Does Platelet Rich Plasma Really Work?

By Amy Price PhD

What is Platelet Rich Plasma Treatment (PRP)?


PRP has been around since the 1980s but mostly as an adjunct to surgical or dental procedures. PRP patients have a small amount of their own blood removed and then processed through a centrifuge machine. The high speed rotation separates red blood cells from the platelets. A teaspoon or two of the clear platelet rich concentrate (3 to 10 times that of regular blood) will be returned and injected into damaged areas to catalyze the growth of new cells.

Various methods are now commercially available for preparing PRP and a similar material called “autologous growth factor,” which is PRP plus the white blood cell buffy coat obtained during PRP preparation. As a result, assessment of these strategies in clinical orthopedic practice has accelerated.

The platelet rich mixture can be injected where the area does not normally have a rich blood supply and has the advantage of not triggering a clotting response. Patients are their own donors so there is little risk of rejection, allergy or transmissable infections Some stem cell companies are combining PRP with stem cell therapy to increase healing results. The theory and technique behind PRP is similar to that of Prolotherapy (proliferation therapy). Typically Prolotherapy treatments are offered first, and mostly resolve musculoskeletal problems. When results from traditional Prolotherapy treatments are not adequate, PRP may be employed. PRP and Prolotherapy, are office procedures.

How does PRP therapy help?

The body’s responds to injury by mobilizing platelet cells. Platelets are packed with multiple healing and growth factors which initiate repair while attracting stem cells the bodies built in construction managers. PRP intensifies the body’s healing efforts by delivering concentrated platelets. The technique appears to help regenerate ligament and tendon fibers, which shortens rehabilitation time.

How long will it take?

One to two hours, including preparation and recovery time is the average time for the procedure. Advantages include pain relief and speedy healing without the risk of surgery, Many individuals can return to work right after the procedure.

How often can a person have PRP done?

The norm is three injections within a six-month time frame, two to three weeks apart. Relief is usually recognized after the first or second injection.

What are the expected results?

Initial improvement may be seen within a few weeks, gradually increasing as the healing progresses. Some doctors describe PRP as a growth factor cocktail. MRI images after PRP have shown definitive tissue repair. It seems to work better on soft tissue areas like tendons and ligaments, in bone injury it may even slow healing. Results are donor dependent and certain health conditions such as diabetes, thyroid disease or habits like smoking and heavy drinking may hinder the effectiveness as can hormone deficiencies. Younger patients and athletes have more growth factors resident in platelets so this makes them better overall candidates Research into the effects of platelet-rich plasma therapy has accelerated in recent months, with most doctors cautioning that more rigorous studies are necessary before the therapy can emerge as scientifically proven. Even with a 20-40% failure rate many researchers suspect that the procedure could grow in attractiveness treatment for reasons both medical and financial. PRP is about 2000.00 dollars, stem cell therapy is about 8000.00 per site plus travel, diagnostics, preparation and time whereas surgery is much more expensive with extensive recuperation time. PRP has also been used to augment surgery with promising results.

References

1. Rai B, Oest ME, Dupont KM, Ho KH, Teoh SH, Guldberg RE: Combination of platelet-rich plasma with polycaprolactone-tricalcium phosphate scaffolds for segmental bone defect repair. J Biomed Mater Res A 2007;81:888-899.

2. Sipe JB, Zhang J, Waits C, Skikne B, Garimella R, Anderson HC: Localization of bone morphogenetic proteins (BMPs)-2, -4, and -6 within megakaryocytes and platelets. Bone 2004;35:1316-1322.

3. Kark LR, Karp JM, Davies JE: Platelet releasate increases the proliferation and migration of bone marrow-derived cells cultured under osteogenic conditions. Clin Oral Implants Res 2006;17:321-327.

4. Gruber R, Kandler B, Fischer MB, Watzek G: Osteogenic differentiation induced by bone morphogenetic proteins can be suppressed by platelet-released supernatant in vitro. Clin Oral Implants Res 2006;17:188-193.

5. Ranly DM, McMillan J, Krause WF, Lohmann CH, Boyan BD, Schwartz Z: Platelet-rich plasma: A review of its components and use in bone repair, in Akay M (ed): Encyclopedia of Biomedical Engineering, vol 5. Hoboken, NJ: John Wiley & Sons, Inc., 2006, pp 2804-2815.

6. Ranly DM, Lohmann CH, Andreacchio D, Boyan BD, Schwartz Z. Platelet-rich plasma inhibits demineralized bone matrix-induced bone formation in nude mice. J Bone Joint Surg Am 2007;89:139-147.

7. Schwartz Z, Somers A, Mellonig JT, et al: Ability of commercial demineralized bone allograft to induce bone formation is donor age-dependent but not gender-dependent (abstract). Trans Orthopaed Res Soc 1997;22:230.

