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Platelet-Rich-Plasma-PRP-Injections-Debate
Why Are We Still Debating Platelet-Rich Plasma?

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.

Fast forward 7 years later, in 2016, and we had the first FDA-Sanctioned, Randomized, Double-blind, Placebo-controlled Clinical Trial on Platelet-Rich Plasma for Knee Osteoarthritis which showed that PRP improved the outcome by 78% compared to 7% for placebo.

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 Osteoarthritisfirst 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?

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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.

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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.

Here’s one study that explains why accurate localization is linked with an improved clinical outcome Study of intra-articular infiltrations with intra-osseous injections of Platelet-Rich Plasma.

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.

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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)
  • Quadriceps tendon
  • Patellar tendon
  • Medial meniscus
  • Anteromedial joint line (AMJL)
  • Medial midpatellar (MMP)
  • Superomedial patellar (SMP)
  • Anterolateral joint line (ALJL)
  • Lateral midpatellar (LMP)
  • Superolateral patellar (SLP)
  • Lateral suprapatellar bursa (LSB)
  • Infrapatellar (IFP)
  • Lateral meniscus
  • Subchondral bone
  • Femur bone

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.

By the way, if you’re wondering if there really is a study on Platelet-Rich Plasma for Spinal Muscular Atrophy, here is one from Egyptian researchers.

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Does Age Play A Role?

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.

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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.

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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.

And check out the IOF membership information here.

One last thing…

Platelet-Rich Plasma Standardization

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.

We suggest using the latest MARSPILL classification for Platelet-Rich Plasma developed jointly by Brazilian and US researchers.

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.

Here’s the chart for the MARSPILL classification.

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And you may also want to check out the DRPRP Kit for the most ideal concentration of Platelet-Rich Plasma.

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How Platelet-Rich Plasma Is Changing Arthritis Treatments

From a mere 6% in 1940, the rate of knee arthritis in our nation has jumped to almost 16% to become one of the top causes of disability. The consequences are paramount as arthritis doesn’t just affect knees – it overpowers people with fatigue, pain, depression and even difficulty getting out of bed. Over the past few years, Platelet-Rich Plasma has quietly emerged as a
savior for many of these patients. It ushered in the anabolic era of treating Arthritis.

Of course, this coincides with Platelet-Rich Plasma’s skyrocketing adoption rate and it’s media popularity. In fact, it has become so popular that, there is even a research paper about it’s popularity!

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How Platelet-Rich Plasma Is Changing Arthritis Treatments

Traditionally, the only road available for chronic knee arthritis patients was the road to total knee replacement. It will start out with the administration of corticosteroid injections. After going through that for quite a bit, the patient will show no further progress and the surgeon would suggest knee arthroscopy for debridement of affected tissues. That would feel better for a while before the patient returns for more. The surgeon would then give them a date for total knee replacement.

All of that has changed with Platelet-Rich Plasma and Stem cell treatments. Now, we have found out that the best bet we have is to administer Platelet-Rich Plasma at the earliest stages of knee arthritis to regenerate the affected tissues as soon as possible. Platelet-Rich Plasma, with its growth factors and cytokines, not only relieves the symptoms but it is proven to reverse the condition as time goes by. It creates a very beneficial, positive cellular change in the joint pathology.

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All of that without the adverse effects of an invasive surgery.

Proven Regeneration Tool Abandoned By The Big Pharma

Right now, Platelet-Rich Plasma is used for a number of musculoskeletal conditions like Rotator cuff injuries, Tennis and golfer’s elbow, Ligament strains, Knee instability, Chronic back pain, Knee and Achilles tendonitis and more. There is no adverse effects or long term implications. Few other treatments can match this record. The important distinction to be made when comparing Platelet-Rich Plasma with other existing treatments is its regeneration potential. Injecting PRP doesn’t just correct the condition – it has the potential to make it a little better than before. As far as research is concerned, most of the PRP literature concerns around knee osteoarthritis. Here’s a Level 4 systematic review and a more recent Level 1 systematic review of 10 studies with a total of 1069 patients if you want to verify the results.

Of course, it doesn’t mean all you need is a couple of PRP Injections and things will be better. Or maybe that’s it?

If the big pharma is able to package this and market, they would’ve carved out a multi-billion dollar market by now. But they can’t because the primary raw material – blood – has to be autologous and fresh for this to work efficiently. Some researchers are exploring the possibility of freeze-drying Platelet-Rich Plasma. This may or may not work depending on how well it can preserve the key elements of Platelet-Rich Plasma – the bioactive proteins in the platelets, plasma and white blood cells.

According to Bert Mandelbaum, MD, DHL (Hon), Chairman of Santa Monica Orthopaedic & Sports Medicine Foundation and Co-Chair of Medical Affairs at the Institute of Sports Sciences, Cedars-Sinai, Platelet-Rich Plasma is more promising than stem cells. See his recent article in Medscape here.

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Still there are plenty of doctors who comes to us asking, “Where is the research? The FDA-cleared prospective, multi-center, sham-controlled, randomized, double-blind clinical trials?” Actually, the FDA is hard at work clearing devices that provide relief of pain and symptoms associated with knee osteoarthritis (OA) for up to 90 days by nitro-freezing the nerves!

Many Research, Many Doctors

The amount of research from independent research institutes around the world on Platelet-Rich Plasma is just a tad bit overwhelming. New findings are published almost every month on the topic. The vast number of research mirrors the immense potential of PRP Injections. And for knee osteoarthritis, there is already unquestionable proof.

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Here are some of the advocates of Platelet-Rich Plasma:

  1. Caring Medical’s Ross Hauser, MD has written a well-researched article about Platelet-Rich Plasma for knee osteoarthritis here.
  2. Dr. Lewis G. Maharam, MD, FACSM, one of the world’s most extensively credentialed and well-known sports health experts known as Running Doc™, always show great enthusiasm when describing Platelet-Rich Plasma.
  3. Best selling author and team physician of Philadelphia 76ers, Dr. Nicholas DiNubile MD recently wrote an article saying Platelet-Rich Plasma may make knee-replacement surgeries a thing of the past.
  4. Famous Long Island physician Dr. David J. Weissberg, MD, says for his patients, with just one shot of PRP, in general, gets relief from their problems without any need for surgery and slow but progressive cure in their problems.
  5. Dr.Kevin F. Darr, M.D., a national leader in orthopedic medicine and a visionary in cell therapy, combines PRP with other cell therapies and finds the results “outstanding.” Dr. Darr is one of the fifteen physicians selected to participate
    in an FDA approved Level 1 clinical study utilizing cell therapy techniques. Here’s a recent testimonial from one of his patients.

Of course, there are many more. But for those who’re skeptical in trying Platelet-Rich Plasma or even offering them to their patients – a doctor once told me he’s skeptical because he might appear as a greedy physician to his patient if he offered unproven techniques for the sake of trying it – they can rest assured that many nationally reputed doctors are ardent fans of this therapy. Plus, there’s really no risk in trying it.

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The Best Approach For Skeptical Doctors

We know many of your patients rely on medical insurance coverage for their osteoarthritis and other treatments. And many of them are pensioners. Asking them to pay out of their pockets for a treatment that you yourself have doubts in – that’s impossible. While we hope the insurance starts accepting it, we can’t just ignore the results. You’ve seen the research, and heard the testimonials and read the media pieces.

