DrPRP USA will be at the Medica World Forum For Medicine 2018
We’re pleased to announce that our team will be represented at the MEDICA world forum for medicine, the #1 international medical trade fair in Europe – it’s happening in Germany from 12 – 15 November 2018. More than 5000 exhibitors from around the world will be here so it’ll be a great event for meeting new people, technology and trends.
The use of immunosuppressive biologics, non-steroidal drugs (NSAIDs) and corticosteroids, collectively known as Anti-Inflammatory Therapeutics (AIT), has been rebuked by many, including well-known MDs. But there are, still, a good majority of family doctors, pain-management specialists, and orthopedic surgeons who routinely prescribe them for arthritis, tendonitis, and bursitis because apparently, there’s no other better alternative. This is evident in the ballooning anti-inflammatory therapeutics market which is projected to reach a valuation of $100 Billion by 2020. But according to researchers, there already exists a better alternative and that is Platelet-Rich Plasma and scores of physicians are now prescribing it as a first line treatment instead of AITs.
Why Anti-Inflammatory Therapeutics?
One of the reasons why AITs are popular is the belief that most musculoskeletal diseases are due to inflammation. It is believed that inflammation is the cause of injuries and pain. But over the years, numerous studies have shown, rather persuasively, that inflammation is a signaling process used by the body to recruit growth factors and cytokines to the tissue microenvironment. While suppressing the inflammation with drugs interrupts this natural process and provides short term relief to the symptoms, in the long run, it prevents structural healing.
But the argument among pro-AIT physicians is that they provide the best short term relief. They claim that a short or two of AITs keeps the situation under control and is not a big deal in the larger scheme of things.
Not true. They have pain-relieving properties but not as dramatic as we may think.
Third, the immunosuppressive biologics like DMARDS, cytokine-blockers and TNF-blockers are not effective pain-killers anyway.
But they all have one thing in common. And that is, a long-list of side effects.
The Debilitating Effects of AITs
It would have been acceptable if we could just temporarily harness the whatever little pain-relief that AITs offered while we’re looking for a favorable course of action. But that isn’t the case. Studies show that even a single dose of these AITs can lead to unwanted complications. Let’s take a deeper look.
Steroids are evidently the most destructive ones. Physicians know that they must prescribe steroids very cautiously. But the problem is once they work, patients may prefer them again and again. Especially athletes who just want to get back in the arena for that final game. After all, who wants to sit on the sidelines when life passes by? Just one more time, they’ll say.
NSAIDs are a totally different beast. Medscape reports that more than 70 million of them are prescribed to patients each year in the United States alone. This is in spite of the warning issued by the Arthritis, Rheumatism, and Aging Medical Information System (ARAMIS) against NSAID use.
Anti-inflammatory biologics include drugs that block pro-inflammatory cytokines like tumor necrosis factor alpha (TNF) and interlukin-6 (IL-6) as well as conventional disease-modifying antirheumatic drugs (DMARDs). The problem with these drugs is that they suppress the biologic entities responsible for the natural immunity of the body. Applying them to a joint for example, doesn’t limit its effect to that area. Instead, it suppresses these biologic entities THROUGHOUT the body including liver, colon, small intestine, bones, skin and even neurons.
Blocking pro-inflammatory cytokines are definitely a bad idea. For example, the cytokine IL-6, one of the main cytokines targeted by the new generation of Arthritis drugs is a major component of the central nervous system. So is anti-TNF drugs. Blocking these can only lead to adverse events in the long term elsewhere in the body.
Can PRP Disrupt The Anti-Inflammatory Therapeutics Market?
Although not immediately evident, the trend for these Anti-inflammatory Therapeutics are actually going down. As researchers discover more serious side effects, the market will start shifting to more natural solutions like Platelet-Rich Plasma. In fact, it’s already happening as we speak. Even without the support of insurance companies, more and more people are opting for PRP instead of AITs. That means people are willing to pay out-of-pocket for PRP instead of accepting free drugs. In other words, the downward trend for AITs has begun.
Patients and physicians are learning the hard way that SUPPRESSION OF INFLAMMATION DOES NOT EQUAL TO HEALING.
On the other hand, the trend for Platelet-Rich Plasma is climbing organically.
Here’s Allen Mishra’s tweet about PRP’s Google trends. Alan is the founder of the Biologic Orthopedic Society that has over 6,500 members in Linkedin.
The study shows that sacroiliac joint (SIJ) injection of Platelet-Rich Plasma has a longer-lasting effect on pain than steroids. And the difference is HUGE. While efficacy of steroids was only 25% at 3 months, it was 90% for PRP.
In this study, the steroids were only able to suppress symptoms for recalcitrant lateral epicondylitis, while PRP was able to biologically heal the lesion. Furthermore, the steroids caused further tendon degeneration. Another study proved that patients who had PRP shows better pain and functional improvements than patients who had corticosteroid injection.
Why PRP Is Actually Good For Both Patient And Physician
As you can see, the reason why more and more physicians and patients favor Platelet-Rich Plasma over Anti-inflammatory Therapeutics is that PRP not only eliminates the symptoms (pain and function) but it actually heals biologically. Yes, of course, the manufacturers of the conventional drugs would love you to believe that their billion-dollar-research-backed miracle drug is VASTLY superior to the autologous Platelet-Rich Plasma that can be produced within 10-20 minutes in a small clinic. But what we’ve seen is quite the opposite.
One of the early pioneers of Platelet-Rich Plasma, an orthopedic surgeon Dr. Allan Mishra, M.D., says, that soon this biologic tool would be “safe, simple to use, inexpensive, and available immediately at the point of care.”
And that requires a tipping point in its adoption by physicians. It’s already accelerating at a good pace.
Dr. Mishra goes on to say that, “chronic tendinopathy is the most common indication for applying PRP in my practice. I have used the treatment for tennis elbow, patellar tendinosis, partial Achilles tendon tears and occasionally partial rotator cuff tears as a stand-alone treatment. I also now routinely augment all of my Achilles and patellar tendon repairs with PRP. And I am considering augmenting my arthroscopic rotator cuff repairs as well with PRP. For nonunions or difficult fractures, I combine PRP with bone grafting.”
For the patients, Platelet-Rich Plasma has been helping them avoid surgery for years now. See the videos below for actual testimonials from real patients.
Here’s another patient’s story of how PRP helped avoid surgery.
“When I tore my rotator cuff in 2008, I had conventional laparoscopic surgery to repair it. The outcome was excellent, but the recovery was long and horrible. The orthopedist wouldn’t let me drive for six weeks, or run, swim or lift weights for three months. I suffered through weeks of torturous physical therapy. It was nearly six months before I felt normal again.”
And the patient vowed to never go through that ever again.
Unfortunately, the patient suffered another injury in 2014.
But this time decided to try Platelet-Rich Plasma instead.
The patient said, “I had the first PRP injection on Oct. 23. It was painful, and the aching persisted for about 36 hours. I had one bad night, followed by an uncomfortable day. After that, the pain stopped. Still, my doctor advised me to baby the shoulder — to use my other arm when holding a dog leash and to skip swimming and weights for two weeks. Running was fine. He also recommended physical therapy after two weeks.”
The patient reported that by February 2015, the shoulder was 80% healed. The doctor advised the patient to have a second PRP injection to heal the remaining 20%.
Here’s what the patient said:
“I had [the second injection] on March 4. When I returned to see [the doctor] on April 12, I was feeling pretty good. No pain, no problems. He rolled in the ultrasound machine, and I was not surprised by the results.”
Watch this second video for another excellent patient story.
Get Started On Platelet-Rich Plasma Now
The best way to start making a big difference in your patients, especially if you’re an orthopedic surgeon, rheumatologist or any kind of pain management specialist, is to get going with Platelet-Rich Plasma. Don’t just have it as a back up treatment that you can try when things don’t go well. Instead, it can be used as a standard first-line treatment for musculoskeletal issues.
Give it a serious consideration.
We can guarantee that once you start offering Platelet-Rich Plasma, you’ll end up prescribing less and less Anti-Inflammatory Therapeutics and more and more Platelet-Rich Plasma. And it will have a tremendous impact on the lives of your patients. We want to see a world where the “replacement surgeries” are a thing of the past.
And Platelet-Rich Plasma can make it happen.
Give us a call if you need more information. We can be reached at (844) 377-7787 or email via firstname.lastname@example.org. Or you can order a Platelet-Rich Plasma kit online and try it in your practice.
Together, let’s welcome the Anabolic Era of Medicine.
