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Debunking myths about PRP

Debunking myths about PRP

Mar 20, 2022

Photo by Kindel Media on Pexels
PRP is a minimally invasive outpatient procedure and can reduce pain, improve function and help you return to your normal activities or sporting pursuits. This novel approach, despite its success in clinical studies, is still surrounded by several myths. So, let’s debunk them.

1. PRP therapy requires surgery.

The plasma, the liquid where the platelets reside, is drawn from your body before being placed in a machine that separates the PRP from the rest of the blood. This PRP is then injected into the area of your body being treated. Once the platelets are in the target area, they will break down, releasing growth factors, important proteins that stimulate cell growth, differentiation, survival, inflammation, and tissue repair; collectively triggering your body’s healing process.
As you can see, PRP therapy does not require surgery, solely injections. In most instances, real-time imaging will also be used to guide us and ensure that the PRP is injected directly at the site of your injured tissues.

2. PRP is only good for pain relief.

Although PRP is generally used in patients with chronic pain conditions, there are so many additional benefits that this treatment will present beyond pain relief. This includes reduced inflammation, the recruitment of stem cells to the area triggering new tissue production, stimulation of blood vessel growth, and the degeneration prevention of healthy tissues. These benefits combine to speed up tissue regeneration and healing, relieving your pain. This is especially beneficial for athletes who are looking to get back on their feet as soon as possible.

3. PRP is a highly risky procedure.

Given that PRP therapy relies solely on injections, the procedure itself is deemed exceptionally safe. For starters, the plasma injected is autologous, meaning that it is made for your own blood, and you do not need to worry about potential negative reactions or side effects. What’s more, PRP therapy has been used for several years now, with no major complications being reported.

One study, in particular, investigated the clinical application and safety of PRP therapy for patients with patellar tendinopathy, a condition that causes chronic back pain. One of the key points the researchers noted, besides the remarkable improvement in back pain, was the safety of PRP and that no complications or side effects were seen across all 15 clinical studies included.

Considering PRP therapy but don’t know where to start? Or have more questions that you need answering? Get in touch with our team to discuss your options and how we can help relieve your pain.

Can regenerative medicine help with back pain?

Can regenerative medicine help with back pain?

Mar 4, 2022

Photo by Gordon Cowie on Unsplash

Back pain is a silent problem amongst the general population, with figures suggesting that approximately 1 in 6 people are experiencing back pain at any given time in England. What’s more, back pain is deemed the largest single cause of disability across the UK. But why is this? And why are the numerous treatments available not bringing these numbers down?

Most cases of back pain are caused by muscle and ligament strains and, in the vast majority of cases, cannot be avoided. However, there are several other causes of back pain, including sciatica, a slipped disc, and ankylosing spondylitis, that can often occur spontaneously and without trauma. Then, we move to treatments. For the most part, treatments of back pain focus on rehabilitation and pain management, which, although great in getting you back on your feet, does not always treat the underlying cause and prevent further injury. Sports medicine is a great option to educate you on preventative measures; however, regenerative medicine offers more long-term symptom relief.

The role of regenerative medicine

Let’s first consider platelet rich plasma (PRP) injections. For those experiencing repetitive and debilitating back pain, surgery is usually the last option you want to take; however, PRP offers an effective alternative that could treat the pain of your injury as well as prevent further strains. Depending on the root of your back pain, PRP can be injected into the discs, facet joints, and paraspinal muscle, with previous patients seeing an improvement in their symptoms within six weeks of their first treatment. In clinical studies, PRP injections have been used to treat patients with degenerative disc disease, join-related pain, and pain or functional decline caused by facet joint arthropathy.

Mesenchymal stem cell therapy, on the other hand, has shown great success in patients with chronic discogenic low back pain. This type of pain is caused by chemically or mechanically damaged discs in the back and is often caused by trauma. However, this pain also arises due to deterioration as a result of ageing. Stem cell therapy is deemed a valid alternative treatment for back pain caused by disc disease, with one study demonstrating treatment success in over 90% of patients. This success is down to the regenerative impact of stem cells and their ability to differentiate into cartilage at the site of injury.