So instead of wondering whether it might work – why not give your patients a try. Give the first treatment for FREE. Yes, I’m suggesting you let your patients try it out for FREE.

From what we’ve seen so far, once patients clearly experience the healing results – they’ll come back for more and you’ll more than make up for the FREE treatment you provided them.

We’ve seen over and over again – in several clinics – that patients always come back for more.

Like this case from Dr. Payel Banik’s office. (Dr. Payel is the owner of Osteopathic Healing Hands, Houston, TX.) The patient in the video below explains why he’d come back for more.

Offer Your Patients A Free Platelet-Rich Plasma Injection

So what do think? Are you going to stand on the lines and watch until government regulatory boards mandate PRP for osteoarthritis and other conditions? Or are you going to start helping your patients right now? Start offering it for FREE so that YOU will be convinced that it works. And win over your patients in the process. And watch them come back for more.

The choice is yours.

If you’re seeing a lot of patients with intermediate to advanced stages of osteoarthritis or other similar musculoskeletal conditions, offer them a FREE Platelet-Rich Plasma injection starting today. We’re very confident that it will make the fall in love with this treatment for life! There will be plenty of referrals for you.

All you need is a PRP Kit and a compatible centrifuge and you’re good to go. Call us at (844) 377-7787 if you need more info.

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The Osteopathic Physician’s Guide to Platelet-Rich Plasma

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.

The Journal of American Osteopathic Association reviewed Platelet-Rich Plasma a while ago and concluded that more studies are needed. Later another study was presented about a surprising case of an 18-year-old high school football player’s rapid healing of muscle injury through Platelet-Rich Plasma. So even though PRP injections are not officially heralded as the future, Osteopathic Physicians stand to gain much, much more than from Platelet-Rich Plasma than others.

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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.

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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.”

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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.

(Click here to download high-resolution version)

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Are these treatments FDA-Approved?

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.

If you need more help, call us at (844) 377-7787. Or check out our Platelet-Rich Plasma store.

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The Rheumatologist’s Guide To Platelet-Rich Plasma

Shelly (not the real name) had been suffering from Achilles Tendonitis for a while now. She has rheumatoid arthritis and celiac disease. Plus she had a minor surgery on one of her toes and it had gone a tad bit bad. She was determined to find a solution and started with all the usual treatments. When it became obvious that the solution she’s looking for is not so straightforward, she began flirting with alternate treatments. Someone suggested Platelet-Rich Plasma. And so began a love-affair.

I got my first PRP for my Achilles Tendonitis and the doctor told me to get a shot each for 8 straight weeks,” Shelly said. A bit doubtful, she stopped after the second treatment. By the third week, the Tendonitis showed more progress than all of the previous months trying so many conventional treatments. She says, ” just three simple shots and my foot was probably 75% better.”

This is what Rheumatologists can expect when they introduce Platelet-Rich Plasma to their patients.

Rheumatology Had Found A Winner

Rheumatology is one of the fields of medicine that has immensely benefited from the advances of Platelet-Rich Plasma. Because it turns out that Platelet-Rich Plasma Injection is one of the most simplest treatments for musculoskeletal diseases – those that affect the joints, muscles, and bones, swelling, and deformity.

However, they have not been pushing the limits of this novel treatment, as well as the dermatologists.

Rheumatologits' Guide To Platelet-Rich Plasma

Are you a rheumatologist?

If you are, I’m pretty sure you have tried Platelet-Rich Plasma for your patients.

And if you did, you may have saved a few of your patients from going under the knife. But not every Rheumatologist have bought into the idea of Platelet-Rich Plasma. This is unfortunate since just in the osteoarthritis segment alone there are over 27 million U.S. adults who’d be much happier if their rheumatologist had suggested Platelet-Rich Plasma Injections.

Like Kenneth (not the real name), who was part of an experimental group at a local university and got PRP Injection for his torn hip ligament. Prior to this, he was told that he’d need surgery. But three (!) years later, the pain has never really returned and he’s had no surgery.

Another patient, Desiree (not real name), said she and her husband are firm believers of the treatment. It shoved her plantar fasciitis into oblivion and gave her husband’s shoulder joints and knees a big boost.

Cases like these are not rare.

Not All Treatments Of Platelet-Rich Plasma Are Successful

We’d be the first to admit that we’ve seen quite a number of cases where Platelet-Rich Plasma failed to show improvements. Sometimes, we’ve seen cases where the same patient can have mixed results. Like Lynda (not real name) whose PRP treatment for her severely sprained right ankle worked like a charm whereas the one for her similarly compromised left big toe turned out to be a dud.

Rheumatologits' Guide To Platelet-Rich Plasma

But we can improve the chances of success dramatically by adhering to a standard for the following.

1. Concentration

By definition, PRP must contain a higher concentration of platelets than baseline. This can vary as the baseline, which is the platelet concentration in the patient’s blood, varies. But the use of a good PRP kit like this can result in a concentration that’s 5X-8X times the baseline concentration. This kit can also be used to get a downgraded sample with 2.5X – 3X times the baseline concentration, which may sometimes be required based on the treatment performed. Therefore, getting a PRP kit that only produces lower grade PRP is not advised.

2. White Blood Cells (Leucocytes)

PRP containing white blood cells have a different biologic effects than the ones without. The most popular form of PRP is L-PRP which contains Leucocytes. The DrPRP Kit which provides higher concentration of platelets delivers an end product that’s classified into three fractions: the Red Blood Cells (RBC) without platelets, the Platelet Serum in which the platelets are suspended and the Buffy Coat which contains both the platelets and white blood cells (WBCs). This makes it possible to adjust the end product to include some White Blood Cells. Because, the macrophages (circulating monocytes) present in WBC can remove debris and ingest harmful foreign particles, bacteria, and dead or dying cells to speed up the healing process.

3. The Use Of ACD

The standard protocol for Platelet-Rich Plasma requires the addition of an Anti-Coagulant (ACD) to prevent the blood clotting. The addition of ACD makes the blood more acidic than normal. This can have a negative effect on the half-life of growth factors. So in certain cases, we recommend buffering the PRP back to a physiologic range prior to injection.

Rheumatologits' Guide To Platelet-Rich Plasma

The Growth Factors In Platelet-Rich Plasma

The Platelet-Rich Plasma owes it’s healing prowess to the growth factors found in platelets. They are made accessible to the tissues and ligaments when the platelets are activated. The exact roles of these growth factors remain a bit vague at this time but from what researchers have been telling us it is evident that they support a wide range of processes in all three of the healing stages – inflammation, proliferation and remodeling.

Here’s a nice little infographic that lists out the functions of the primary growth factors in Platelet-Rich Plasma.

GROWTH FACTORS IN Platelet-rich Plasma

Clinical Evidence

1. Platelet Rich Plasma and Subacromial Tendonitis

In recent years, Platelet-Rich Plasma has proven to be effective for Subacromal tendonitis. In a study conducted by Dr. Turlough O’Donnell, MD, and Aamir H. Shaikh, MSc, MRCSEd, MCh, of UPMC Beacon Hospital in Dublin, Ireland, 102 patients were treated with PRP injections administered directly into the suprasimatos tendon (shoulder) and 102 patients were treated with treated with 20 mL solution of 0.05 percent bupivacaine and 80 mgs of methylprednisolone.

“At 12-month follow-up, patients who received a series of PRP injections were 16 times less likely to have undergone surgical intervention than patients who received corticosteroid injections,” the authors reported.

