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.

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

Save This Brain

By Amy Price PhD

There have been multiple articles featuring brain and serious neck injury stating how people have overcome cognitive obstacles despite adversity. I celebrate these articles as I know from personal experience the tolls that this road takes and the cost to family members and supporters. One mother was explaining how one minute her brain injured son could do complex algebra and the next he could not tell a red diamond from a black spade in a deck of cards. I too remember those days.

The cognitive inconsistencies are joined by emotional areas. Sometimes the brain will forget what we want it to remember and play over and over like a broken tape those areas we only want to put behind us. The other day I found some practical help in the way of videos and research on how to navigate the initial trauma. These outline what to expect in the emergency room, how to protect yourself in the event of a crash and ways you can help yourself get the best medical care. I thought I would share them here. If you go to the web site you can download the material as MP3 or as PDF files. This is a brilliant solution as watching a video makes it tough to pick up the references which are the key to deeper study...Enjoy!

In the next few posts there will be strategies for overcoming brain fog and getting the sharp mental edge back

Your Brain On Trauma

By Amy Price PhD

Brains have axons. These are tiny fibers that are like an electronic circuit board. Axons make brain communication possible. If these are stretched past ten percent of their length they can not function and the connection is broken. To put this in perspective you can stretch your hair sixty percent beyond its length before it breaks. Broken connections mean lost function. Hair can be broken simply by running a brush through it. We seldom question the news when we are told the ninety pound teenager shook the baby to death. Yet when an adult brain is shaken by the impact of a 2500 pound car people think this could not happen. The injured are often asked if they were unconscious. The sad truth is that most brain injured people will not know if they were unconscious and will just say no.

The brain...you can build it a team can help!

Dr. Gail Denton author of the best selling book Brainlash states the Brain Injured person needs a team to restore their potential. Dr Denton wrote the first addition of this book after she sustained a brain injury. She is a successful artist, author and therapy consultant. She is presently working on research to determine the optimal brain diet and has contracted with her publisher to produce a new book featuring food for the brain and great recipes. Brain Injury does not have to be a death sentence! For helpful strategies for yourself or others take a look at this book!

Every brain injury is unique. Recovery usually does not mean returning to who and how you were before, but rather finding a new relationship to your abilities and your world. Lisa sustained a brain injury in 1993. She used her recovery to create a remarkable tool for individuals and families that struggle with brain injury. The kit was developed with Sandra J. Knutson, CRC, CDMS, CCM, Lisa’s former brain injury caseworker, and a thirty-year veteran in the brain injury recovery community. The Brain Injury Recovery Kit™ (BIRK) was created by Lisa Keller.

Try the complimentary 39 Point Learning Assessment to see if you can be set free from brain fog and live in the land of clarity! Try some free brain games to help with brain fog. CDC has published a helpful guide about what to do if you or a loved one has experienced a head injury with or without loss of consciousness. It is free http://www.cdc.gov/ncipc/tbi/tbibook.pdf

'Peace is not the absence of war....it is a deposition for benevolence, confidence and justice' (Francis Bacon)