The key distinction between Opus and other private clinics in the UK is that we are the only institution that offers a regulated and licenced mesenchymal stem cell treatment. Get in touch with our team to discuss how we can support you in your treatment journey using either our world renowned sports medicine specialists or regenerative medicine.

Platelet rich plasma: The scientific evidence

Platelet rich plasma: The scientific evidence

Feb 17, 2022

We have already had a look at how platelet rich plasma (PRP) works (if you haven’t had a chance to read this yet, you can find it here), but now we are going to dive more deeply into the scientific evidence behind this treatment.
Randomised controlled trials (RCTs) are the gold standard study for determining if one treatment offers superior benefits over another. In these trials, patients are randomly assigned to either receive the treatment of interest or an alternative treatment, usually the standard of care or a placebo. Moreover, the patients are ‘blind’ to what treatment they are receiving. Here, we are going to look at two RCTs that investigated the use of PRP to treat knee osteoarthritis and chronic tennis elbow.

Knee osteoarthritis

A study by Bansal et al. (2021) investigated the optimal dose and concentration of therapeutic PRP required to achieve the desired physiologic efficacy. One hundred and fifty patients were enrolled in this trial, with then being randomised to either receive PRP or hyaluronic acid for their knee osteoarthritis.
The results revealed a significant improvement in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), International Knee Documentation Committee (IKDC) score*, and six-minute pain free walking distance. Besides external improvements, this trial also noted a significant decline in IL-6 and TNF-a levels in the PRP group when compared to the hyaluronic acid group at six months, both of which assist in mediating an inflammatory state (Bansal et al., 2021). If you would like to read more about the role of these cytokines in osteoarthritis, we have an additional blog post discussing just that.
Collectively, this trial, along with several others, demonstrate the efficacy of PRP, specifically with an absolute count of ten billion platelets, in achieving a long sustained chondroprotective effective in arthritis.
*The WOMAC represents an osteoarthritis index and measures a patients’ physical function, pain, and stiffness over a 48 hour period. The IKDC, on the other hand, gives an indication of a patients’ condition, containing questions on knee symptoms, overall function, and sports activities. The scoring system ranges from zero to one hundred, with zero representing the lowest level of function and the highest level of symptoms.

Chronic tennis elbow

A study by Mishra et al. (2014) evaluated the clinical value of tendon needling with PRP in 230 patients with chronic tennis elbow compared with an active control group. Patient outcomes were followed for up to 24 weeks, with the findings revealing several beneficial results at this mark. In those treated with PRP, a significant improvement of 71.5% was observed in their pain scores. Moreover, the percentage of patients reporting significant elbow tenderness notably decreased over this time. This demonstrates the clinical efficacy of PRP in the treatment of chronic tennis elbow on a larger scale (Mishra et al., 2014).

References

Bansal, H., Leon, J., Pont, J. L., Wilson, D. A., Bansal, A., Agarwal, D. & Preoteasa, I. 2021. Platelet-rich plasma (PRP) in osteoarthritis (OA) knee: Correct dose critical for long term clinical efficacy. Scientific Reports, 11, 3971. Mishra, A. K., Skrepnik, N. V., Edwards, S. G., Jones, G. L., Sampson, S., Vermillion, D. A., Ramsey, M. L., Karli, D. C. & Rettig, A. C. 2014. Efficacy of platelet-rich plasma for chronic tennis elbow: a double-blind, prospective, multicenter, randomized controlled trial of 230 patients. Am J Sports Med, 42, 463-71.
Platelet rich plasma injections for tendonitis

Platelet rich plasma injections for tendonitis

Feb 17, 2022

Platelet rich plasma treatment(PRP)
represents a promising approach to therapy for a range of conditions, including torn tendons, arthritis, muscle injuries, and tendonitis. We have already looked at the process of PRP and the underlying scientific evidence in our previous posts. Now, we are going to look specifically at the use of PRP in the treatment of tendonitis. But first, what is tendonitis, and how does it affect a person?