In the 2000s, when Platelet-Rich Plasma first started shifting its role from being a healing assistant in cardiac and orthodontic surgeries to the more leading role of healing bone grafts and joint tissues, many leading physicians claimed that the practitioners were putting profiteering before truth and science. They even said it was outright theft to charge $300 for an injection that, according to them, had an efficacy no less than placebo. That was in 2009 and the confusion back then was justifiable.
This was also confirmed by two Chinese major review studies this year, both Meta-analysis of Randomized Controlled Trials of Platelet-Rich Plasma for Knee Osteoarthritis – first one here and the second one here.
Yet, we still see physicians here in the US – orthopedists and rheumatologists, among them – who don’t even bother to try it once on their patients!
What’s going on?
The Hidden Factor That’s Holding PRP Back
Platelet-Rich Plasma, as we know, contains 7X-9X concentration of platelets in a serum with a balanced ratio of plasma, leukocytes and RBC. This special mixture helps supply growth factors and other proteins that tissues can use to recruit stem cells and heal itself. This process is pretty straight-forward. Yet, we know for a fact that there are some physicians who fail to see results with Platelet-Rich Plasma, including some clinical studies performed by veterans.
Are they missing something?
We suspect it has got to do with the second part to PRP’s healing mechanism. It’s right application.
It can be summed up in the following two questions.
1. Precisely which tissue are you delivering the PRP to?
2. How are you making sure that the PRP is used by the tissues and not wasted?
This is where the science of Interventional Orthopedics come into play.
The Science Behind Interventional Orthopedics
On the outside, interventional orthopedics look very simple. You identify the area which needs healing, and then administer Platelet-Rich Plasma (or stem cells for that matter) to that particular area and wait for it to heal. Thinking that its this simple screws up the process for physicians who’re merely trying their luck with PRP. Because, the bulk of the Platelet-Rich Plasma treatment – the actual work that the physicians need to do – has to do with the following.
1) Identifying the exact group of tissues that are broken or degenerated (Accurate Localization),
2) Creating lesions in the damaged tissue, and
3) Delivering Platelet-Rich Plasma precisely at that location.
These advanced injections are much more effective and requires a different level of expertise.
For example, typical injections in the knee can only deliver the Platelet-Rich Plasma serum to the synovial fluid, synovial membrane and articular cartilage. The advanced injections like intraosseous infiltrations can deliver the PRP serum to the subchondral bone and the deep layers of cartilage that are affected by Osteoarthritis.
These kind of advanced injections require the use of fluoroscopic guidance for proper administration as well as proper training on the physician’s side.
The thing is, not all physicians are trained to do it. The scope of these advanced injections are vast and warrant extensive training and expertise.
To continue with the example of the knee, most physicians are proficient only in the superomedial or anteromedial/anterolateral injections to the knee. However, advanced Platelet-Rich Plasma injections can deliver the PRP to precise locations like…
Medial collateral ligament (MCL)
Posterior cruciate ligament (PCL)
Anterior cruciate ligament (ACL)
Lateral collateral ligament (LCL)
Patellar ligament (PL)
Anteromedial joint line (AMJL)
Medial midpatellar (MMP)
Superomedial patellar (SMP)
Anterolateral joint line (ALJL)
Lateral midpatellar (LMP)
Superolateral patellar (SLP)
Lateral suprapatellar bursa (LSB)
Most physicians, instead of getting highly proficient in identifying and administering precise PRP injections, they get concerned over the relative lack of protocols for PRP Injections. They get carried away by details like the frequency of the injection, the leukocyte levels, and red blood cells, when the fact is… as long as you get the platelet concentration right (5X-9X baseline), the therapeutic effects are guaranteed. The frequency and the presence of Leukocytes are minor factors that have little to no impact on the outcome.
The most important factor is physician training for advanced injections under Ultrasound or Fluoroscopy.
If It Works For Knee Osteoarthritis, It Probably Works For Other Degenerative Diseases
There is another concern among some physician who claim that there’s no evidence for the particular condition that they’re treating. For example, let’s say they’re treating Spinal muscular atrophy in a patient and see that there has been no study that proves Platelet-Rich Plasma is a good candidate.
Does that mean it won’t work? Absolutely no.
It just means no one has ever studied it in detail. The working mechanism behind Platelet-Rich Plasma is so universal that if it works for the knees, it will work for the spine and other similar areas of the body as well. In fact, there is almost no part of the body that is not currently known to have a therapeutic effect upon application of Platelet-Rich Plasma – nerves, joints, muscles, skin, hair, and even the eyes are treated by PRP.
We’ve noticed that age does not have a correlation with the effectiveness of Platelet-Rich Plasma injections. It works just the same for the young and old.
However, the one thing that do have a correlation is the degree to which the disease has advanced.
The more advanced the disease, the less likely that Platelet-Rich Plasma can reverse its course. That is the reason why we recommend physicians treat Platelet-Rich Plasma as a first-line treatment for all possible conditions. It has already shown to be much more effective than both Cortisone and Hyaluronic Acid injections.
Education in Advanced regenerative-medicine injections
So, back to the single biggest needle-mover when it comes to Platelet-Rich Plasma injections: ACCURATE LOCALIZATION. This means the physicians must undergo advanced training for this type of injections.
And there are not many options available until recently.
Thankfully, we now have the Interventional Orthopedics Foundation (IOF) foundation – the first non-profit in the US dedicated to providing training for core injection skills. According to IOF, only 1% of the physicians in the US are trained to do these advanced injections. And chances are you may not have been trained.
With IOF, you can get trained for that in a real medical setting with skilled instructors and support staff.
According to the IOF website, they can train you on:
Injections for the healing of bone, tendon, ligaments, muscle or cartilage.
Accurate localization of these injections on damaged structures using image guidance.
New tools that facilitate percutaneous tissue manipulation.
This is a wonderful non-profit education initiative by Christopher J. Centeno, MD, Gregory Lutz, MD, Don Buford, MD and Richard D. Striano D.C., RMSK, all leading players in the regenerative medicine field.
Here’s a video you can watch to learn about IOF foundation.
As a Platelet-Rich Plasma practitioner, you’ll be out on the leading-edge. You’ll discover things that others may not be aware of. And you’ll have the opportunity to publish your findings. That’s when you’ll think of a standardization. By then, it’s too late. You’ve already performed a lot of injections and your data in unstandardized.
To avoid this, consider using a standard for the preparation of Platelet-Rich Plasma.
The lack of standardization is the main culprit when it comes to debates over the efficacy of Platelet-Rich Plasma. We would love to see more and more researchers and everyday practitioners accepting a common standardized classification system for PRP.
According to the famous sports medicine expert, Brian J. Cole, M.D., M.B.A., a good orthopedic surgeon is one who works hard to prevent his/her patients from going under the scalpel. To this end, he advocates a lot of contemporary thinking and treatments like Platelet-Rich Plasma rather than the usual MRI-driven surgical procedures. And we’re seeing more and more orthopedic surgeons who are following the cues of the people like Dr. Cole and are genuinely astounded by the sheer number of surgeries they could avoid by a little poking around with alternative treatments.
“The art of medicine consists of amusing the patient while nature cures the disease.”
A Little Late to The Regenerative Game?
Generally speaking, orthopedic specialists have been hesitant in adopting regenerative therapies. They’ve been relying on visual technologies like MRI machines a tad bit too much and hence accustomed to “seeing” in order to believe it. But regenerative therapies like Platelet-Rich Plasma doesn’t work that way. One has to believe in it to see the results. You can’t half-heartedly try PRP injections and give up if it doesn’t work. In our opinion, that’s what separates a passionate orthopedic surgeon from a “just doing my job” orthopedic surgeon. The former has a lot of belief in the rather invisible but non-surgical options. As the saying goes, “All surgeons know how to operate, a good surgeon knows when to operate, but a great surgeon knows when not to operate.”
And no doubt, one of the key treatment options in Orthopedics that ends up actually saving a lot of patients from going under the knife (and has since become a powerful force in medicine) is Platelet-Rich Plasma. Of course, we’re biased but there is probably no other medical discovery in the modern medical history that has as much an impact on the medical industry as Platelet-Rich Plasma. Physicians now prescribe it as first-line treatment for a variety of medical conditions. And although Plastic surgeons are leading the way in pioneering its application, we believe the nature of PRP is such that it will eventually be of massive benefit in Orthopedics than any other field.
Another reason is runners. They constitute a good portion of the orthopedic surgeon’s patients. These patients do not have life-threateningly serious conditions. They might have minor pain or discomfort that prevents them from enjoying their daily run. They just want to be able to run again. The great news is, a single shot of Platelet-Rich Plasma can do wonders for them.