Another study by Michael Carpone DO et al, which concluded that “a single ultrasound-guided, intralesional injection of PRP resulted in safe, significant, sustained improvement of pain, function, and MRI outcomes in participants with refractory Rotator Cuff Tendonitis.”

2. Platelet Rich Plasma and Epicondylitis

Epicondylitis is often a chronic case of tendinopathy and a healing response is usually hard to obtain. Platelet-Rich Plasma’s role in this started in 2006, when in a Pilot study by Allan Mishra, 19 patients with refractory epicondylitis who were prescribed surgery, was given a single Platelet-Rich Plasma injection. After 8 weeks, patients reported 60% improvement which rose to 93% and after just two years.

In another controlled clinical study, the effect of PRP was compared with corticosteroids, in a randomized, double-blind manner with 100 patients who had chronic epicondylitis. After one year, the authors concluded that PRP significantly exceeded the clinical benefit obtained by corticosteroids.

3. Platelet Rich Plasma and Plantar Fasciitis

Plantar fasciitis is one of the bigger fields in rheumatology – and the standard procedure for rheumatologists has been to mask the symptoms using corticosteroid injections. However, in this study, platelet-rich plasma injection was found to better than corticosteroid injections at the three-month follow up.

4. Platelet Rich Plasma and Knee Osteoarthritis

There are multiple studies in the past 3 years, both controlled and open, which highlight the efficacy of Platelet-Rich Plasma for Knee Osteoarthritis. In the largest of these studies, researchers in Taiwan, conducted 8 single-arm studies, 3 quasi-experimental studies, and 5 randomized controlled trials with 1543 participants to validate that Platelet-Rich Plasma does improves outcomes for patients with knee joint cartilage degenerative pathology. And does that better than Hyaluronic Acid.

However, recent research suggests that a combination of HA+PRP may be even more effective.

Platelet-Rich Plasma Knowledge Mandatory For Rheumatologists?

There is no doubt that Platelet-Rich Plasma is here to stay. And it can be the biggest item in the rheumatologist’s therapeutic rolodex. The safety, efficacy and simplicity is something that no other treatments can rival. However, as I mentioned before rheumatologists have not been taking advantage of it as much as others. Perhaps they are waiting for more conclusive evidence or insurance acceptance of the procedure, but considering that this procedure carries virtually no risk, it’s the somewhat of duty of every rheumatologist to give it a try. And come to new discoveries of their own.

You can try this at a relatively inexpensive way – with this kit and a standard lab centrifuge like this.

The medical community need more rheumatologists’ acceptance of Platelet-Rich Plasma to formalize the frequency, volume and etiquette for this life-saving procedure. After all, there are 27 million Americans at stake here.

Plus, the Platelet-Rich Plasma industry is undergoing rapid changes. New innovations are added every month. Getting in the game in these early stages will make you one of the pioneers in the field.

Here’s a recent interview with Dr. Lance Johansen who says we might see Platelet-Rich Plasma being combined with genetics like Bone morphogenetic proteins (BMPs) and DNAs to help grow new cartilage.

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Why Insurance Will Soon Start Paying For PRP Injection

As a nation, we’re already seeing big movements in the adoption of Regenerative Medicine. Last November’s 21st Century Cures Act and the recent Arkansas HB2014 bill are just two examples. We believe it’s a matter of time before mainstream insurance companies will not only approve PRP Injection (at least for selected cases) but insist on it as an alternative to Corticosteroid injections and Hyaluronic Acid injections.

Athletes who have PRP injections instead of the standard anti-inflammatory drugs is a regular feature in Sports news these days. The Met’s Steven Matz had a platelet-rich plasma injection on last Wednesday. Last month it was David Wright.

DRPRP PRP INJECTION INSURANCE CORTICOSTEROID

We covered the case against Hyaluronic injections here.

And recently there has been larger scale studies in China. First it was from Shanghai Jiaotong University School of Medicine earlier in January. It included 14 Randomized Controlled Trials comprising 1423 participants and has shown that PRP Injection is more effective in the treatment of knee OA in terms of pain relief and functional improvement compared with saline placebo, HA, Ozone, and Corticosteroids. This is a randomized controlled trial with level 2 evidence. Full study here.

More recently it was a study at Chongqing Medical University, China that included 10 randomized controlled trials with a total of 1069 patients which found out that compared to HA and saline, PRP injection is more effective for pain relief and functional improvement in patients with symptomatic knee OA. You can read the full brief here.

And now, we also have a new randomized, double-blinded clinical trial confirm that Platelet-Rich Plasma injections can perform as well as Corticosteroid injections.

Back here in the US, researchers have been busy too. They did this double-blind Randomized Controlled Study on Lumbar Intradiskal PRP Injections for Low back pain (LBP). And as expected, PRP group showed significant improvements in FRI, NRS Best Pain, and NASS patient satisfaction scores over 8 weeks compared with controls. Full brief here.

DRPRP PRP INJECTION INSURANCE CORTICOSTEROID

A Significant Win for PRP Injection

Every year, tens of millions of injections are given for OA knees. Out of these, only a tiny fraction are PRP Injections. The majority injections are corticosteroid or HA injections. Which only accelerates the knee degeneration. Which means most of these patients go on to have the expensive and traumatic knee surgery leading to over 1 million the knee-replacement surgeries performed annually worldwide.

The question now is…

Why are we continuing to use the expensive, side-effects-ridden Corticosteroid or HA injections for Arthritis symptoms? It’s important to note that one of the side-effects of Corticosteroid injections is Osteoporosis. That’s why many physicians insist on a bone density test before these steroid injections.

Platelet-Rich Plasma Arthritis Doctor

The bottom line is that the steroid injections which were introduced in 1948 as a standard treatment for spine and sports injuries should be replaced by PRP Injections.

Or else we’ll continue having 3.5 million knee replacements costing insurance – at $25K per pop, an astounding $87.5 billion – a sum that ordinary, healthy citizens help pay.

The Problem: 90% Of Patients Call, Only 10% Take It

This statistic will hit you in the head right away the moment you start looking at the Platelet-Rich Plasma industry. I mean, the science of Platelet-Rich Plasma is simple. So everyone understands the risks (or the lack thereof). And almost all patients with wanted an extra hand in healing of tendons, ligaments, muscles & joints would love to try PRP injections.

But they don’t want to pay for it. Understandably. Because they are paying dearly every month for their insurance and why should they paying this PRP injections? It’s not patient’s fault. They shouldn’t be paying for it when they are paying for and expecting world-class medical coverage.

Platelet-Rich Plasma PRP Injection Doctor HB2014

PRP market has climbed to an estimated $120 million in 2016. If people can vote for this treatment with $120 million of their own money, without any single red cent from the big pharma, there’s definitely something the 90% of the interested-but-refuse-to-pay patients miss out on.

DRPRP PRP INJECTION INSURANCE CORTICOSTEROID

We Need To Work On Standardization Of PRP Injections

One thing researchers agree is that we need standardization. For instance, doctors now are unsure of the duration PRP Injection’s benefits last. If we have a prolonged condition like arthritis, should injections be given at a monthly interval or twice a month? Or should the injection be repeated at all? Because there are several studies that trace PRP Injection’s effects up to a period of 24 months.

All we need is studies that confirm the best practices that the PRP market is already following in terms of

  1. Concentration of the platelets and RBC in the preparation.
  2. Frequency of intra articular injections needed.
  3. Security measures to prevent overuse of this novel procedure.