8. Weibrich G, Kleis WK, Hitzler WE, Hafner G. Comparison of the platelet concentrate collection system with the plasma-rich-in-growth-factors kit to produce platelet-rich plasma: A technical report. Int J Oral Maxillofac Implants 2005;20:118-123.

9. Thibault L, Beausejour A, de Grandmont MJ, Lemieux R, Leblanc JF: Characterization of blood components prepared from whole-blood donations after a 24-hour hold with the platelet-rich plasma method. Transfusion 2006;46:1292-1299.

10. Li H, Zou X, Xue Q, Egund N, Lind M, Bunger C: Anterior lumbar interbody fusion with carbon fiber cage loaded with bioceramics and platelet-rich plasma: An experimental study on pigs. Eur Spine J 2004;13:354-358.

11. Weiner BK, Walker M: Efficacy of autologous growth factors in lumbar intertransverse fusions. Spine 2003;28:1968-1970.

12. Muschler GF, Nitto H, Matsukura Y, et al: Spine fusion using cell matrix composites enriched in bone marrow-derived cells. Clin Orthop Relat Res 2003;(407):102-118.

13. Muschler GF, Matsukura Y, Nitto H, et al: Selective retention of bone marrow-derived cells to enhance spinal fusion. Clin Orthop Relat Res 2005;(432):242-251.

14. Brodke D, Pedrozo HA, Kapur TA, et al: Bone grafts prepared with selective cell retention technology heal canine segmental defects as effectively as autograft. J Orthop Res 2006;24:857-866.

15. Murray MM, Spindler KP, Ballard P, Welch TP, Zurakowski D, Nanney LB: Enhanced histologic repair in a central wound in the anterior cruciate ligament with a collagen-platelet-rich plasma scaffold. J Orthop Res 2007;25:1007-1017.

Keep Todays Memories For Tomorrow-Free Screenings

Sparks of Genius Brain Optimization Center to Hold Free Memory Screenings

National Event Stresses the Importance of Proper Detection and Treatment

Boca Raton, FL— Consumers who want a status check on their memory can take advantage of free, confidential screenings on November 17 as part of National Memory Screening Day, an annual initiative of the Alzheimer’s Foundation of America (AFA) designed to promote proper detection of memory problems and strategies for successful aging.
Memory screenings are a significant first step toward finding out if a person may have a memory problem. Memory problems could be caused by Alzheimer’s disease or other medical conditions.
Now in its seventh year, AFA’s National Memory Screening Day coincides with National Alzheimer’s Disease Awareness Month, which takes place during November.
On November 17, Sparks of Genius Brain Optimization Center will hold memory screenings at 7777 Glades Road, Boca Raton, from 10 am – 3 pm. Please call 561-859-4060 for more information or to make an appointment. You are also welcome to stop by. Refreshments will be provided.
At Sparks of Genius we offer cognitive training program which can slow down the progression of memory loss or delay it’s onset.
AFA suggests memory screenings for adults concerned about memory loss or experiencing warning signs of dementia; whose family and friends have noticed changes in them; or who believe they are at risk due to a family history of Alzheimer's disease or a related illness. Screenings also are appropriate for those who do not have a concern right now, but who want to see how their memory is now and for future comparisons.
The event features a face-to-face screening, which takes only about five to ten minutes, and consists of a series of questions and tasks. Screenings will be conducted by Dr. Rohn Kessler, Dr. Amy Price and Ninah Kessler, LCSW. The results do not represent a diagnosis, and AFA advises those individuals with below-normal scores or those who have normal scores but are still concerned to follow up with a qualified healthcare professional.
Eric J. Hall, AFA’s president and CEO, is urging consumers “to be proactive about brain health.”
”We pay so much attention to the health of our bodies, but we should be equally concerned about the health of our brains,” he said. “National Memory Screening Day offers the opportunity to find out how your memory is now and to learn how to protect it in the future.”

For more information about National Memory Screening Day, visit www.nationalmemoryscreening.org or call 866-AFA-8484.

Telomeres, Telomerase and The Graduate Student

By Amy Price PhD
Carol Greider was still a graduate student when she started work on a project that along with Elizabeth Blackburn and Jack Szostak  won this year's Nobel prize for medicine. These US-based researchers  discovered how the body protects the chromosomes housing vital genetic code.

Genetics intrigue me because they are beautifully ordered and I have wondered and asked how the telomeres and telemorase are sequenced. When the telemeres are shortened life span is reduced whereas if there is uncontrolled growth cell corruption occurs. These scientists did more than ask they worked together to find answers.

Elizabeth Blackburn, of the University of California, San Francisco, and Jack Szostak, of Harvard Medical School, discovered that a unique DNA sequence in the telomeres protects the chromosomes from degradation.