Evidence-Based PRP Treatments In Orthopedics
Although few physicians question the efficacy of Platelet-Rich Plasma for joint diseases like knee arthritis, there are well-meaning physicians who resist recommending it to their patients lest they end up wasting the patient’s money. We regularly receive enquiries from such physicians asking for “hard evidence” of PRP’s efficacy. We know that skepticism is natural. And that’s why we’re doing our best to educate physicians so they can come to their own conclusion about Platelet-Rich Plasma.
The truth is there has been more evidence than we can handle.
Let’s take a look at a few of them.
Platelet-Rich Plasma is huge in arthritis. Earlier this year, researchers from Shanghai, China published a review of the 14 existing randomized controlled trials related to PRP treatment of knee-OA that comprised a total of 1423 participants. And they concluded that Platelet-Rich Plasma could be more efficacious than HA, ozone, and corticosteroids in terms of pain relief and functional improvement at 3, 6 and 12 months follow-up. This justifies why some physicians are confident enough to use PRP injections as first-line treatments for all osteoarthritis cases.
And just recently, Spanish researchers took the next step. They tested an advanced method of Platelet-Rich Plasma infiltration for treating severe hip osteoarthritis and found that the technique extended the distribution of PRP and improved its efficacy. Simultaneously, another Spanish study established that a single PRP injection can be effective in treating late-stage knee OA. This is really really great news. Because if you’re physician dealing with arthritis patients, you probably have never seen any treatment that is this simple which has long-term therapeutic effects like that.
However, on the standardization of the PRP treatment itself, there has been no major progress except that most of the research agrees that a concentration of 1,000,000 platelets per µl (or 5X-7X above baseline) is required for therapeutic effect. This can be obtained through buffy-coat based double-spin process similar to the one followed by Dr. PRP Kits.
Some researchers have suggested using Leukocyte-poor PRP for Osteoarthritis but there isn’t enough evidence to support the notion that having less leukocytes enhances OA treatment results. In fact, there are some RCTs like this that used leucocyte-poor PRP that have failed to produce significant results while leukocyte-rich PRP had a beneficial effect as evidenced by this study.
Bone regeneration is a little-known field of medicine where Platelet-Rich Plasma has been quietly performing well. In a 2014 study, researchers concluded that there is little doubt that PRP can be beneficial for bone regeneration. But the mechanism through which PRP was able to achieve this is still largely unknown. Recently, researchers in Japan has discovered that a combination of Bone Marrow Stem Cells and PRP appeared to enhance bone formation in mice. Another RCT by Iranian researchers suggested using PRP along with autologous bone graft for long bone non-union fractures.
Platelet-Rich Plasma has also been compared with bone marrow aspirate (BMAC) concentrate by Japanese researchers and they found that PRP has almost the same capability for bone regeneration as BMAC. This is significant considering the simplicity of PRP extraction vs BMAC extraction.
Historically, tendons are known to respond well to Platelet-Rich Plasma. And this review of current literature confirms the fact. This review also concluded that Leukocyte-Rich PRP (the normal PRP) was more ideal for intratendinous injections.
Platelet-Rich Plasma also has a long history with tennis elbow and Rotator cuff injuries. Researchers in China looked at 8 randomized controlled trials (RCTs) that involved 511 patients with tennis elbow and came to the conclusion that PRP is a more ideal treatment than steroids.
But PRP’s relationship with Rotator cuff injuries suffered a setback last year when a Chinese review concluded that PRP is not beneficial. Prior to that, AAOS had reported that it might be beneficial.
Intervertebral disc degeneration is one of the leading causes of lower back pain and is usually the one of the most expensive conditions to be treated – mainly due to the complexity of the condition. In one case we know, a patient with degenerative disc condition in both his lumbar and cervical spine – he had both a degenerative bulging disc at L4 and a sacroiliac joint dysfunction – was still pain-free 2 years after his doctor administered 2 PRP injections. But for this post, let’s put anecdotes aside and look at latest studies like this by Chinese researchers which seems to support the notion that PRP is indeed beneficial for retarding intervertebral disc degeneration.
Another study by researchers in New York also found that PRP is beneficial in the treatment of degenerative intervertebral discs.
Over 100 active clinical trials on Platelet-Rich Plasma
What we’ve presented here is only a fraction of the literature available. As you can see, this is an interesting time of development for Platelet-Rich Plasma. It continues to be of great interest to medical researchers and the patient population. Though the scientific community is torn apart by the lack of standardization and “hard evidence” for PRP treatments, patients are showing huge interest in it even though they have to pay out-of-pocket for these injections. And the reason why patients are voting with their wallets for this treatment is because 1) it’s simple and highly practical and 2) lot of anecdotal evidence. The research community is trying hard to catch up to these patients’ belief – there are currently over 100 active clinical trials on Platelet-Rich Plasma – and we believe it’s only a matter of time before they succeed in their quest. The lack of funding is only major hurdle the research community has to overcome before they uncover the full therapeutic effects of Platelet-Rich Plasma. And we’re excited and so should you because it’s great news for your patients.
But for now, there’s plenty of evidence to suggest that Platelet-Rich Plasma treatments can be a standard regimen for treatment of musculoskeletal disorders. In the coming years, you will see more standardization in PRP preparation, concentration, pre-activation, injection volume, injection frequency and post-injection protocols.
The Cost Effectiveness of Platelet-Rich Plasma
One other thing to keep in mind, when weighing on the pros and cons of offering Platelet-Rich Plasma to your patients is the cost-effectiveness. Yes, you may not want to waste your patient’s money. But Platelet-Rich Plasma is something that has enormous upside with a relatively low downside. This is especially true when compared to surgical intervention. Average cost of the highly invasive arthroscopic debridement, for example, is $5000. But the same results may be obtained by 3 shots of PRP that costs $1000. The amount of improvement reported by patients undergoing both is similar – about 50%. That’s $20 for every percentage point improvement vs $100 for every percentage improvement in the case of arthroscopy. Even if the patients have to pay out-of-pocket for PRP injections, that’s not a good reason why they should not try Platelet-Rich Plasma.
As a powerful medium of regeneration, Platelet-Rich Plasma has seen the most aggressive growth in demand among patients suffering from Alopecia. This is despite the relative lack of evidence surrounding the treatment. All because the results of PRP Hair Regeneration just can’t be ignored.
And researchers are starting to take it more seriously now.
New studies are emerging that prove the results are more than just opinions of dermatologists. The most recent one is a study published by Egyptian researchers, where they analyzed the results of 90 patients for a period of 3 months using digital camera photography and dermoscopic scans, and concluded that Platelet-Rich Plasma is more effective in the treatment of Alopecia than widely accepted topical minoxidil 5% solution.
One of the most interesting studies is a study conducted by researchers in Southern Medical University, China. Although the study was conducted on lab mice, it presented very conclusive evidence for Platelet-Rich Plasma as a powerful biologic substance that both shortened the time of hair formation and increased the number of newly formed follicles. The possibility that Platelet-Rich Plasma can promote both of these functions at the same time makes it the holy grail of hair science.
There’s also this other study By Italian researchers suggest that the optimal concentration of Platelet-Rich Plasma for PRP Hair Regeneration is 1.5 million platelets per microliter and that higher concentrations doesn’t seem to improve results (or may at times minimize the results). Although the study size is small (20 patients), it reported significant positive results after administering three PRP injections for each patient at 30-day intervals.
Little wonder that during the AAD 2017 Summer Meeting, it was one of the hottest topics discussed.
American Academy of Dermatology 2017 Summer Meeting
At the American Academy of Dermatology 2017 Summer Meeting, which took place a few days ago, Dr. Neil Sadick, MD, from Weill Cornell Medical College, was quoted as saying that Platelet-Rich Plasma is the hottest therapeutic tool dermatologists nationwide are talking about. Dr. Sadick also acknowledged the lack of a standardized treatment protocol that is holding back the procedure from going mainstream. But all of this is about to change as he mentioned that there are three MAJOR ongoing studies on the topic of PRP Hair Regeneration currently, whose outcome may shift they way this treatment is perceived right now.
Dr. Sadick’s co-presenter, Dr. Maria Hordinsky, MD, said that there’s no question that the demand is growing. And advocated dermatologists to start accepting the reality that if they don’t believe in it now, their customers might go somewhere else to get it.
She concludes by saying, “You have to get on the bandwagon of PRP if you work with patients with hair loss. There is no choice. It is very popular.”