Then it’ll be easy for insurance companies to trust PRP Injections as a valid procedure to not only help heal their members without any side-effects or complications but also help them avoid expensive surgery. Now, that’s what’s called a win-win-win.

You see the big winner probably will be the insurance.

So it makes sense for insurance companies to take the lead in implementing the standardization procedures since the big pharma is not interested as they stand to gain nothing.

Is that what will happen? Let’s wait and see.

Platelet-Rich Plasma Market Trends 2017 2018
Platelet-Rich Plasma Market Poised For A Liftoff in 2018?

As you probably know, Platelet-Rich Plasma treatment is the ONLY treatment that allows us to harness a patient’s innate healing mechanisms quickly and easily (and more economically) to jumpstart the natural healing process.

And it’s the most interesting thing to ever happen in modern medical history for a long long while.

Take the patient’s own blood and spin it to isolate Platelet-Rich Plasma.

And inject it into specific areas to promote healing. It can also be used in gel format for applying on chronic, non-healing wounds.

No other drug, surgery or vaccine in the history of western medicine was able to secure this wide a scope of application that Platelet-Rich Plasma alone enjoys.

And without the side effects that western medicine is particularly known for.

Yes!

Harnessing the body’s natural healing power leads to fewer unintended consequences (aka side effects).

Platelet-Rich Plasma For Athletes

Now, there is one more thing you may not be aware of.

The trend for Platelet-Rich Plasma is inching closer to a tipping point.

By Platelet-Rich Plasma, I mean Pure-Platelet Rich Plasma (P-PRP), Leukocyte-Platelet Rich Plasma (L-PRP), and Pure-Platelet-Rich Fibrin (P-PRF) combined.

A Forecast For Platelet-Rich Plasma Treatments in The USA

Here’s a WARNING:

There are quite a few “market analysis experts” who predict that the Platelet Rich Plasma (PRP) Market is expected to reach US$451.9 million dollars by the end of 2024.

They are DEAD WRONG.

Measured at a valuation of US$160.0 million in 2015…

Platelet-Rich Plasma market could double or triple that amount by the time we enter 2018.

Here’s why. Our research indicates…

There are FOUR segments where interest in Platelet-Rich Plasma are exploding:

1. Hair restoration

2. Skin care and anti-aging

3. Sexual regeneration

4. Pain management

To understand why we’re reaching a tipping point with PRP, let’s look at the latest developments in these 4 segments alone.

Platelet-Rich Plasma Kit Market Trends

1. Platelet-Rich Plasma for Hair Restoration

The Hair Restoration industry is embracing Platelet-Rich Plasma big time. Recently, Atlanta-based Dr. John Cole, the world’s most respected hair transplant surgeon, has been experimenting with his own cutting edge modifications to existing Platelet-Rich Plasma separation procedures.

He has been testing with Ultrasound waves (4.5 MHz) generated from piezoelectric ceramics to prepare PRP with possible higher platelet concentration and less RBCs contamination.

This is a genuine effort on the part of Dr. Cole (his PRP Combined with FUE Procedure was an industry-first) to improve the overall field of hair restoration…

And he picked Platelet-Rich Plasma as the one of his key levers!

To understand why this field is going to explode, you have to see what users are saying. Like this user who posted on Realself website:

For years I’ve tried it all. Started going to Doctors when I was in my late 20’s and have tried Rogaine, Vivascal and other herbal treatments. I finally decided to seek PRP when I saw it on Good Morning America. I’ve had two sets of treatments. First one at the end of June and the second one in August. I’m going to do my third and final one around November. The results are phenomenal. Not only do I see hair growth and yes, it’s still coming in, but the condition of my hair has also improved. It’s healthier and easier to style. I still use rogaine daily but stopped the Vivascal. The difference the PRP made is remarkable.

It’s fascinating that Platelet-Rich Plasma, a relatively new medical innovation can trump years of scientific development and billions in research dollars by the hair regeneration industry.

Here’s what PRIME International Journal of Aesthetic and Anti-Aging Medicine reports on it’s peer-reviewed article on PRP for hair loss:

So far, PRP has shown some very promising results in hair rejuvenation through prolongation of the anagen phase and signaling some complex pathways involved in hair growth cycle. The results showed enhanced proliferation, differentiation, and angiogenesis of the derma papillae cells and stem cells in the bulge. Clinically, observed outcomes included increased hair count and enhanced hair thickness. Additionally, these results were achieved with a relatively acceptable cost and a good safety profile.

That last sentence is a crucial one.

Because traditionally, the recognised treatments for Female or Male Pattern Hair Loss namely androgenic alopecia are things like minoxidil and finasteride that can cause really unpleasant side effects like hair growth in other unwanted areas and loss of libido and sexual dysfunction.

And PRP Treatments have none of that!

And that’s just the first application of Platelet-Rich Plasma that’s poised for a take off in 2018.

Platelet-Rich Plasma In 2017 2018

2. Skin Care, facial correction and anti-aging

Over the last few years, we’ve seen tremendous demand for PRP-related cosmetic procedures. It’s not only just a US-trend. It’s a world-wide trend. There is nothing more powerfully alluring than the promise of harnessing your own healing power to look good.

And the market response says it all.

Americans spent an estimated US$ 59 Million for Platelet-Rich Plasma related cosmetic surgery applications in 2016.

That’s approximately 0.5% of all the money that Americans spend on ALL COSMETIC PROCEDURES IN TOTAL.

And I think that number is way too conservative. There are so many mom and pop skin care centers offering these procedures – often with just a registered nurse on payroll – that the market should be so much bigger by now.

These skin care centers offer a variety of skin treatments with Platelet-Rich Plasma. Skin Tightening, Stretch Marks, Facelifts and Acne Scar Treatments to name a few. They also combine PRP with MicroNeedling and call it Platelet-Rich Plasma Facelift.

But we’ve found that the scope of Platelet-Rich Plasma is even bigger than we thought.

Platelet-Rich Plasma For Skin Rejuvenation

New Trend In Platelet-Rich Plasma For Skin Rejuvenation

The newest trend is turning Platelet-Rich Plasma (or Platelet-Poor Plasma, it’s byproduct) into…

DERMAL FILLERS!

If I say that I’m surprised by how innovative, cost efficient and effective this is, it would be an understatement.

Turning PRP/PPP into dermal fillers is a bloody miracle that is bound to upset the dermal filler industry over time.

Things like Radiesse can cost upwards of $600 while Fat-based fillers can cost $1200 or more. Now, they have to compete with PRP/PPP based fillers that cost providers next to nothing to harvest.

THIS. IS. HUGE.

Especially considering that according to International Society of Plastic and Aesthetic Surgeons (ISAPS), about 3 million dermal filler procedures were conducted worldwide in 2013.

And the secret weapon behind turning PRP/PPP into dermal fillers is this little machine that uses a special heating and cooling algorithm.

That machine is one of the hottest selling products for us in 2016. You can read more about it here.

So we’ve covered the Hair Loss industry and the Skin Care/Anti-aging industry.

Let’s hit the next segment which is the Sexual Wellness industry. OMG.

3. Platelet-Rich Plasma For Sexual Regeneration

Now, if you’re reading this, you probably know Platelet-Rich Plasma’s history for helping men and women restore confidence in themselves and strengthen their relationships.

