Essential Differences in PRP Therapies

Platelet rich plasma (PRP) therapy is the use of a patient’s own platelets to accelerate healing.  It is termed rich because the platelets are concentrated, typically 5-10x above the concentration that is circulating in your blood.

PRP therapy has been used for a number of different indications  including wound healing in surgery,tendinitis, cardiac care and dental health.

Platelet-rich plasma (PRP) therapy made headlines following the Super Bowl, when it was revealed that Pittsburgh Steelers Hines Ward and Troy Polamalu had undergone PRP injections in the days leading up to the game.

Are all PRP therapies the same?

NO.

There are distinct differences in platelet rich plasma .

Most PRP is created by a bedside machine that creates a platelet concentrate by spinning (centrifuge) the blood thereby separating the platelets from the other blood products.

A cell biologist in a laboratory, however,  is able to separate the platelet from other blood products and so much more.

A cell biologist can create PRP that is pure and free of any red or white blood cells.  A machine cannot.

A cell biologist can create PRP in a specific concentration for specific indications.  A machine cannot.

A cell biologist can make PRP that has a very high levels of specific, naturally occurring growth factors such as VGEF, vascular  growth endothelial factor.  A machine cannot.

At the  Centeno-Schultz Clinic we are not reliant on a machine.  Rather through the use of a state of the art lab with full-time cell biologists we are able to provide our patients with customized PRP therapies that are specifically designed for them.  This is the critical difference which translates to improved outcome.

Low Back and Leg Pain Successfully Treated with Stem Cells

A disc protrusion can cause severe lower back and leg pain.  Treatment options vary from conservative to surgical.  Conservative therapies often include physical therapy, the use of muscle relaxants, non-steroidal anti-inflammatory medications and narcotics.  Surgical options include trimming the protruding disc through a large incision, a small incision with the assistance of a microscope or laser.  Some studies have demonstrated that surgical repair of a disc protrusion places the patient at increased risk for subsequent back problems in the future.

NQ is a 30+ y/o patient who has a long-standing history of lower back and leg pain.  She had undone conservative therapy in addition to epidural steroid injections with little sustained benefit.  She elected to undergo the Regenexx procedure where she used her own culture expanded cells to treat her back and leg pain.  Her own bone marrow derived stem cells were grown in a state of the art lab and then injected under x-ray into the disc protrusion.  thirty days after injection NQ reports a 90% reduction in her leg back and 40% improvement in her low back pain.   Her lumbar spine MRI shows improvement as illustrated below.    Two matching slices from several months before the procedure (on the left) and two from one month after the procedure (on the right). These are side views of the spine and since MRI’s literally slice across an area, I have included two slices to be as accurate as possible. The images are on an ultra high field magnet (3.0 T) and are also closely matched for imaging parameters (Before=Sag STIR: ET-12, TR-4166.7, TE-37.3; After=ET-12, TR-4166.7, TE-37.3). Note the red arrows in the before images show a large disc bulge that the yellow arrows in the after images show has been reduced.

She has been able to increase her level of activity and is enjoying this Memorial Day weekend with her family.

Platelet Rich Plasma (PRP) Therapies and Growth Hormone

Platelet rich plasma therapy (PRP) involves the injection of a concentration of platelets  into an area of tissue injury.  Platelets are rich in naturally occurring growth factors which can speed up the healing process.   Blood  obtained from the patient is  spun down (centrifuged) creating a highly concentrated pellet of platelets.

Processing of the blood is done, in most cases, by a bed-side machine or, in the case of Regenexx, by a cell biologist in a state-of-the-art lab.

Injection of the platelet concentrate is performed under ultra-sound or x-ray guidance to ensure accurate placement.

PRP has been used successfully by professional athletes, as well as weekend warriors.

Unfortunately, the recent attention of a Canadian health provider utilizing PRP therapy has led to some confusion over this therapy.

At this Canadian practice, ultra-sound guided PRP therapy was combined with IV infusion of growth hormone and actovegin.  The latter two medications are total -body performance enhancers, whereas PRP is intended to have an effect only on the local tissue into which it is injected (meniscus, ligament, muscle.)

This is not the standard practice.  PRP therapy is not routinely combined with the use of performance-enhancing medications (growth hormone or actovegin).

If in doubt, ask your doctor questions.  How was the PRP made, what is the concentration, route of administration and whether or not other medications (enhancers) are being used.

At the Centeno-Schultz Clinic, PRP therapy is just one of  the many regenerative therapies directed at getting individuals back to pursuing their dream.

Knee Outcome Data for Expanded Stem Cell Injections

The Regenexx procedure utilizes expanded autologous mesenchymal stem cells for a variety of orthopedic conditions.  Knee pain  secondary to degenerative changes, post-surgical or trauma has been treated with The Regenexx procedure.

How successful is this therapy?

New data has been released and was posted on their website:

For 126 patients reporting and 29 patients that failed to respond (drop out rate of 23%).  Approximately 75% of these patients were knee replacement candidates, 25% were knee surgery candidates to treat a solitary osteochondral lesion (micro fracture, ACI, MACI):

66.7% of patients are reporting more than 50% improvement.    

43.7% of patients are reporting better than 75% improvement.

Avoiding the risks associated with surgery and anaesthesia with no significant recovery time makes the use of cultured stem cell therapy attractive.