Lack Of Evidence Or Lack Of Funding?
The lack of clinical studies may allude to the fact that funding for this kind of research is next to impossible to obtain. The Brown University and University of Miami researchers who conducted the literature review we cited earlier did not receive any funding for their work.
And so are almost all other literature on PRP Hair Regeneration. It explains the relative lack of robust evidence. But the dermatologists on the field are amazed by growth in demand they’re seeing. PRP looks like a disruptor in the long-stagnant Hair Regeneration industry. What they thought was a passing fad is now turning out to be a powerful force.
Isn’t time that every dermatologist in the country embrace Platelet-Rich Plasma as a standard treatment? Read this article to learn about other reason why you should consider offering the Platelet-Rich Plasma suite of treatments.
82% “Worth It” Rating In Real Self
Perhaps the best indicator of the effectiveness of a treatment is the customer feedback. The website Real Self is a portal that lists different cosmetic treatments and asks its user to share their experiences. PRP Hair Regeneration is among the most popular treatments discussed in that portal. And on this portal, PRP Hair Regeneration has a whopping 82% “WORTH IT” rating as rated by real customers who’ve had the treatment. It is also the cheapest treatment listed on the site with an average cost of just $1675.
One user in Real Self, who posted a before-after picture that was taken after only ONE PRP treatment, says he was impressed by how much Platelet-Rich Plasma had thickened his receding hairline. Comments like this are not uncommon on the Real Self portal.
More and more patients are seeking out PRP Hair Regeneration instead of the oral drugs and topical medicines because of its holistic, regenerative aspect. This is a “true solution” for hair loss with NO MAJOR SIDE EFFECTS.
Dr. Amiya Prasad, MD, a cosmetic surgeon and fellowship-trained Oculofacial plastic and reconstructive surgeon who’s been in practice for over 20 years, says, he has no doubt about the efficacy of PRP Hair Regeneration. In fact, he even says that he’s never seen any reversal of results in his patients.
6 Lessons From More Than 1,000 PRP Hair Regeneration Treatments
Here are the tips shared by top dermatologists who’ve each performed more than 1,000 PRP Hair Regeneration treatments for their clients.
1. There is no substitute for precise intra-dermal injection of Platelet-Rich Plasma at the level of the follicles.
2. It may be helpful to be supported by micro-needling and topical Platelet-Rich Plasma in some cases.
3. The concentration of platelets must be at least 5x the baseline or 1.5 million platelets per microliter (μL).
4. Combining Platelet-Rich Plasma with non-surgical medication and laser light therapy may be beneficial.
5. PRP Hair Regeneration is usually done 3 sessions about 1 month apart, followed by one more session about 12-18 months later depending on the results.
6. Addition of an allograft matrix product to Platelet-Rich Plasma can greatly enhance the results of regeneration.
How to Prepare Platelet-Rich Plasma
Based on the input from dermatologists and Platelet-Rich Plasma experts, here’s how you can prepare the Platelet-Rich Plasma for hair regeneration.
There are three types of Platelet-Rich Plasma Kits. The ones that uses separator gels, ones that uses buffy coat with a single spin on the centrifuge and the ones that uses buffy coat with double spins on a centrifuge. Almost all physicians agree that the last option – using a buffy coat based Platelet-Rich Plasma kit that can be double spun produces the best concentration of 5X-7X above baseline, i.e., more than 1.5 million platelets per micro liter.
This concentration packs the most nutrients for the regeneration of blood vessels and recruitment of new stem cells that are required for hair regeneration.
The way to achieve this concentration using the DrPRP Kit is simple.
1. Draw 17cc of blood into a DrPRP tube pre-filled with 3cc Anti-coagulant ACD-A.
2. Centrifuge it for 3400 rpm for 4 minutes.
3. You’ll see perfect PRP separation (else you can centrifuge it for another 1 minute.)
4. Sequester the platelet serum from the RBC by adjusting the knob at the bottom of the DrPRP tube.
5. Centrifuge it for another 6 minutes at 3,200 rpm.
6. You’ll get about 10cc of Platelet serum with Platelets lying at the bottom of the chamber. Draw out the top 6cc of the serum, which is the Platelet-Poor PRP.
7. The remaining 4cc is your Platelet-Rich Plasma that has more than 1.5 million platelets per micro liter. Shake it well, draw it out in a syringe and administer it.
With Micro-needling Or Without?
Some dermatologists’ recommended PRP Hair Regeneration protocol includes Micro-needling with topical application of Platelet-Rich Plasma. In some cases of hair loss, this can have a beneficial effect.
Micro-needling, using a device like Bella, creates a series of micro-trauma that warrants a healing response in a manner that covers the entire area of the scalp. This together with the applied Platelet-Rich Plasma will stimulate growth activities in the cells.
Most dermatologists who do micro-needling sandwich it between PRP injections. Say they’re giving a 3-session treatment at a 30-day interval, they’ll inject Platelet-Rich Plasma deep into the derma for the first and the last treatments while the second treatment will be just the Micro-needling with topical application of Platelet-Rich Plasma.
So yes, it is purely optional. With or without this, there is no avoidance of intra-dermal application of Platelet-Rich Plasma for PRP Hair Regeneration. Micro-needling with PRP is most effective for skin rejuvenation of wrinkles and sun damage.
If you’d need a micro-needling system, check out our Bella Micro-needling device. It’s been used by some of the top skincare centers we know.
PRP with Allograft Matrix
One of the hidden gems we uncovered when looking at Hair Regeneration experts is that they often combine Platelet-Rich Plasma with some kind of allograft matrix. Allograft matrices are widely used in chronic wound healing – it actively changes inactive adult stem cells back into progenitor cells (its active form) and facilitates faster healing and regrowth.
When a high concentration of Platelet-Rich Plasma is combined with Allograft matrix, the matrix acts as scaffold for growth-factor induced cellular proliferation. There are many respected hair restoration experts in the field offering this combination with a very high degree of success. One prominent NY-based hair restoration expert says this combination has never failed to work in his practice with hundreds of clients.
The most commonly used Allograft matrix is derived from porcine urinary bladder tissue. But we recommend a more superior allograft matrix that is derived from amniotic fluid and tissues. This type of Allograft matrix is “immune privileged” meaning that it can be introduced into the body with virtually no chance of a harmful immune response as compared to allografts obtained from porcine bladders.
If you want to choose an allograft product, take a look at our post on the topic.
Standard drugs vs PRP Hair Regeneration
So far the widest prescribed drugs for male pattern hair loss are Minoxidil and Finasteride. These drugs are designed to prevent progression of hair loss. Minoxidil works by opening up the cell channels allowing more oxygen, blood, and nutrients to reach the follicles. Finasteride prevents the conversion of testosterone to dihydrotestosterone (DHT) which translates to less androgen activity in the scalp. In other words, these are temporary solutions. If these drugs are discontinued, any therapeutic benefits will reverse within about 6 months. I think almost every physician knows that. And the people who take these drugs will still lose hair as it’s not 100% effective in its function of stopping hair loss. Plus as I said, there’s no stimulatory effect on hairs.
You may know where I’m going with this. Platelet-Rich Plasma is a whole another story. It’s perhaps the only treatment out there that has clinically proven to regenerate hair follicles. Meaning it not only slows down hair loss, it actually helps promote new hair growth. The question is how long can the effects last. Some patients report that a single injection treatment with a combination of PRP and Allograft injection has produced for them hair regeneration results for FIVE YEARS AND RUNNING. Of course, different patients have varying outcomes.
The point is… until recently we only had two serious options for hair loss recovery. We had drugs that produced temporary effects, and we had surgery that transplanted hairs. And nothing in between. That’s why PRP Regeneration has gained a lot of traction recently.
This doesn’t mean all other treatments are obsolete. Some patients prefer a comprehensive approach to battling hair loss and they’ll want to fire-on-all-cylinders right from the start. Fortunately, Platelet-Rich Plasma treatments have little side effects or contra-indications and can be safely combined with other treatments.
Combining PRP with other treatments for maximum results
We haven’t found any adverse effects in using Platelet-Rich Plasma with either the Minoxidil foams or the Finasteride drugs, nor with other Laser light scalp stimulation therapies. So potentially you could do it all together. It’s entirely up to your patients – whether they want to focus on PRP Hair Regeneration alone or also pursue temporary solutions like drugs, foams and light therapy.
Another potential treatment that can be combined with Platelet-Rich Plasma and Allograft injections is Vitamin D. Vitamin D is proven to increase transformation of hair follicles.