You know. The Platelet-Rich Plasma for Sexual Regeneration.Sexual Regeneration With Platelet-Rich Plasma Is A New Trend O Shot P Shot

It has given the sexual wellness industry a much-needed breath of fresh optimism – there has never been a more scientific approach to sexual regeneration that doesn’t involve even a tiny dose of side-effects.

Little wonder patients are paying thousands of dollars – and willing to go the extra mile (literally) to undergo this procedure. I think the beauty of Platelet-Rich Plasma is it’s simplicity. It’s so ridiculously easy to explain to your clients and they can see right away that there’s no need to worry about side-effects.

And the clients have reported great results not only in terms of increased sexual pleasure…

…in terms of increased sexual feelings, greater arousal from clitoral & G-spot stimulation, increased lubrication and tightening of the vagina…

But it has a curious positive side effect of relieving urinary incontinence as well!

I think that’s what makes Platelet-Rich Plasma a rockstar treatment – it’s list of positive side effects make it well worth the clients’ money.

Speaking of positive side-effect, the most curious of them all is this:

The Unbelievable Effect Of Platelet-Rich Plasma On Menopause

According to a team of researchers, the most amazing thing they’ve witnessed is that when Platelet-Rich Plasma was injected into the ovaries of post-menopausal women, it restarted their menstrual cycle. (Kudos to the team at Futurism for pointing it out.)

RESTARTED THEIR F**CKING MENSTRUAL CYCLE!

This literally blows the lid off the upper age limit of would-be mothers.

Isn’t this the greatest advancements in western medical history?

No complicated surgeries, no harmful drugs, no artificial interventions.

Just a few simple injections for OUT-OF-THE-WORLD results.

Now let’s look at the last segment where I think Platelet-Rich Plasma is about to become hugely popular.

And that’s pain management.

4. How Platelet-Rich Plasma Is Changing The Pain Management Industry

Right now, at this level of understanding of Platelet-Rich Plasma, it would a huge missed opportunity if you don’t try it for conditions like…

  1. Rotator cuff injuries
  2. Shoulder instability
  3. Tennis and golfer’s elbow
  4. Hamstring and hip strains
  5. Knee sprains and instability
  6. Patellar tendonitis
  7. Achilles tendonitis
  8. Plantar fasciitis
  9. Knee, hip, shoulder and ankle osteoarthritis
  10. Carpal Tunnel Syndrome
  11. Sacroiliac (SI) joint dysfunction

Doctors now consider PRP the first-in-line procedure for these conditions.

However, one surprising – again coming back to it – positive side effect is…

Platelet-Rich Plasma As A Pain Killer

Research studies and clinical practice have shown that injecting Platelet-Rich Plasma immediately after an injury or any other painful instance can be very effective at relieving the pain.

This is because of PRP’s ability to jump-start and strengthen the body’s natural healing signal actually triggers the brain to stop producing the pain response – meaning it signals that the situation is under control.

In addition to pain relief, Platelet-Rich Plasma is also found to have the following functions…

  1. Anti-microbial
  2. Adhesion
  3. Aggregation
  4. Pro-coagulation and clot retraction
  5. Cytokine signaling
  6. Chemokine and growth factor release

That is a complete healing package right there, isn’t it?

So anytime you hear a client complain about pain – think Platelet-Rich Plasma.

Platelet-Rich Plasma Injection Tube

At least that’s what’s happening in Sports Medicine. Look at how the Los Angeles Angels ace Garrett Richards was instantly given Platelet-Rich Plasma injection into his severely damaged right elbow – and not Tommy John surgery as is usually the practice.

If all of this doesn’t make Platelet-Rich Plasma hard to ignore, there’s one more development that completely elevates the game for PRP fans.

Freeze-Dried Platelet-Rich Plasma

Researchers have found a way to make it even easy for using Platelet-Rich Plasma. Instead of freshly preparing and applying immediately after a wound or operative procedure, they found a way to preserve the PRP in advance using freeze-dried PRP (FD-PRP).

And not only that, they found out that freeze-dried PRP contained more growth factors than freshly prepared PRP – almost three times. Here’s a well-detailed article on Nature about that. It even says the results were better when FD-PRP was used.

Fascinating.

This means Platelet-Rich Plasma can now…

  • Have increased shelf life (ideal for repeated applications)
  • Can be offered at even lower costs
  • Provide higher concentration of Growth Factors
  • Cut down the application time with ready-to-use samples

All from a single blood collection.

The process of freeze-drying typically involves rotating in an ethanol bath at −60 °C and then keeping it frozen at −30 °C for the next 4 hours.

These samples are then attached to a vacuum freeze-dryer.

Freeze-dried Platelet-Rich Plasma can be stored for up to 8 weeks according to preliminary research. Not bad.

That, I think crushes one of the important barriers to its widespread adoption.

Last but not least, I want to add the role technology will play in skyrocketing the popularity of Platelet-Rich Plasma in 2018.

Medical Technology Doubles Every 3 And Half Years

Coming back to the market for Platelet-Rich Plasma, analysts’ conservative guess put it at about $160 Million for 2015. That might be right but they’re terribly wrong about the future growth.

As medical technology continue to double every three and half years, our knowledge in Platelet-Rich Plasma will grow exponentially.

We will have more knowledge on how the many growth factors – mainly platelet-derived growth factor (PDGF), Transforming growth factor (TGF)-[1 and 2], Vascular endothelial growth factor (VEGF) – and various other cytokines and their roles in healing.

And there will be newer applications like dermal fillers that Platelet-Rich Plasma will sneak into.

Today, we discussed only 4 medical categories where Platelet-Rich Plasma is making a dent.

There are literally hundreds more.

Conclusion:Platelet-Rich Plasma Is Not The Be-all And End-All Solution

While discussing the rise of Platelet-Rich Plasma, I also feel the need to acknowledge the fact that there are limitations.

Platelet-Rich Plasma isn’t perfect.

The first limitation is that it comes in just one-size – we need a huge insights into how its constituents work and develop new ways of extracting the exact growth factors and cytokines we want. Then we’ll be able to offer custom Platelet-Rich Plasma prescriptions for different situations.

But I believe further discoveries are just around the corner.

Another thing to acknowledge is this: PRP is not the be-all and end-all of all solutions.

Instead, we need to look at it as a healing accelerator that can make medications that previously failed finally work. This is a huge distinction that the critics failed to understand.

It’s not just a remedy – it’s could be remedy for all other remedies.

What a missed opportunity when doctors don’t realize this.

Let’s not forget what Hippocrates, the father of modern medicine has taught us:

Natural forces within us are the true healers of disease. ~ Hippocrates

Platelet-Rich Plasma Technology

Stem Cell Platelet-Rich Plasma
Stem Cell Platelet-Rich Plasma: The Best Regenerative Therapy?

To understand why stem cell platelet-rich plasma or co-transplantation of Adipose-derived mesenchymal stem cells and PRP, is such a remarkable idea in regenerative medicine, let’s spend a little time looking at the mechanics of PRP.

Platelet-Rich Plasma’s Role As Repairmen

The one thing that makes Platelet-Rich Plasma a hero in several fields (if not all) of medicine is the fact that the diverse growth factors in it are able to stimulate stem cell proliferation and cell differentiation (the factors that determine effective tissue regeneration and healing) on any part of the body.

These growth factors are abundant in the blood and act as the natural repairmen of tissues.