Joined by Johns Hopkins University's Carol Greider, then a graduate student, Blackburn started to investigate how the teleomeres themselves were made and the pair went on to discover telomerase - the enzyme that enables DNA polymerases to copy the entire length of the chromosome without missing the very end portion.

Some inherited diseases are now known to be caused by telomerase defects, including certain forms of anaemia in which there is insufficient cell divisions in the stem cells of the bone marrow. Apparently elevated telomerase can be a biological marker for malignancy and there is research underway to see if vaccines can be developed to arrest the defects.

The Nobel Assembly at Sweden's Karolinska Institute, which awarded the prize, said: "The discoveries... have added a new dimension to our understanding of the cell, shed light on disease mechanisms, and stimulated the development of potential new therapies."

Disease and Genomic Advances

By Amy Price PhD

Until recently only a geneticist Francis Crick and one other individual have had their genome read. Apparently Dr Crick did not wish to know if he had a specific dominant gene for dementia but was happy to know all other variants. No one knows the public impact in the face of fullscale  genetic information and there are ethical concerns as genetic engineering has not enjoyed a widespread safety or success rate but it appears the tide may be shifting.

A 5 month old male baby from Turkey was critically ill. Scientists and doctors teamed together from multiple nations to enable the reading of  his genome quickly and were able to work out that he had a wrong diagnosis. This was reported in 'Proceedings of the National Academy of Sciences'. The analysis only took ten days and determined that the boy suffered a genetic mutation that coded for a gut disease that eventually destroys other organs including the kidneys. Additional clinical tests determined that the boy had the rare disease and he is now recovering.

The boy's physician sent a blood sample and Dr Lifton of Yale Medical school along with teams in Beirut and Turkey decoded the DNA to reveal a diagnosis. The scientists did a follow up study with 39 patients who had the same condition the boy was originally thought to have and found that five them had the same genetic mutation. For practical reasons, the initial concentration is on the small percentage of the genome which codes for proteins rather than the non coding DNA.

Rather than the usual method of  looking one gene at a time hoping to guess which was the right gene causing the problems,  a new method was utilized where they could look at all the genes in the genome simultaneously.  They identified a specific allele which had mutations on both copies and which causes the sufferers not to be able to absorb water or electrolytes through the gastrointestinal tract.

This is a turning point in personalized predictive medicine. Professor Mike McCarthy, a geneticist at Oxford University commented, "This is an interesting study - lots of groups are now using the power of new methods for sequencing the human genome to find DNA changes that underlie rare diseases (and increasingly for common diseases too)".

There is tremendous potential for Genomics to pave the way for diagnostic breakthroughs.

Brain Optimization For The Job You Want!

By Ninah Kessler, Brain Fitness Coach

Can an economic downturn be good? Can it help you to recreate your life at a higher level? It can if you have the right mindset. That’s why it’s so important to teach your brain to think positively. But we also have to take care of the machinery of the brain itself. We need brain fitness.

The experts used to think that we all had a limited number of neurons in our brain. Then in the 1990’s, the decade of the brain, neuroscientists discovered that we could develop new neurons and new neuronal connections at any age. If we want to succeed in this new millennium, it behooves us to strengthen our brains.

Without help, our brains reach their peak in our twenties and then start deteriorating. By our 40’s we can usually notice a difference. It’s really very similar to what happens to our bodies. On the cognitive level, names disappear and our brains slow down. Multitasking becomes more challenging. The technical term for this is age related cognitive decline. It’s normal, but it’s not nice.

The good news is that there are things that we can do to slow down and reverse this process.

I’d like to give you an analogy from the physical world. In the 2008 Summer Olympics Dara Torres beat out women half her age to bring home silver medals. How did she do that? It wasn’t luck or chance. She created a professional training team to supercharge her body. On the everyday level, if you want to create a functional aesthetically pleasing body, you have a better chance if you work with a professional trainer or at least take a class. If you are extremely motivated, you can create your own program, but most of us do not have this level of commitment.

The key to training our brains is to expose ourselves to new and novel stimulation, continually challenging ourselves to take it to a higher level. Now we can all do this on our own to a certain degree. Crossword puzzles and suduko are good, and Nintendo DS, bridge, golf and bananagrams are even better. Traveling is great, especially if you learn a language, and playing a new musical instrument is a great neuronal enhancer. And don’t forget to eat a healthy diet, get physical exercise and decrease stress.

But the experience is enhanced with the expertise of a brain fitness coach. It is brain science to know that there are many different abilities that need training – logic, memory, attention, processing speed and mental flexibility, to name a few. Creating a training program that compensates for your weaknesses and enhances your strengths is an art.

When you’re looking for a job, you need your brain to be at its best. You need mental flexibility to figure out where the jobs are and how to format your old job qualifications into skills sets that will take you where you want to be. You need auditory processing ability and processing speed to answer questions in an interview. The best way to get these skills is with a brain fitness coach. You can even increase your brain fitness even if you’re dyslexic, have adult ADHD or a brain injury. Those with cognitive challenges often benefit the most.