Get On The Bandwagon Of Platelet-Rich Plasma
The trend for PRP Hair Regeneration, PRP Skin Rejuvenation, PRP Sexual Revival And PRP Facelift Procedures are on the rise. And it’s not showing signs of any slow down.
As many of the dermatologists already believe, you have to get on the bandwagon – there’s no choice. The demand for this treatment is only growing. And by refusing to believe in it, you’re potentially denying your customers their right to use regenerative medicine.
If you’d like to talk to us about the specifics of various protocols, give us a ring at (844) 377-7787. Or head on to our shop to order a trial pack. We’ll be happy to assist you in making a decision about Platelet-Rich Plasma. And don’t worry, we’re not sales professionals. We’re medical professionals just like you. : )
Even though they’re licensed to perform surgeries, Osteopathic Physicians are primarily trained to keep their patient’s treatments as non-surgical as possible. Furthermore, their philosophy leans towards prevention and overall wellness than on treating diseases. And for these reasons, we believe Platelet-Rich Plasma is one of the best treatment options they have. After all, the Osteopathic profession was founded on the basis of the human body’s innate capacity to heal itself – the very function PRP injections perform.
Platelet-Rich Plasma, An Osteopathic Physician’s Best Ally?
Here’s why we think PRP Injections is probably the best treatment to arrive in Osteopathic Physicians hand.
1. PRP is holistic.
Osteopathic Physicians love treating the whole patient, rather than just the disease. And so is Platelet-Rich Plasma, which merely utilizes the body’s own healing mechanism. And it’s not aimed at eliminating just one symptom either. It heals entire areas – this is evident in cases where multiple symptoms are eliminated after administering PRP. For example, there are many cases where female patients experienced sexual revival after being treated with PRP injections for urinary stress incontinence. So even though PRP Injections were pioneered by allopathic doctors – who still are some of its best advocates – Platelet-Rich Plasma basically functions like an Osteopathic medicine. That’s why we think it’s one of the best allies of an Osteopathic Physician.
2. PRP is a musculoskeletal hero
Depending on the specialization of the Osteopathic Physician, chronic musculoskeletal pain can be one of major issues that they deal with. And we know PRP Injections are slowly becoming the first-line treatments for musculoskeletal issues. For example, some researchers believe PRP should be first-line treatment for Knee Meniscus issues. Last year (2016), Dr Patrick Smith from the University of Missouri, Columbia, published the results of an FDA-Sanctioned, Randomized, Double-blind, Placebo-controlled Clinical Trial on Platelet-Rich Plasma for Knee Osteoarthritis – and they concluded that PRP provided safe and quantifiable benefits. Here’s another systematic review summarizing about 29 of those studies.
3. Limitless potential of PRP is hard to ignore
There is a third reason why all physicians, let alone Osteopathic Physicians, must get acquainted with PRP Injections – and that is PRP’s vast scope of application. Because Platelet-Rich Plasma’s mechanism is generic (and straightforward), it can be safely assumed that if it works on knees, it can work on any joints, muscles, tendons, bones etc. It’s only a matter of time that PRP Injections will be a standard first-line treatment for all musculoskeletal issues. If you’re keen on hard evidence, have a look at these the randomized trials as well as other studies in the NCBI database.
This limitless potential is especially a boon for Osteopathic Physicians as they look at problems through their Unity of Function lens. Because if there is a strain for a patient on the wrist, there may be other areas of the FASCIA that might be linked to the trouble on the arm. In cases like these, multiple Platelet-Rich Plasma injections on different areas can significantly enhance the typical Osteopathic treatments for restoration of balance and freedom to the entire body.
Dr. Peter Lewis, a fellow of the American Academy of Regenerative Medicine, and the clinical director of the Surecell Group, who’s administered over 100,000 PRP injections to 12,000 patients says, “More than 80% of the patients who undergo PRP treatments enjoy very good results. Even people who’ve been told they’d need surgery have a 70% chance that Platelet-Rich Plasma will help them.”
List of conditions treated by Platelet-Rich Plasma [INFOGRAPHIC]
For your reference, we’ve included a nice INFOGRAPHIC here that lists common PRP treatment areas.
At the time of writing, Platelet-Rich Plasma treatments are not subject to FDA approval. Because all of these treatments are performed on the same day with minimal manipulation of the patient’s blood. This feature places the PRP procedure within the FDA Code of Federal Regulation (CFR) title 21 Part 1270 1271.1 and as such it enjoys exemption. (FDA rule in 1271.15 (b)).
So no, you do not have to follow the traditional FDA regulatory pathway.
For an incredibly straightforward process, the science of Platelet-Rich Plasma extraction has been surrounded by scores of debating researchers for over a decade about the composition and the method. Today, we’re going to clear up all of that by helping you choose the best Platelet-Rich Plasma (PRP) kit.
How to choose the best PRP Kit
First of all let’s talk about not using a kit. Yes, you can draw blood into a test tube, centrifuge it, take the top portion and call it PRP. That’s called “bloody PRP” and it is the least effective containing maybe 1-1.5x platelets if you’re lucky – and a whole lot of Red and White Blood Cells. This is what you should not ever think of doing because it’s not the real Platelet-Rich Plasma. In some cases, this way “bloody prp” has been known to have caused post-injection flare ups.
Using a Platelet-Rich Plasma kit on the other hand, you can get a platelet concentration anywhere between 5X and 7X the average.
This 5X-7X concentrated serum is what is known as Platelet-Rich Plasma or Autologous Conditioned Plasma. These professional kits allow you choose to allow or disallow red and white blood cells in your final product depending on applications. For example, researchers now suggest Leukocyte-poor Platelet-Rich Plasma for osteoarthritis and Leukocyte-rich Platelet-Rich Plasma for tendinopathy applications.
However, there are some commercial kits that may not deliver exactly what you want in your PRP.
To understand that fully, here’s a diagram of the components in blood.
And here’s how it will segregate itself after centrifugation.
Based on the technique of segregation, the kits are classified into two types.
1. Gel separators
Gel separators are those that basically nothing but a special test tube with some gel inside. It works because the gel has the density that’s in between blood and platelets. So when you fill it with whole blood and spin, the platelet portion of the blood will go to one side of the gel and the blood portion on the other side. But the biggest drawback of these gel-based PRP kits is that most of the platelets will end up getting caught in the separator gel itself. Hence the 1-1.5X concentration you get when you sequester the platelet part. One positive aspect is that the gel also separates white blood cells. So the PRP obtained is has almost zero RBC and WBC.
2. Buffy coat based
The kits that produce a visible buffy coat layer after centrifugation are the best at giving concentrations of platelets anywhere from 5X to 7X. What’s a buffy coat? Buffy coat is a thin layer, neutral or buff in color, formed between the blood and the platelet serum and are essentially plasma with suspended platelets. Now, having a buffy coat by itself will not be of much use. Instead you must be able to carefully separate the buffy coat from the RBC without contamination. When separated the right way, the buffy coat will be mostly plasma and white blood cells (leukocytes) with 5X-7X platelets concentration with less than 10% RBC.
3. Buffy coat based, double-spin
Yes, there is a third type of Platelet-Rich Plasma kits and those are buffy-coat based and that can do double-spin without introducing further Red Blood Cells into the mix. This is the best Platelet-Rich Plasma kit you can hope to have. Because essentially what it can help you do is sequester the Plasma + Platelets mix and do a further short run spin in the centrifuge to further isolate the Platelets. This time the platelets will be accumulated at the bottom of the Plasma serum. Once this is done, all you have to do is take the bottommost portion of the serum which will be 5X to 7X concentration of Plasma. This is what is called Platelet-Rich Plasma or Autologous Conditioned Plasma.
Getting this kind of end-product is key here as researchers have identified that for clinical benefits, the Platelet-Rich Plasma needs to be 1 million platelets per μL or more. This is 5x to 7x the normal platelet count of 200,000 platelets per μL.
The DrPRP Kit – Probably The Best PRP Kit
There are various kits for Platelet-Rich Plasma separation. But our kit, the DrPRP kit, is special in that it uses the dynamics of the tube design to give you full control over the end-product. You can get 10cc of usable product that you can manipulate to your specific needs. You can sequester the platelet serum and double spin it for 5X-7X above baseline platelet concentration. You can get a completely amber product or red product depending on whether you want a little red blood cells in your end product or not.