In the perfect scenario, there’s plenty of blood flow to every part of the body and these “repairmen” are always on-call to address any healing needs that may arise. However, if the injured area has a poor blood supply — especially areas that are constantly move like tendons, ligaments and joints — demand for these repairmen can outgrow supply. Meaning, healing (or regeneration of tissues) is put on hold till further repairmen are available.

The train of Platelet-Rich Plasma then arrives with enough of these repairmen to warrant resumption of healing.

There’s another part of this picture we haven’t talked about so far: stem cells.

As far as Platelet-Rich Plasma and it’s growth factors are concerned, they are mere repairmen. They can’t do the work by themselves. They need the basic raw materials to work with. And that raw material here is the stem cells.

Stem cells are the ones actually being regenerated to form new tissues for healing.

Stem Cells As The Raw Materials For PRP

Stem cells are the only raw materials that PRP works with for regeneration. These are like the fundamental building blocks of all other cells. These cells can be can be guided into becoming specialized cells under the right conditions.

In addition, they can also divide themselves to form new stem cells or new specialized cells.

So for Platelet-Rich Plasma to work well, it needs to be applied to an area with lots of stem cells like the heart, liver, blood vessels etc. Incidentally Platelet-Rich Plasma’s healing properties were first discovered by cardiac surgeons who played with concentrated blood for faster healing of heart after surgery and it showed tremendous promise because stem cells are abundant in heart tissues.

But what if healing is needed in an area where there are not much stem cells?

With the new developments in stem cell technology that can be solved too. Because now we can supply the stem cells to areas where there are less like the joints, ligaments and tendons. For this, scientists usually use “mesenchymal stem cell” or MSCs. These are cells isolated from stroma and can differentiate to form adipocytes, cartilage, bone, tendons, muscle, and skin.

The most easiest way is to harvest it from adipose tissue or fat that we call Adipose-derived mesenchymal stem cells or ADSC.

Stem Cell Platelet-Rich Plasma

Supplying Both PRP And Stem Cells For Regeneration

In regions with hypoxia (poor blood supply) like joints, meniscus tissue, rotator cuff, spinal discs etc the supply of platelets (and therefore growth factors) as well as the stem cells are limited. So what if we supplied both the stem cells and Platelet-Rich Plasma for triggering the regeneration process?

That’s the question these Japanese scientists answered in their research. Here’s another group of scientists who took on the same challenge.

They used Adipose-derived mesenchymal stem cells (ADSC) which is known for their ease of isolation and extensive differentiation potential. These researchers noted that these stem cells often can’t survive in areas of local hypoxia, oxidative stress and inflammation – thereby making them ineffective. However, when Platelet-Rich Plasma (or thrombin-activated PRP) is added to ADSC, it kept them alive for prolonged periods and the growth factors in the Platelet-Rich Plasma triggered cell differentiation and proliferation more easily.

Why This Exact Combination Is The Future

Done this way, both Adipose-derived mesenchymal stem cells (ADSC) and Platelet-Rich Plasma are raw materials for healing that’s already available in plenty in almost every one (there are exceptions of course). That means, for complete healing to take place this combination treatment, still in it’s very primitive stage of development, may have the potential to replace expensive synthetic drugs that carry complex unexplained side effects. The procedure takes our body’s natural healing agents — stem cells from body fat and PRP from blood — and then inject it inside knee or other joints (or other areas where they are insufficient) for regeneration.

Isn’t that like the most wonderful thing ever?

Whether it’s cartilage cell, or a bone cell, or a collagen cell for ligaments and tendons that needs to be healed, all you need is a same-day procedure by a local, but specialized doctor, using the natural ingredients of the body.

I believe this special combo is a huge win for Platelet-Rich Plasma.

Here’s a video from San Diego Center for Integrative Medicine’s Dr. Joseph where he talks in detail about the science of this particular procedure.

The Challenges For Growing Adoption Of This Treatment

We know Platelet-Rich Plasma has safe, yet high-speed recovery potential with it’s multiple growth factors. And it is effective in regenerative healing of cartilage injuries – the most toughest injuries to heal – as well as Osteoarthritis. However the challenges are Platelet Quality. We need to somehow ensure the Platelet-Rich Plasma quality is uniform. Currently it varies from two to several fold above baseline concentration based on donor’s physical condition.

Next we need to identify the exact PRP growth factors that promote ADSC proliferation. Scientists believe growth factors such as basic fibroblast growth factor (bFGF), epidermal growth factor, and platelet-derived growth factor stimulate stem cell proliferation while some growth factors under certain conditions are known to inhibit the process.

The percentage of PRP matters too. 5 percent, 10 percent, 15 percent and 20 percent Platelet-Rich Plasma in ADSC are tested by scientists.

The Only Treatment In Modern Medicine For Cartilage Regeneration

The bottom line is that Stem Cell Platelet-Rich Plasma or ADSC + PRP procedure is the only treatment in modern medicine that has showed cartilage regeneration. So it’s too important to ignore. And it could one of greatest advances that science has brought to the millions of people suffering from serious pain in their joints, knee and spine as well people suffering from all kinds of tendon diseases and injuries.

Stem Cell Platelet-Rich Plasma

PLATELET-RICH PLASMA TRENDS
Platelet-Rich Plasma Stays Quietly Popular Despite Neglect

Fact: According to research, PRP treatments are one of the most in-demand treatments available in healthcare.

This is impressive considering the following.

  1. PRP is not supported by the medical industry. No big pharma funding on extensive research or marketing. No medical associations lobbying to increase its awareness.
  2. PRP is shunned by the insurance companies. No reimbursements from them. So getting patients to pay is difficult. Especially for a treatment that’s relatively “unproven” like this.
  3. The cost of PRP treatments are actually rising. In 2006, you can get a PRP treatment for $450. Today it costs $800. The cheapest we’ve seen is $650. The prices are still robust as demand keeps up.

However, we believe the best of PRP is not even here yet. We’re just one breakthrough study away from exploding into mainstream hospitals and clinics. We see the biggest growth in Platelet-Rich Plasma happening in Asia.

Strongly based on fundamental healing theory

The growth can be attributed to PRP’s fundamental healing property. More platelets. More growth factors and cytokines. And therefore more healing. It’s as simple as that. And no one can argue this fact.

Our body’s natural healing mechanism operates with 150,000/ul-350,000/ul platelets in blood. Using Platelet-Rich Plasma means this number is amplified by 3X to 5X. How can this be not translated into better healing?

Believe it or not, the best orthopedic doctors use Platelet-Rich Plasma. And do so regularly.

PLATELET-RICH PLASMA TRENDS

PRP can be used to promote healing of injured tendons, ligaments, muscles, and joints, can be applied to various musculoskeletal problems. And they conduct regular studies to test it’s effectiveness.

One landmark study involved double-blind randomized controlled trials to see the effect of PRP on patients with chronic low back pain caused by torn discs. The study outcome says 60% of the patients felt significant improvements.

Some were cured. CURED!

Platelet-Rich Plasma Variants

So far, there are the following type of PRP variants.

  • Plasma Rich in Growth Factors (PRGF)
  • Plasma Rich in Platelets and Growth Factors (PRPGF)
  • Platelet-Rich Plasma (PRP); Platelet Poor Plasma (PPP)
  • Plasma Rich in Platelets and Rich in Leukocytes (LR-PRP)
  • Plasma Rich in Platelets and Poor in Leukocytes (LP-PRP)
  • Platelet-Rich Fibrin Matrix (PRFM)

All of them involve Plasmapherisis — the two stage centrifugation process to separate platelets from blood. However, what happen what happens after that can be different. And the industry hasn’t found it’s middle ground as to which variant to be standardized. We believe the confusion will clear up in 3-5 years.

