”. ”Early clinical trial successes of dozens of treatments bring hopes some will hit the market in 5 years.” To paraphrase, the promise of stem cells lies in their ability to repair tissue and reduce inflammation. While the Food and Drug Administration has not yet approved unfounded claims of success with regenerative menu of offerings, the FDA does not interfere in the clinical practice of medicine as long as there are no unsubstantiated claims made. Next week, I will announce a Pilot Study using autologous bone marrow concentrate for the treatment of patients impacted by arthritis made possible because of the Regenerative Pain Center.
Mitchell B. Sheinkop, M.D.
1565 N. LaSalle Street
Chicago, Illinois 60610
847-390-7666
PRP, Stem cells or Surgery
Posted by Mitchell B. Sheinkop, M.D. in Platelet Rich Plasma, Regenerative Pain Center, Stem Cells, Uncategorized on October 4, 2011
To operate or not to operate?
Although Joint Replacement Surgery is a fairly predictable and cost-effective intervention for severe osteoarthritis of a major joint, it is not necessarily the treatment of choice for everybody. There are issues surrounding the decision-making process for surgeon and patient. Treatment should begin with most basic options and progress to the more involved as not all treatments are appropriate for every patient. Not everybody gets better after a total hip or total knee replacement. An important minority estimated at 10%-20% does not improve or are made worse by surgery. Then there is the population of patients who have associated conditions, co-morbidities, which prevent them from undergoing a surgical procedure without severe medical risks.
Try Nonsurgical Therapy First
While orthopedic surgery is based on allopathic medicine, that is the scientific process; the key to good decision-making about whom should have a joint replacement should be a holistic approach. Weight Reduction is paramount; anything greater than a BMI of 25.5 will result in excess loading of your hip and knee. Activity modification is strongly recommended using a bike and the swimming pool for exercising, Low-impact aerobic fitness, range of motion and flexibility exercises, muscle strengthening, and core strengthening. I find a patellar stabilizing knee sleeve to be very valuable, the one with the hole in the center. Acupuncture, glucosamine and chondroitin sulfate still are homeopathic. While there seems to be a greater than 50% positive response to visco-supplementation in the knee, the American Academy of Orthopedic Surgeons will not endorse this approach. There is no question that intra-articular corticosteroids offer short-term pain relief both in the hip and the knee.
Arthroscopy
Not advised for debridement of an arthritic hip. The same holds in the primary diagnosis of symptomatic osteoarthritis of the knee. On the other hand, there is a place for partial meniscectomy or loose body removal when the primary symptom arises in the presence of osteoarthritis.
Orthobiologics (PRP and Stem Cells)
We do not yet know exactly who may benefit from platelet concentrate or bone marrow concentrate and which factors are most critical in assuring the best possible outcome. Even the exact scientific explanation for how stem cells really work is still in the works. Preoperative severity of arthritic disease is probably most important. At this time, the decision to undergo an ortho-biologic procedure is about balancing potential benefits against potential risks. Given the fact that the biologic is autogenous and confined to a major joint, the significant risk is infection; that’s the risk of any invasive procedure and exceedingly rare to date. The case studies suggest that the new world of stem cells is worth consideration before a joint replacement
Treating knee arthritis via joint preservation and regeneration
Posted by Mitchell B. Sheinkop, M.D. in knee, Osteoarthritis, Regenerative Pain Center on June 21, 2011
Musculoskeletal Care of the Mature Patient
There is a very unique challenge concerning how to manage the effects of aging and its impact on musculoskeletal well-being and continued participation in sports-from the weekend to the master athlete. As the majority of patients I see come for impairment of the knee, that will be the subject of this Blog. No matter which joint though, the major problem as we age is weight gain despite a high level of activity and the same nutritional patterns as when we were younger. One must be aware that the body’s Resting Metabolic Rate (RMR) comprises 60-75% of daily energy expenditure and that RMR decreases 20% from childhood to retirement. So too, just as there is a tendency to gain weight, there also is the reality of continued loss of muscle mass with aging. Even if your weight remains unchanged, your percent body fat will increase. If you don’t believe me, take your clothes off and look in the mirror. To make matters worse, joint cartilage doesn’t physiologically reproduce after age 40, so whether it be genetically programmed or from injury, the cartilage loss is historically irreversible.
All bad news so far about athletics with aging but the vicious cycle can be broken. First of all, try to be as thin as possible while still maintaining good health. Second, you need to strength train in addition to aerobic and anaerobic conditioning. That’s where cross training is exceedingly helpful. When your knee hurts, water based exercising is the fix. When you can’t run, biking is the approach. From my perspective, when the over the counter analgesics and anti-inflammatories aren’t affective, the first line of approach is an intra-articular cortisone injection coupled with a prescription for an anti-inflammatory and physical therapy. Bracing is beneficial starting with an over the counter support. Also consider an orthotic in your shoe to level your running and walking and thereby correct force transmission to the knee. The next step in magnitude for the arthritic knee is the unloading brace (orthotic) with or without the electro-stim adjunct. If the intra-articular cortisone injection benefit lasts four months, it may be repeated a total of three times in a year. If not, visco-supplementation is the next option. This injection of hyaluronic acid has proven very helpful in managing knee arthritis. The latter series of injections may be repeated twice a year at six-month intervals. While five years ago, the visco-supplementation series required up to five injections per series, now the demand is one to three visits owing to advances in science.