Leukocyte-Poor Platelet-Rich Plasma
When you’ve gotten the Platelet-Rich Plasma, deciding on if you need Leukocyte-poor Platelet-Rich Plasma is the next step. Although there is no consensus on the presence of leukocytes, some researchers maintain that the leukocytes are inflammatory and may inhibit the power of cytokines and growth factors to create new cells. The researchers on the other side of the argument claim that without inhibitory effect of the leukocytes there will be excessive scar tissue at the healing site. Leukocytes-Rich Platelet-Rich Plasma is known to contain more growth factors like TGF (which improves collagen synthesis), PDGF (increases cell metabolism) and VEGF (assists the formation of new blood vessels).
Other studies show that Leukocyte-rich PRP is most effective in the treatment of tendinopathy while Leukocyte-poor PRP is most effective in the treatment of osteoarthritis. It’s better that you try them out both and come to your own conclusion.
In case you need to use Leukocyte-poor Platelet-Rich Plasma, you may need a Leukocyte-Reduction (LR) filter. Conventional LR filters use electrostatic attraction in micro-sized filter membrane to retain Leukocytes while allowing the rest of the components to pass through. Drawbacks of this filter include clogging of the filter membrane half-way through the filtering process. A better LR filter is based on Controlled Incremental Filtration (CIF) method. With the CIF-LR filter, you will be able to remove 99.99% of leukocytes from the Platelet-Rich Plasma.
The Lack Of Clinical Evidence Myth
Let’s address ignore the elephant in the room, shall we? There are some doctors who believe that Platelet-Rich Plasma is just a fad. They say, “Show me the double-blinded peer-reviewed evidence.” It’s not that the other stuff they use for their patients are all double-blind proven and peer-approved. They just want to see it for this one. It doesn’t matter that the scientists who discovered growth factors in plasma got Nobel Prize in the 1950s. It doesn’t matter that they started using Platelet-Rich Plasma to heal gums in 1970s. It doesn’t matter than there are more than 6,000 studies on it till now. Use this search query in the NIH database and you’ll spot more than 1000 of them.
The hard evidence is of course money. Why are hundreds of thousands of customers taking out hundreds of dollars out of their wallets to pay for Platelet-Rich Plasma? Why are the independent researchers worldwide spending the very little research dollars they have (compared to the big pharma research moola) on studying this treatment?
A doctor who’s reviewed over 700 PRP treatments said the treatment has over 70% satisfaction rates with over 50% patients coming back for more.
An Incredible Healing Story
So far, Platelet-Rich Plasma is spreading mainly through word of mouth. Many patients take it up as the treatment of last-resort and later go on to shout it over the mountains. Here is one such story.
Three years ago, Bernie (not real name) came to see an Orthopedic Surgeon for a troubled shoulder affected by OA. After trying out the usual remedies, the OS suggested a shoulder replacement surgery. He wasn’t willing to do it. But the pain became unbearable. So the OS got him to do an arthroscopy instead. Bernie came out of the “clean out” like a new person. Unfortunately, the feeling didn’t last long.
In fact, things started getting worse. He couldn’t even hang up a shirt or pick up a pile of magazines on the floor. His arm would lock down every night. And took as much as 3 painkillers every night before sleep. As days passed, things only got worse. Then someone told him to give Platelet-Rich Plasma a shot. At this point, he was considering the OS’s original recommendation for the replacement surgery. But thought he’d try Platelet-Rich Plasma before that.
Bernie was also working with a Physiotherapist at that time. Both the PT and OS said it’s doubtful that Platelet-Rich Plasma would be beneficial – not only because the OA had advanced but also because his shoulder has 3 tears and most of bones were already worn out (his humerus was basically flat.)
Anyway, they decided to give Bernie two Platelet-Rich Plasma injections. After the injections, Bernie was told to continue the painkillers as the PRP would take some time to take effect. But what Bernie experienced was something totally unexpected.
He started improving almost immediately. And stopped taking the painkillers after two nights.
In the next two months, his shoulder became problematic only on 2-3 occasions – all while performing all the activities that he couldn’t previously perform, including activities that he wouldn’t dare think of before the injections. For example, he could ride the lawn mower for more than 45 minutes.
Needless to say, both the OS and the PT was impressed.
After seven months, Bernie has reported that he’s sleeping most nights without painkillers. After about a year, Bernie came back to say he has even less pain now. He haven’t been to the PT or the OS in several months.
Now take a guess. No points for the right answer though. Do you think Bernie will recommend PRP to others?
Few things are as life-shrinking as chronic pain. Health economists report that chronic pain costs our nation more than $635 billion each year in medical treatment and lost productivity – more than cancer, heart disease and diabetes. Painkillers have been the only relief medication in modern history. That’s changing with Platelet-Rich Plasma. It has been emerging as one of the key players in pain management.
In any life that’s exclusively ruled by pain, Platelet-Rich Plasma has the power to bring back pleasure and normalcy. It’s certainly a better option for those who’re getting by on four or five Advils a day and wondering what the long term consequences would be.
First of all, Platelet-Rich Plasma injections are completely safe. The PRP, prepared by centrifuging the patient’s blood in a special blood tube, works in a two step way. First the injections, often guided by ultrasound, breaks up the tissues and second, the growth factors in the PRP helps rebuild the entire tissue. This produces a healing effect and reduces pain.
Here are five common types of pain that can be healed with Platelet-Rich Plasma.
1. Arthritis pain
It’s been well-proven that a few shots of Platelet-Rich Plasma can produce a huge effect for Arthritis patients. It has the potential to…
Inhibit inflammation and thus slowing down degeneration
Stimulate cartilage formation
Kickstart the production of lubricating fluid
These activities in the affected site ends up reducing the pain sensation.
As a long term effect, Platelet-Rich Plasma injections tend to preserve the joints in more than 70% of the cases – as reported by a landmark study in 2013. Recent studies have shown similar results too. They discovered that a two or three injection treatment over a period of 4-6 weeks with Platelet-Rich Plasma does more benefit that similar injection treatments with either Corticosteroids or Hyaluronic Acid. Moreover, the cartilage degeneration was significantly slowed even for patients in advanced stages of Osteoarthritis.
The researchers also conclude that repeating the injections after 6 months ensured better results.
2. Neurological pain
Platelet-Rich Plasma is one heck of a wonder treatment whose healing potential seems to be expanding everyday and seems like it’s only limited by the physician’s imagination. The latest of those new discoveries is in the field of nerve regeneration and the resulting neuropathic pain. Nerve fibers consisting of neurons are very delicate structures and not much has been discovered about its operating mechanism. But recently, platelet rich plasma have been shown to promote the restoration of nerve fibers.
In a study performed at Hasanuddin University in Indonesia, Platelet-Rich Plasma was successful in nerve regeneration for patients with leprosy peripheral neuropathy – a situation where all traditional treatments have failed. Which means PRP injections are effective in restoring sensations when it has been lost. This is remarkable news.
Then there is another study conducted in Greece the shows very encouraging mid-term results regarding PRP for treatment of Carpal tunnel syndrome.
All of this is proof that Neuropathic pain can be alleviated by Platelet-Rich Plasma. This paper by a researcher at the University of Puerto Rico analyses how Platelet-Rich Plasma has been able to eliminate neuropathic pain. He reports that PRP’s ability to promote axon regeneration is the key.
Chronic back pain and sciatica are mysterious conditions and physicians generally have a hard time figuring out what’s causing them. They first thing they do is to scan the lower back area for defects. When they find one, they’ll recommend surgery to correct that defect even though they have no idea if that defect is indeed the culprit of the pain. When they can’t find any defects, they end up being puzzled and sent the patient away with a bunch of Advils.
In a spine health forum, a patient explains his situation which was similar. His physician suspected the tears in L4-L5 spine segment to be the causing the pain. But there were minor tears and bulges everywhere, so the physician was confused. The patient ended up having to take 8 Advils a day. Unable to continue with that, the patient skeptically tried Platelet-Rich Plasma injections. He went from not being able to sit back in office or drive in a car (even with those medications) to stopping the medications altogether and going on a family trip overseas. Talk about a dramatic shift in life experience!
Another patient on the same forum describes how she had PRP injection for chronic pain in the cervical spine, and it’s been pain-free for two years.
In addition to back and knees, almost all other joints are being treated by Platelet-Rich Plasma now. As the science of PRP evolves, the treatment is vigorously gaining popularity with more and more patients demanding it from their physicians. After all, the procedure is incredibly straightforward and is easily understood by most. The physicians hardly need to talk before the patient accepts eagerly.