PLATELET-RICH PLASMA TRENDS

No matter which variant you end up using, the bio-factors at play are the following:

  1. Growth factors: TGF-B, PDGF, IGF-I,II,  FGF,  EGF, VEGF, ECGF
  2. Adhesive proteins: Fibrinogen, Fibronectin, Vitronectin, Thrombospondin-1
  3. Clotting & Anti-Clotting factors: Proteins,  Antithrombin, Plasminogen, Proteases, Antiproteases
How Platelet-Rich Plasma Actually Work

Why is the treatment commonly used for wound healing and pain management? The answer is because the platelets’ main job is to aid coagulation, act as a biological glue and support stem or primary cell migration. In addition, it also helps in restoring hyaluronic acid and accelerates the synthesis of collagen and glycosaminoglycans and increases cartilage matrix.

Not only that, the platelets are delivered in a clot which means it can immediately act as a scaffold to enable the healing process. 95% of the bio-active proteins are released within 1 hour of injecting Platelet-Rich Plasma. The platelets continue to release growth factors for 7-10 days. Thus it’s recommended to re-inject PRP every 7 days.

PLATELET-RICH PLASMA TRENDS

Why are patients coughing up their hard earned money for this?

This reminds me of hundreds of thousands of PRP treatments paid from patient’s own pocket even though they’ve been paying for years to get covered by their respective insurance provider. In 2015, PRP costs were anywhere between $600 and $800 per site per treatment. And most patients go for repeated treatments. So why were they forking up their hard earned money if the treatment was not working? Weren’t there any better alternatives under the “coverage” of their insurance provider? The answer is 1) the treatment works. 2) there’s nothing else out there that’s as natural and side-effect-free as PRP.

Consider the case of osteoarthritis. 27 millions Americans are impacted by it. 33.6% of people older than 65 are victims. All of them experience gradual degeneration of cartilage and bones — they lose roughly 5% cartilage per year. Yet, our medical industry doesn’t have a fix to stop it.

However, when doctors started doing PRP treatments for their osteoarthritis patients, they found a large majority of them had no further cartilage loss.

To me, it means we should make PRP treatments the default first-line treatment for osteoarthritis across the country.

Another huge market is hair loss and cosmetic facial applications. I know there are many people who believe PRP doesn’t work for hair. Here’s what one of the Platelet-Rich Plasma studies found were the effect of the treatment on hair loss.

“Hair loss reduced and at 3 months it reached normal levels. Hair density reached a peak at 3 months (170.70 ± 37.81, P < 0.001). At 6 months and at 1 year, it was significantly increased, 156.25 ± 37.75 (P < 0.001) and 153.70 ± 39.92 (P < 0.001) respectively, comparing to baseline. Patients were satisfied with a mean result rating of 7.1 on a scale of 1-10. No remarkable adverse effects were noted.”

I’ll take that.

That’s me getting PRP for hair. 🙂

PLATELET-RICH PLASMA TRENDS

PRP market is expected to hit $126 million in 2016

That number looks paltry. But that’s an 180% increase over the 2009 figure of  $45 million.

Consider this. Just for osteoarthritis alone, if all the 27 million Americans receive 1 PRP shot a year at a conservative $400 per treatment, it would be a market of $10 billion. And that’s one condition out of the many that Platelet-Rich Plasma injections are proven to work.

Another condition that PRP is known to work very well is Tennis Elbow. It affects on average 1% to 3% of the overall population. That number is as high as 50% among tennis players.

Do the math.

Just getting Platelet-Rich Plasma covered by insurance will unleash the market big time and will help heal millions of patients naturally, more effectively.

Oh ya, that means the insurance companies will have to pay more. Why would they?

HOWEVER, if this treatment could reduce further expensive intervention like surgery then it may actually be a blessing for the insurance guys in terms of savings. One surgery avoided by a patient through right intervention through PRP treatments will save the insurance companies at least $25,000. Now, that’s a win-win for both patients and insurance.

I believe it’s a matter of time before insurance companies start realizing their folly of not supporting this treatment.

PLATELET-RICH PLASMA TRENDS

After all is said and done, it’s still “unproven”

The problem with PRP is that it can be used for just about everything, which is a good problem to have until health care officials (and insurance companies) start realizing that people are going to misuse it.

So it’s classified as unproven. The VAST scope of the treatment calls for urgent structure and guidelines. There are some 20+ conditions where researchers have found it “helps” in one way or another. It’s a daunting task to prove its efficiency in all the areas. Nevertheless, we’ll get there.

Though we’ll need a lot of funding for that.

And yes, we need to standardize the procedure. As well as come up with optimized protocols for each conditions. Someone need to take initiative on that. We’re counting on independent doctors and medical institutions. The big pharma won’t jump in because what’s in it for them, right?

It’s so simple, you’d be an idiot to not try it.

You only need a vacuum blood harvesting tube like what we offer here, a centrifuge with adapter for the tube, pipettes and 10ml ampules of 10% calcium chloride.

The only complexity comes from not following a standard PRP system. Because the final platelet count can depend on a variety of factors. Like initial volume of blood, the technique used and relative concentration of WBC and/or RBC. As well as on the patient’s side, there are factors such as age, growth factor and WBC content.

However, concentration-wise, there’s little confusion as once a sufficiently high range is reached, more doesn’t have any adverse or enhancing effect — it saturates at a certain point. So that’s the minimum. Once you reach that, you’re good. Although the outcome is not always guaranteed to be same, with the right number of platelets, platelet activation and cytokine release, you can get a consistency in your PRP offerings.

There’s still some uncertainty over the number of injections, the timing and delivery method of Platelet-Rich Plasma. But with wide-spread adoption, some kind of structure will emerge.

Let’s hope the first glimpses of it will arrive this year.

Do you know in 2015, the world saw approximately 1 million knee arthroplasties for osteoarthritis? At $25,000 apiece, $25 billion.

How many of these patients had the good fortune of their doctor recommending PRP early on?

PLATELET-RICH PLASMA TRENDS

Platelet-Rich Plasma Injections: More Than Just Placebo

Platelet-rich plasma (PRP) injections are one of the most controversial, but potentially highly effective solutions for a wide range of medical ailments. PRP injections have come to the forefront as a treatment option as many well-known athletes have used them to get back on the field or golf course sooner. Often considered a treatment for knee pain and chronic tendon injuries, they are consistently sought after by patients as a fast solution to chronic or acute situations. Yet, controversy exists in whether or not this treatment option is effective or nothing more than a placebo.

The Mysterious Unpopularity of PRP Injections

What’s truly the problem with using PRP injections? Is there truly a problem with using them? The treatment is often hailed as an effective solution for many needs. It’s a jack-of-all-trades. With such a large range of potential areas to help, there’s little doubt it could prove to be one of the simplest go-to-solutions available.

There are several areas of doubt. First, its effectiveness is hard to measure. It’s hard to measure its efficiency as well. Additionally, there is a significant amount of variability in effectiveness because this is a patient-derived product. That unknown factor offers some specific concern. What works for one patient may have no effect on another patient due to the composition of platelets.

Others find it’s a virtual miracle solution. There are some orthopedic specialists and prolotherapists who believe it is one of the best solutions available to quickly restore functionality to the patient. This group is actively marketing PRP injections to many groups of people including those seeking help for arthritis pain and those in need of clinical dentistry. It’s even being used as a solution for hair loss treatments.