OK, you have done all these things and the pain and impairment relief are no longer affective, now what? Platelet Rich Plasma is the latest and maybe the greatest; we shall see. My colleagues and I are using PRP with early very positive early results. Caution, up until the usage of Platelet Rich Plasma, treatments were covered by private indemnification and Medicare either all or in part. PRP is an out of pocket expense. Naturally, the final step before a joint replacement will be stem cell based and we’re working toward that end. If you can’t wait, have a total knee replacement; there are inherent risks that are permanent so be a well-informed consumer. If you are able to wait, take my prescription and follow the algorithm for TREATING KNEE ARTHRITIS VIA JOINT PRESERVATION AND REGENERATION.
Rejuvenative Cellular Medicine Anecdotes
Posted by Mitchell B. Sheinkop, M.D. in Platelet Rich Plasma, Regenerative Pain Center, Stem Cells on March 1, 2011
Musculoskeletal Care of the Mature Patient
I am off skiing this week in Colorado so I thought I would let my readers entertain themselves with some anecdotes from the web.
Regenexx Knee Patient Finishes the Ironman
“This 68 year old went from being told he needed a knee replacement, to successfully resuming his triathlon career with a Hawaii Ironman finish! After the Regenexx-C procedure, he was able to complete the 2.4-mile swim, 112-mile bike ride and 26.2 mile run. You may read more at www.regenexx.com
10 Years of Knee Pain Erased
Patient underwent the Regenexx-C procedure to deal with osteoarthritis of the knee.
“I’ve had pain in both of my knees for the last 10 years. It began when I was in the Army, and I was finding it harder and harder to do all the lifting, running and physical exercise that I needed to do. I went to the Army doctors, who told me I had osteoarthritis in both knees, but there wasn’t much I could do. Even the Army medical review board simply remarked in my record that I couldn’t do some of the physical requirements because of my knee pain, but they didn’t offer any solutions.”
“Since then, I’ve been doing lot of physical therapy, but that only helps so much. I’m not much of a medicine taker, so I usually just worked through the pain. I’d have good days and bad days, but the pain was always there.”
“We did the right knee in March 2007. I was off my feet for about an hour after each of the treatments, but that was it. No long recovery time, no time off from work – it was great. The cartilage began to grow back, and the knee was feeling much better, so we did the left knee in October. Since about two weeks later, I haven’t had any pain at all in either knee for the first time in 10 years. It’s fantastic.” You may read more at www.regenexx.com
Hip Arthritis 2 Year Stem Cell Results Update
“A 50 year old woman was treated 2 years ago for moderate hip arthritis with an injection of her own cultured stem cells. The patient at that point had bone cysts, but good cartilage remaining. Two years later she reports good relief for the past 24 months with the hip feeling much more fluid. At this point, her hip is just beginning to feel less fluid with more stiffness, so she would like an updated injection. She was very good at growing stem cells in culture (some patients aren’t as prolific a cell grower as CM), so she has cells in cryo preservation (“on ice”), which can be used for this next injection (without having to draw more cells and re-culture). CM brings up an important point in our hip data. First, hip patients tend to have less relief on average than knee arthritis patients. This will be part of an upcoming publication, but we believe this may be caused by technical issues with getting stem cells to attach to the right areas of the hip when cells are placed through injection. CM had great range of motion when she was injected (often not the case with hip arthritis patients) and as a result, we got excellent placement of cells. The second observation in our data is that hip patients have less duration of effect than knee patients. This is likely due to the reasons above. Finally, since we only have 3-4 year follow-up data on a reasonable number of patients, any or all of our patients may need re-injections at some point in the future as a stem cell “booster shot”. You may read more at
Tissue Genesis awarded joint repair grant
More about rejenerative cellular medicine
Posted by Mitchell B. Sheinkop, M.D. in Platelet Rich Plasma, Regenerative Pain Center, Stem Cells, Uncategorized on February 22, 2011
Centrifugal force is used to create platelet-rich plasma. Solid blood elements (white blood cells, red blood cells, and platelets) are separated via centrifugation due to variations in size and density.
Because of the FDA mandated prohibition on the maximal manipulation of stem cells and the rigorous enforcement crackdown this past September, those clinical propnents of autologous bone marrow derived adults mesenchymal stem cells have not been able to continue with their respective therapeutic initiatives. As a result, poorly informed patients are seeking Platlet Rich Plasma.
PRP an unproven options, say experts
An international group of orthopaedic surgeons, clinician scientists, and researchers concluded during the American Academy of Orthopedic Surgeons annual meeting this past week that, for many orthopaedic conditions, administration of platelet-rich plasma (PRP) may be an option, but its efficacy is unproven. The participants of the 2011 PRP Forum also endorsed the development of standards in the manufacture of PRP, noted that PRP may be contraindicated in some conditions, and called for the establishment of a study group to follow up on the other recommendations resulting from the session.
Attendees discussed the applicability of PRP in the following areas:
- treatment of acute soft-tissue injuries, such as Achilles tendon rupture and rotator cuff repair
- chronic tendinopathies such as plantar fasciitis or medial/lateral epicondylitis
- augmentation of soft tissue or bone such as in spinal fusion
- treatment of cartilage defects such as those resulting from osteochondral lesions or osteoarthritis.
All PRPs are not the same
All PRPs are not the same and the treating physicians may not be aware of what they are putting in the patient. Although PRP is a concentrated, autologous preparation developed from your own blood, some concentrations may contain double the number of platelets while others may contain five or ten times the number of platelets. The proportion of white blood cells, growth factors, and other compounds such as thrombin can also affect the compound.
If the truth be told, we don’t know how PRP works.. Most of the published literature on the efficacy of PRP in treating orthopaedic conditions that range from acute rotator cuff repair.