Hence the doctors are now quick to prescribe Platelet-Rich Plasma for any case of chronic bursitis – in areas like fingers, elbow, toes, hip, shoulders, neck, wrist, ankle, and hip – and the results are almost always positive.
In fact, Platelet-Rich Plasma can be – and must be – prescribed for more than 50% of the musculoskeletal issues that are usually treated with surgery or steroid injections.
5. Post surgical pain
Surgical pain relief is one of the newer areas where Platelet-Rich Plasma is gaining ground. This is primarily to take advantage of the wound-healing and bone regeneration aspects of PRP, but pain-relief is a very evident beneficial side-effect. Some medical perfusionists advice Platelet-Rich Plasma after almost all surgeries including Neurosurgery, Tumor removal surgery, Oral and Maxillofacial Surgery, Head and Neck Surgeries, Reconstructions and Cosmetic Surgery, Orthopedic/Spinal Surgery, Hand and Foot Surgery, Bone Graft Surgery, Cardiothoracic Surgery and Bariatric Surgery.
By cutting short the time it takes to heal from the wounds of surgery, Platelet-Rich Plasma plays a pivotal role in assisting patients get productive as early as possible. And when done in conjunction with surgery, Platelet-Rich Plasma injections are almost always paid for by the insurance provider covering the surgery.
The beginning of the end of orthopedic surgery?
At a time when big hospitals are racing towards a possible automation of orthopedic surgeries, there are some physicians who believe that the rise of Platelet-Rich Plasma together with the rise of stem cell technology marks the beginning of the end for 80% of the orthopedic surgeries. They say science is finally waking up to the fact that human intervention is not the most efficient way of dealing with musculoskeletal issues. Rather, it’s best to provide the necessarily biologics in the form of PRP and stem cells so that the body can invoke it’s own healing.
I hope you agree – because today’s regenerative medical trends are certainly pushing the medical industry in that direction.
If you haven’t started offering Platelet-Rich Plasma – or would like to know some general protocols, we would love to share them with you. Just call us at (844) 377-7787 or email via email@example.com.
Some believe that Platelet-Rich Plasma is nothing but a new-age medical nonsense that preys on the gullible. And let me the first to admit that there are some carefully controlled studies out there showing that PRP Injections work no better than a placebo. But there are also thousands of doctors who swear by the efficacy of Platelet-Rich Plasma which seems to do a better job at healing patients, and at a much lower cost, than traditional medicine.
This trend is only growing.
What does these doctors see that escapes medical establishments’ eyes?
One branch of medicine where it is particularly evident is Podiatry. We believe that Platelet-Rich Plasma is not as widely accepted in Podiatry as it should have. Making it the first line treatment for pain in the foot and ankle treatments will help orthopedic surgeons to reduce complication rates, achieve favorable clinical outcomes faster, and improve patient satisfaction.
Here are some of the cases where a Foot and Ankle Surgeon might use PRP or PRFM (Platelet-Rich Fibrin Matrix).
1. Plantar fasciitis/fasciosis
It’s widely accepted that Platelet-Rich Plasma Injection has become a very common treatment for Plantar Fasciitis. Studies like this prove it’s efficacy. In the words of Dr. Daniel Kassicieh, D.O., FAAN, FACN, of Sarasota Neurology, PRP seems to be “one of the most effective treatments for Plantar fasciitis to actually cure it permanently.” He says many of his patients have avoided surgery with a single Platelet-Rich Plasma injection – no rehab, no down time, and certainly no unwanted consequences of surgery to deal with. That explains why Plantar Fasciitis has been the 5th popular musculoskeletal condition (the first four are knee meniscus, shoulder, shoulder rotator cuff and tennis elbow in that order) treated by Platelet-Rich Plasma. Part of the reason is that over 3 million people are diagnosed with this condition and we haven’t found a viable treatment for it yet.
Here’s a video of the procedure done by Los Angeles Foot and Ankle Specialist Dr. Baravarian.
2. Achilles tendonitis/tendinosis
Achilles tendinopathy is a another difficult to treat condition which is progressive and often results in tendon rupture. Surgical approaches, either tendon debridement or tendon transfer, are risky and does not end up with predictable results. Patients are usually given corticosteroid injections to reduce pain. But studies like this have shown that Platelet-Rich Plasma is a much more helpful treatment than corticosteroids. Another study released by European Foot and Ankle Society revealed that a single PRP injection can be a safe and attractive alternative for the treatment of non-insertional CRATs than anything else available today.
3. Diabetic Foot Ulcers
Non-healing diabetic foot ulcers are a major problem for diabetics and in the US, there are over 2.5 million people affected. Eleven percent of them may go on to have lower extremity amputation. That’s not pretty. But according to this study, just a single injection and a bi-weekly topical application of Platelet-Rich Plasma turned around the chronic non-healing ulcers of 24 patients in just 8.2 weeks. In another study, the effects of topical application of Platelet-Rich Plasma was compared with Anti-septic creams for clean diabetic foot ulcers and PRP was proved to be more effective.
Platelet-Rich Fibrin Matrix, derived from Platelet-Rich Plasma, is also another excellent candidate (as demonstrated in this study) for diabetic foot ulcer.
4. Bone regeneration
Foot and ankle is one of the most common areas where bone regeneration is needed. Though nothing trumps mechanical stabilization, researchers are now surprised by the role of Platelet-Rich Plasma.
PRP assists bone and soft-tissue healing by providing platelets and thus growth factors at the site of damage. The phenomenon was studied recently, where they conducted a systematic review of all the 64 independent articles that discussed PRP’s role in bone tissue regeneration. This study calls for further optimization of the PRP treatment.
Nevertheless, the science for using Platelet-Rich Plasma for bone regeneration is solid. In order for bone or tissue to form, three key components are required at the surgical site. These three components are:
A scaffold for cellular growth and attachment
Biological stimulants that provide signaling proteins to recruit cells
Undifferentiated stem cells that provide osteogenic potential
The combination and synergy of these three key components is critical to bone formation. Platelet-Rich Plasma can provide two of three of these components — a scaffold and a biological stimulant. Hence there is no reason why we should not use it for assisting bone regeneration.
5. Ankle Sprains
This is a fairly common condition among both professional athletes and weekend warriors. An ankle sprain can be a stretch, tear or a complete rupture of the ligaments in the ankle. In any of these cases, Platelet-Rich Plasma can be very effective in accelerating the healing process. In one of the randomized controlled studies, researchers analyzed the effect of Ultrasound-guided Platelet-Rich Plasma injections on athletes with Syndesmotic or high-ankle sprains. Platelet-rich plasma was injected into the injured antero-inferior tibio-fibular ligaments (AITFL) and their Return to Play (RTP) time was measured. Not only was the Platelet-Rich Plasma group saved 20 days of healing time, they also experienced significantly less residual pain. Expert physicians tell us that Platelet-Rich Plasma can cut down the normal 6-week recovery period for a torn ligament from an ankle sprain to just 2-3 weeks. That’s a 50% reduction in healing time.
Immobilization The Key In Successful Platelet-Rich Plasma Treatments?
One of the missing pieces when it comes to Foot and Ankle related injuries, is Rest and Rehabilitation. With or without Platelet-Rich Plasma, there is no avoidance of Rehab. And we found that some of the studies that disprove Platelet-Rich Plasma for Foot and Ankle Injuries were done without Rest and Rehabilitation – meaning they were testing whether Platelet-Rich Plasma is a stand-alone “magic pill.”
We can assure you that Platelet-Rich Plasma is not a magic pill. And that there is no avoidance of Rest and Rehabilitation. The Platelet-Rich Plasma injection must be followed by a standardized rehabilitation protocol – which, depending on the severity, can include full weight-bearing in a splint, pneumatic boot, or cast for a 2-3 weeks.
What’s Feeding The Resistance For PRP Adoption?
We believe the biggest hindrance is the current system of healthcare. The big-pharma-dominated healthcare in the US would be more than happy to spend almost $2 trillion for chronic diseases than educate doctors on the advantages of alternative, autologous and integrative interventions such as Platelet-Rich Plasma. Studies after studies have shown that the earlier you introduce Platelet-Rich Plasma, the more results the patients end up getting. Yet, we’re in a system that encourages all kinds of short-term-results-oriented treatments before considering Platelet-Rich Plasma because it’s “expensive” and not reimbursed by insurance companies.
How Foot And Ankle Surgeons Can Benefit
The use of PRP in the foot and ankle is here to stay. So get involved with Platelet-Rich Plasma as soon as possible. Try it out with your patients. Play with the Platelet-Rich Fibrin Matrix. And before prescribing conventional drugs and surgeries, give your patients an opportunity to try Platelet-Rich Plasma at a low cost. We know how thankful your patients are going to be.