Then, there is another group of people. These outright reject the potential benefits and functionality that PRP injections can offer. They claim it’s nothing but a placebo.

These are valid points, but it all comes down to this. There are numerous instances in which PRP injections are working. Many professional athletes with various types of injuries are seeing improvements and success. And, there is very little risk present. At the end of the day, why not try it?

PLATELET-RICH PLASMA INJECTIONS

Placebo vs PRP: Scientific Proof

Science has taken on the topic of PRP injections in a variety of studies. The goal is to determine if this is a true solution or nothing more than a placebo effect. Take a look at a few examples.

In one double-blind, randomized trial, researchers worked to determine if treatment with PRP was more effective than the use of a placebo in the treatment of knee osteoarthritis. The group followed 78 patients with bilateral OA spread over three groups where the first group received a single injection, the second group received two injections three weeks apart and the final group received an injection of saline solution. Both groups saw improvement over those with saline injections. Those who received two injections saw the highest level of improvement.

In another study, where researchers looked at 10 trials to determine the effectiveness of PRP injections in osteoarthritis in the knee, the group found interesting results. The group considered decreasing pain, improved function, changes in joint imaging and global assessment. They found that PRP injections do reduce pain more efficiently compared to a placebo.

Placebos Have a Real Effect

Set aside these trials for a moment. Put aside all of the satisfied people who have used PRP injections previously. There are some studies and trials that have shown that PRP did not perform any better than a placebo. That’s an important statement to make because, as mentioned, the results of these injections do vary a great deal. But, don’t count out that benefit itself.

Now, consider the placebo effect itself. There are numerous studies easily found that show that the placebo effect actually is effective. In hundreds, if not thousands, of cases, placebo pills and injections, which are often nothing more than saline, have shown to be helpful to patients. In fact, in many of these trials, well-known, highly effective drugs that are used every day for treatment of conditions did not perform as well as placebos.

What does this mean for PRP injections? In short, it means it is not possible to use placebo effect itself as a sole yardstick for measuring the effectiveness or use of these injections. Ultimately, it depends significantly on the faith of the patient involved.

The Depressing Case of Anti-Depressants

Many people dispute the effectiveness of the placebo effect. However, consider anti-depressants. Unfortunately, patients are prescribed these medications by doctors at even the slightest mention of any depression-like symptoms. Anti-depressants are a billion dollar industry on their own, accounting for as much as $12 billion in the United States annually.

Anti-depressants are supposed to work by repairing the chemical imbalance created in the brain by a lack of serotonin. However, numerous studies prove that simple placebo pills can produce the same results as actual anti-depressants—they actually increase the serotonin level in patients as well. Which means that placebos do the same thing that medications do but they do it without the harmful effects. It’s clear to see the patient’s desire to improve is often the underlying determent of success.

Arthroscopic Knee Surgery Not Better Than Placebo?

Placebo effect doesn’t just apply to pills. Consider the case of arthroscopic surgery for osteoarthritis of the knee. According to this article in New York Times it doesn’t fare better than Placebo either. More and more studies are proving it. Yet, 700,000 of these knee arthroscopies are performed every year. And that is for a condition that could be treated non-invasively through Platelet-Rich Plasma. All because arthroscopy is an approved treatment and so patients can get it done for free.

On the other hand, Platelet-Rich Plasma is 1) much safer with zero side effects, 2) doesn’t take much time to administer and 3) it actually heals the degenerated area.

Placebo Effect in Animals?

Now, let’s come back to the effectiveness of PRP. A good place to look for information about the placebo effective as it relates to PRP is in animals. Generally, we understand that animals are not susceptible to the placebo effect. There are some studies that show there is some improvement, but it’s not anything like what humans experience. But, there’s plenty of evidence that shows that horses, dogs, and other animals benefit from Platelet-Rich Plasma injections. It’s clear there is an impact here. Check out this video for more information.

What To Do Now

What is the solution here? Should patients be given PRP injections? Ultimately, we know the facts. PRP is a simple and fast way to provide natural growth factors to a patient’s injured area. It is well documented in medical science that growth factors speed up and improve the overall healing process and quicken cell regeneration. That’s the true key here.

There is clear reason to use PRP injections as a first line treatment for many injuries and chronic pain situations. It can help those facing arthritis, improve joint movement, quickly aid in the repair of ligament tears, and resolve even long-term chronic pain in tendons. It’s even effective in treating skin conditions.

To reach a unanimous consensus among medical professionals, what we need is more human randomized controlled trials. And develop a standard protocol.

Specifically, there 4 things we’d need.

  • A uniform and standardized nomenclature and preparation protocols
  • Definite recommendation on the number of PLTs and leukocytes cells
  • Using the above two, perform a direct comparison with other therapeutic techniques
  • Define the role of patients and the characteristics of the condition treated in clinical outcome

Take the time to learn more about PRP Injections. There are few reasons to limit patients from a product with so much potential and so few risks.

 

To learn how to prepare Platelet-Rich Plasma using Dr.PRP Kit, click here to watch video.

It’s A Shame If You Haven’t Tried PRP For Osteoarthritis [INFOGRAPHIC]

Approximately 600,000 people seek treatment for Osteoarthritis here in the US every year. Half of them are for knee. Our nation spends more than $150 billion dollars for the treatment. Unfortunately, knee experts (mostly surgeons) believe that there’s no cure for knee degradation. They believe knee-replacement is the only option. Is this true? Let’s take a look.

Osteoarthritis: how to treat it with PRP Injection

What is Osteoarthritis And How to treat it?

Osteoarthritis is the most common form of arthritis in the knee. It is a degenerative “wear and tear” type of arthritis that can affect people of all ages. It results when cartilage in the knee wears out.

The natural solution to this problem is to repair the cartilage. Except that surgeons believe there’s no solution that can repair and renew cartilage in the joints especially knee and hip. Or is there?

A report from Bioresearch Foundation of Milan, Italy, shows us there is. Platelet-Rich Plasma.

PRP For Osteoarthritis

PRP for Osteoarthritis

The guys from Bioresearch Foundation did a 2-year study on 93 patients with advancing osteoarthritis — meaning they were the kind of candidates that opted for arthroscopic surgery. The researchers then administered a simple course of 3 monthly PRP injections instead of surgery.

A total of 119 knees were treated. After 12 months, they randomly increased the dosage of 50 patients to 6 monthly injections.

The results were this: All of the patients experienced significant improvement in pain, mobility and disability score — this was tested throughout and after the 24 months. Of the 50 patients who had 6 monthly injections after month 12, enjoyed even more improvement. Surgery was completely unnecessary for all of them by this point.

What does this say?

It’s in the title of this blog post: it’s a shame to not try PRP.

Consider a knee or hip replacement very carefully. Sometimes, a worn out cartilage isn’t the cause of the pain as shown by the famous Framingham study group in the New England Journal of Medicine. Even though MRI’s show cartilage wear and tear, most people have them as well. Plus, for a good number of patients, their results after surgery is far less that what the patients at Bioresearch foundation had after Platelet-Rich Plasma injection — it’s not uncommon for patients to experience more pain after surgery.

Here’s an infographic to remind you of your options for Osteoarthritis.

The Effectiveness of PRP Injection For Osteoarthritis

drprp Platelet-Rich Plasma prp kit samples

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