A brain fitness coach can help you with stress too. It’s so easy for our thoughts to take a negative direction especially when we are looking for a job. Do you really have the luxury of wasting long periods of time in an unnecessary funk?

At Sparks of Genius, we’ve been training people to get the most out of their brains since 2001 and we have been cited as a brain fitness leader in The Wall Street Journal. You can work with your own personalized fitness coach or be part of a group. One day brain fitness coaches will be as popular as life coaches or personal trainers. But for you, that day can be now.

Ninah Kessler, LCSW, Brain Fitness Coach. SparksofGenius.com 561-859-4060

TBI and Hypothyroid Connection

Thyroid problems may make you fat and moody
By Amy Price PhD

People who have sustained head or serious neck injuries can also damage the thyroid as well. Sometimes people who are diagnosed with whiplash later develop thyroid issues. Many of the symptoms of hypothyroid are the same as those as those for people who have dealt with a brain injury so they tend to be ignored. This is tragic because low thyroid levels can eventually lead to cognitive damage and even dementia. The thyroid can be damaged even if you are thin. It is not always true that people gain massive amounts of weight with this kind of condition just as it is not true that people with a past brain injury need to be constantly exhausted or depressed. The video above will tell you about symptoms and what you can do about this disorder

Your thyroid gland weighs less than an ounce and is located in the front of your neck just below the Adam’s apple. The thyroid acts as a feedback mechanism for your metabolism so when it is too slow or too fast this can upset a lot of body functions The thyroid gland takes iodine and converts it into thyroid hormones. Thyroid cells are the only cells in the body which can absorb iodine. These cells combine iodine and the amino acid tyrosine to make T3 and T4. T3 and T4 are then released into the blood stream and are transported throughout the body where they control metabolism (conversion of oxygen and calories to energy). Every cell in the body depends upon thyroid hormones for regulation of their metabolism.

Get this checked by your doctor. It takes a simple blood test and oral medication. This disorder can show up years after an injury so be aware.


Symptoms of a slow thryroid include

•Fatigue, Depression

•Weight gain or increased difficulty losing weight, or loss of appetite

•Coarse, dry hair, thinning hair or outer portion of eybrows thinning out

•Dry, rough pale skin,

•Cold and heat intolerance  (you can't tolerate cold temperatures like those around you)

•Muscle cramps and frequent muscle aches, weakness

•Constipation

•Depression, Irritability

•Memory loss, lack of focus, reduced coordination

•Abnormal menstrual cycles, decreased interest in sex

Hip Replacement Alternative

By Amy Price PhD
My husband underwent adult stem cell therapy in hopes of staving off hip replacement. The technique in the USA was in the early stages and his hip degeneration was acute. In the end he underwent bilateral hip resurfacing in the UK. The procedure was successful and gave him his life back. The UK surgeons were most interested in stem cell therapy and they were working on getting stem cells federally funded particularly for revision surgery which happens when the artificial hip wears out after about fifteen years.

It was exciting to learn about six hip patients who underwent a very creative stem cell procedure in Spire Hospital, Southhampton UK. This procedure could prevent thousands of people from needing to have an artificial hip fitted.

Here is a short breakdown on how they are doing this. Surgeons are using the patient’s own stem cells to rejuvenate the affected bone and donor bone to speed the process. The stem cells are extracted from the patient’s pelvis, purified and cultured in an organic mixture that promotes growth. When the cells had multiplied they were mixed with cleaned, ground-up hip bone from other patients who had hips replaced.Surgeon then excised dead tissue from the ball of the hip and filled the cavity with the mixture of stem cells and donated bone.

Professor Richard Oreffo of Southampton University explains that stem cells send out chemical signals to attract blood vessels. "Bone is a living vibrant tissue. These stem cells generate new tissue and drive new blood vessel formation to bring in nutrients," he said.

Dr Dunlop is hopeful that this therapy will fix the hip for life. Early reports look promising with good results in 5 out of 6 study participants. The television footage on this was stunning. One patient who had his procedure a year ago looked like he had never experienced a hip problem.
Scientists and doctors are working together to expand this study and to explore the viability of using artificial bone. This would eliminate the problem of donor generated deficits being passed on although I suspect those already in need of new body parts are happy to take their chances.

This news is hot on the heels of research by scientists in New Jersey USA who have successfully isolated nerve growth factors in mesynchemal stem cells and grown them out as published in the latest issue of the Journal of Neurochemisty. Cell biology and Genetic engineering advances may soon provide real answers for those with untreatable neurodegenerative conditions and even those who have sustained brain injury.
Scientist and doctor teams are now considering how this therapy could be applied to other degenerative conditions.