For more info on various protocols for PRP Injections, reach out to us at (844) 377-7787.
Despite the recent trends, Platelet-rich plasma (PRP) is still hugely under represented by the aesthetic community. The fact is, it’s a holy grail in the field – nothing else this non-invasive, non-surgical and pain-free can achieve the same home-run in terms of results that PRP swiftly delivers after just one 45-minute session performed in-office. Nothing else capitalizes on the natural healing properties of the human body.
Plus PRP can be a huge profit maximizer too.
Lowest Cost To You – But Same Results For Patients
While your competitors depend on high-priced brand name products that gobbles up their profit margins, you could use the cheapest yet effective solution ever – your patient’s own blood. And laugh all the way to the bank.
But that doesn’t mean you should stop using those other products. Platelet-Rich Plasma may not have the sex appeal that many of the other aesthetic products have. That’s why it’s a great idea to combine your existing off-the-shelf procedures and methods with Platelet-Rich Plasma.
Injectable treatments like fillers and neurotoxins as well as other treatments like fat transfers, micro-needles, topical serums, and even lasers can be used in conjunction with PRP.
It enhances the results but adds only marginally to the cost of goods.
That’s why we’re seeing tremendous uptick in PRP adoption among skincare clinics.
Why Aren’t Skincare Clinics Adding PRP?
The first obvious hurdle is the investment needed to get started. You’d spend maybe a 1000 or 2000 dollars on equipments which can include a centrifuge and a Plasma Fill™ device. But as many of our successful clients would say it’s a no-brainer. The investment can be recouped in just 2-4 treatments. Then it’s mostly profit. Cost of PRP treatments range from $800 to $1500. And this price point is here to stay that way because the results generated by these PRP are comparable to those equally priced “traditional” treatments like Botox, Dysport or Xeomin. Hence most skincare clinics immediately see a bump in their revenue when they add PRP to their practice.
Second is that the owners believe they have to go through a lengthy qualification process to do the procedure. Don’t get me wrong, you have to be qualified. But the process is much more simpler than most think. For the person licensed to do these procedures, the entire learning can be completed online through a video course that awards up to 6.75 CME credit hours. This can make you confident in doing a variety of treatments including PRP-enhanced Facelift, PRP-enhanced Facial with Micro-needling, PRP Hair Restoration, PRP Breast Rejuvenation, PRP Hand Rejuvenation as well as PRP Scar Rejuvenation.
The Unquestionable Strength of Platelet-Rich Plasma
PRP has the advantage of being able to stimulate both superficial and deep dermis layers. Platelet-Rich Plasma Injections to the superficial dermis is done just like mesotherapy to improve skin texture, increase smoothness and to add volume to the skin surface. PRP Injections to the deep dermis layers can function as a filler. Thus Platelet-Rich Plasma can act as both a skin rejuvenation agent and a skin volumnisation agent at the same time.
In addition to all this, there is the healing power of the growth factor present in the PRP. So we’re seeing patients having other pleasant “side effects” like healing of tissue defects. For example, patients who had genital PRP for urinary stress incontinence were surprised by the increase in sexual drive they experienced.
All of these results are obtained with ZERO RISK. And unlike Botox, the results will look completely natural. And many physicians are now seeing the best ever outcomes for their procedures after combining it with PRP.
Isn’t that what you want for your clients?
The Top 5 Treatments Using Platelet-Rich Plasma
1. Wrinkles and Folds
Unlike Hyaluronic acid (HA) fillers, like Restylane and Juvederm which are solids, PRP is composed of liquid blood components that are easily absorbed and penetrates deeper into the skin. Thus it is safe and effective for use on deep cheek indentations, under eye hollows and the neck areas for a more youthful looking face. However, HA fillers can be effective in filling individual deeper wrinkles and there is nothing preventing you from using both PRP and HA to accomplish an amazing result. Another procedure that PRP goes well with is the fat transfer procedure where the growth factors in PRP can help retain the “aliveness” of the injected fat and thus helps prolong the results.
It’s a good practice to add a layer of PRP on top of regular fillers to not only provide an instant fill or volume correction but also to improve skin tone and texture through regeneration. This set up prolongs the effectiveness of the filler by up to 50% – or 3 to 6 months longer – than when the fillers are used alone. PRP can also combined with neuromodulators and fractional ablative lasers. Plus patients who don’t want to use gel fillers can benefit from PRP as it can stimulate the body to make a small amount of its own ‘filler.’
If you want to learn in detail the right way to do a Platelet-Rich Plasma Facelift, click here.
Platelet-Rich Plasma can be used with Lasers and Radio Frequency devices to deliver a smoother, more rejuvenated look for your clients. The benefit of adding PRP is that the activated platelets in the PRP stimulates the production of natural collagen which enhances the results that your patients get. It also accelerates the healing of the skin from the adverse effects of lasers much faster than using just topical post-care treatments. PRP also reduces the redness of the face much quicker.
If you thought Micro-needling was great for skin resurfacing, the results can be much, much better when combined with Platelet-Rich Plasma. This procedure, made famous by Kim Kardashian and other celebrities, is one of the most sought-after treatments in dermatology. It’s perfect for facial regions that require deeper perforation as well as delicate regions like the area around the eyes. The combination treatment is a match made in aesthetic heaven – because it produces massive amounts of collagen in the skin leading to smoother, firmer and noticeably younger-looking skin. It produces great results in terms of reducing the appearance of imperfections like stretch marks. The micro needling breaks up the fibrous tissues of the skin and the PRP promotes the growth of new, healthy tissues.
4. Hair Regeneration
Just days ago, a new study has revealed that when 5% minoxidil solution was combined with PRP, it showed more improvements in hair regrowth for female patients with androgenetic alopecia than without PRP. This is just one of the few cases. The New York hair restoration specialist Dr. Amiya Prasad, M.D has consistently proven that adding PRP with extracellular matrix (ECM) can work wonders to thinning hair. The beauty of PRP for hair regeneration is that the patients need only ONE treatment to see impressive results. And only a small minority of patients will need a second treatment, usually after 18 months.
5. Scar Revision
Ok, this is not really a domain of Platelet-Rich Plasma since PRP injections alone cannot revise a scar. However, researchers have shown us that a combination of autologous PRP along with LED phototherapy at 830 nm is an excellent treatment for scars. That is really just a start. There are other PRP-combination procedures for scars like the use of PRP bio-fillers using this device as well as PRP and micro-needling using this device. Subcision is another procedure that works well with PRP for re-plumping areas of lost volume or depressed scars.
Warning:PRP may produce no aesthetic result if practitioners don’t follow guidelines
There are three kinds of PRP that you can develop: The Pure PRP (Leucocyte-Poor Platelet-Rich Plasma), L-PRP (Leucocyte and Platelet-Rich Plasma) and PRF (Platelet-Rich Fibrin). Pure PRP and L-PRP are PRP with a low density of fibrin network obtained by adding a small amount of anti-coagulant to the tube prior to blood collection. Most medical applications require the L-PRP for best results. And there are some specific conditions which warrant the use of PRF (either P-PRF or L-PRF), a preparation that has a high density of fibrin network. Whichever ones you choose, there are specific protocols for getting an ideal output each time you do it. Failure to follow the protocols may result in sub-optimal results for your clients and tarnishing of the image your clients have of Platelet-Rich Plasma.
Plus, there are a few contraindications for PRP that you need to keep in mind including the following:
Sepsis of the blood
Cancer and chemotherapy
Critical low blood platelet count
Deficiency of fibrinogen
Abnormal or unstable blood pressure
Acute and chronic infections
Chronic liver disease
Severe metabolic and systemic disorders
Heavy nicotine, drug, and alcohol consumption
And the use of anti-inflammatory drugs within 2 weeks from the date of PRP injection
Plus, there is a list of medications that affect the function of platelets. They should be stopped at least 10 days before and after a PRP procedure. Even stuff like Advil, a non-steroidal anti-inflammatory drug used to treat pain and fever, can affect the regenerative power of platelets.
The bottomline is – a number of growth factors are released from the platelets into the body through PRP – and care must be taken to make sure none of that will go wasted either through inefficient process or through incompatible bodily conditions.
If you ensure that, you will be like one of our clients who came back to us saying, “Hey, we’re seeing amazing results for all of our existing procedures after adding PRP. Thanks for that!”
Want pre-designed marketing brochures for your PRP offering, you can now get them from us here, here and here.