Tendonitis is a term used to define inflammation and pain following a tendon injury. This usually causes significant pain, stiffness and alters how the tendon can move. The most common areas that are affected by tendonitis are the rotator cuff, the elbow, and the Achilles tendon, with an overall prevalence of an estimated 11.6% in the general population. Although most cases of tendonitis resolve themselves within two to three weeks with relative rest of the area, icing, and strengthening exercises, a number of cases require medical intervention if they persist.

PRP therapy for tendonitis generally involves three injections, given at two to three week intervals; however, in certain cases, further injections may be needed to complete your journey. But do not worry; our doctors at Opus will discuss this and the treatment protocol with you throughout the process. The procedure itself follows three stages:

    1. The plasma, the liquid where the platelets reside, is drawn from your body through the blood.
    2. This is then placed in a machine to separate the PRP from the rest of your blood.
    3. The PRP is then injected into the area where you are experiencing tendonitis.

    Once the platelets are in the target area, they will break down, releasing growth factors. These growth factors are the pivotal component of PRP and are the reason that this treatment has shown great promise in conditions such as tendonitis. Growth factors are important proteins that stimulate cell growth, differentiation, survival, inflammation, and tissue repair; collectively, triggering your body’s healing process. Specifically, in the treatment of tendonitis, growth factors play an important role in the tendon healing process. Not only are they directly involved in tendon tissue engineering, but they have also been shown to stimulate the action of mesenchymal stem cells. To understand the role of these stem cells in regenerative medicine, we discuss them in more detail here.

    If you or someone you know are suffering from tendonitis, book an appointment today to speak to one of our team at Opus on the next steps to reduce your pain and improve your everyday function.

    Mesenchymal stem cell therapy: How does it work?

    Mesenchymal stem cell therapy: How does it work?

    Dec 20, 2021

    Photo by Pixabay from Pexels

    Mesenchymal stem cells are defined as multipotent adult stem cells, but what does this actually mean? Stem cells are important cells that are produced by your bone marrow and can differentiate into many types of blood cells, including both red blood cells and white blood cells. 

    Mesenchymal stem cells are a specific branch of stem cells that are able to divide and differentiate into a number of different tissues, including bone, cartilage, muscle and fat cells, and connective tissue. You might still be thinking, how does this work, or how can this help treat conditions, such as osteoarthritis? Well, let’s take a look.

    There are four stages of osteoarthritis. Firstly, we have the minor stage where there is minimal wear and tear to the joints, with little pain experienced. Then we move on to the mild stage. Here, there are more noticeable bone spurs, in addition to increased pain and stiffness after periods of inactivity. As osteoarthritis progresses to the moderate stage, the cartilage in the affected area begins to erode, causing significant inflammation and discomfort when carrying out everyday activities

    The final stage of osteoarthritis, the severe stage, will cause a lot of pain, with the cartilage almost completely gone. This is where mesenchymal stem cells come in. Since the characteristic inflammatory response of this condition is caused by the loss of cartilage, mesenchymal stem cells therapy pose an opportunity to resurface this degenerated cartilage. Treatment with this method has shown promising results across several studies, demonstrating a significant pain reduction, cartilage protection, and healing.

    Mesenchymal stem cell therapy is a form of regenerative medicine, so let’s dive into the process of this treatment. Firstly, we have the extraction of bone marrow stem cells. The procedure takes place in a full operating suite to ensure the most sterile conditions. You will be offered light sedation by our anaesthetic specialist, who will oversee your pain control. Your doctor will thoroughly numb the back of the pelvis and take a small bone marrow sample through a needle. This procedure is called a bone marrow aspirate.

    The next stage of the procedure is called the harvesting step. Here, we will take the cells and use a cultured technique to grow them in the lab. Our researchers are able to produce more than 40 million of your own mesenchymal stem cells. These stem cells are then reinjected around two weeks after our researchers have completed the lab work. This waiting period is crucial as it allows us to thoroughly check the cells for any bacteria that may have grown. The reinjection of the cells can then be performed by a specialist musculoskeletal radiologist using advanced imaging to guide the stem cells to the target site, such as the knee. You can read more about our specialist team here.

    As you can see, mesenchymal stem cell therapy does not require hospitalisation, is minimally invasive and low risk and provides a host of benefits, including pain relief and a significant improvement in cartilage quality. However, if you do have any questions following this post, feel free to contact us directly.
    Mesenchymal stem cell therapy: The scientific evidence

    Mesenchymal stem cell therapy: The scientific evidence

    Dec 20, 2021

    Mesenchymal stem cell therapy has yielded excellent results in patients across the globe, treating conditions from neurological disorders to bone and cartilage diseases. If you haven’t read our previous post on how mesenchymal stem cell therapy works, this provides a great starting point on what this treatment is all about.
    This post will focus on the scientific evidence that demonstrates the efficacy of this procedure and the promising results that have been observed in practice.
    A report of four patients with knee osteoarthritis described the notable improvement seen in walking time for the pain to appear, the number of stairs they could climb, and the pain on the visual analogue scale. Moreover, although only minor, an improvement was observed in the overall range of motion. Collectively, this validated the conclusion that mesenchymal stem cell therapy should be considered in patients with advanced osteoarthritis (Davatchi et al., 2011). This study primarily focused on the short term implications of this treatment on osteoarthritis, with a follow-up period of 12-months.
    However, Davatchi et al. reported on the same patients in the long-term follow-up period at five years. Here, it was observed that, although a mild deterioration was noted, all parameters were better than before the treatment. This included walking time, stair climbing, gelling pain, patella crepitus, flection contracture, and the visual analogue score on pain (Davatchi et al., 2016).
    A 2020 systematic review hypothesised that mesenchymal stem cell therapy represents a feasible option for idiopathic knee osteoarthritis and may delay or even avoid the joint replacement. A thorough assessment of the current literature was carried out, with the findings collaboratively supporting this hypothesis. A total of 18 studies were identified, treating 1069 knees in total, with 72% of patients receiving bone marrow-derived mesenchymal stem cells and the remaining 28% receiving adipose-derived mesenchymal stem cells. We go into more detail on the difference between these approaches here. Across all patients, following administration of mesenchymal stem cell therapy, a remarkable improvement in clinical and functional outcomes were observed. In addition, the pain and function scores also showed a considerable improvement, resulting in a significant improvement in overall quality of life and the patients’ ability to participate in recreational activities (Migliorini et al., 2020).
    New evidence is being published on a regular basis as we gain more data on the efficacy of mesenchymal stem cell therapy. At Opus, we want to ensure that you have access to the most up-to-date information; therefore, as this new research is released, we will relay that through our content.

    References

    Davatchi, F., Abdollahi, B. S., Mohyeddin, M., Shahram, F. & Nikbin, B. 2011. Mesenchymal stem cell therapy for knee osteoarthritis. Preliminary report of four patients. Int J Rheum Dis, 14, 211-5. Davatchi, F., Sadeghi Abdollahi, B., Mohyeddin, M. & Nikbin, B. 2016. Mesenchymal stem cell therapy for knee osteoarthritis: 5 years follow-up of three patients. Int J Rheum Dis, 19, 219-25. Migliorini, F., Rath, B., Colarossi, G., Driessen, A., Tingart, M., Niewiera, M. & Eschweiler, J. 2020. Improved outcomes after mesenchymal stem cells injections for knee osteoarthritis: results at 12-months follow-up: a systematic review of the literature. Arch Orthop Trauma Surg, 140, 853-868.