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Posts Tagged : Platelet-Rich Plasma Trends

Doctors-Ditching-Steroids-For-Platelet-Rich-Plasma-PRP-Injections
Why Doctors Are Now Ditching Steroid Injections For PRP

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.

Doctors-Ditching-Steroids-For-Platelet-Rich-Plasma-PRP-Injections

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.

Doctors-Ditching-Steroids-For-Platelet-Rich-Plasma-PRP-Injections

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.

First, corticosteroids are not as the ultimate pain-killers and there are other methods far superior.

Second, neither can NSAIDs be considered the most effective pain-killers and that’s a fact.

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.

1. Steroids
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.

But the long term effects are disastrous. Not only are they hard to get off of, the steroids have the ability to kill mesenchymal stem cells, lead to cartilage loss, and are one of the most common causes of secondary osteoporosis. Scores of athletes and weekend warriors have used steroids to temporarily push away pain only to end up in the surgery table a few years later.

2. NSAIDS

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.

To the patient, it sounds like a decent proposal – use non-steroidal drug to temporarily alleviate pain. However, the consequences are enormous. In this comprehensively researched article on the Journal of Prolotherapy, the writer calls for a total ban on the use of NSAIDs for joints owing to its potential for degenerating cartilage. This is alarming considering that majority of the NSAIDs are prescribed for joint conditions like arthritis. In another study, use of NSAIDs was shown to have tripled the progression of Knee Osteoarthritis.

Furthermore, even in the 1980s researchers have found that NSAIDs can disrupt intestinal integrity.

3. Biologics

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.

That’s why they have been linked to neurological diseases, and other diseases.

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.

Doctors-Ditching-Steroids-For-Platelet-Rich-Plasma-PRP-Injections

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.

Doctors-Ditching-Steroids-For-Platelet-Rich-Plasma-PRP-Injections

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.

Independent research is also catching up with Platelet-Rich Plasma. It has proved so far that PRP is far superior for:

1. Chronic low back pain

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.

2. Tennis Elbow

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.

3. Plantar fasciitis

This randomized, blinded study concluded that PRP delivered at least the same pain-relief results as steroids. Other researchers have concluded that PRP is actually more effective than steroid injection in terms of pain and functional results. Another study also proved that PRP was more effective and durable than cortisone for plantar fasciitis. Yet another British study also pointed out that PRP injections are superior to corticosteroid injections.

Doctors-Ditching-Steroids-For-Platelet-Rich-Plasma-PRP-Injections

4. Knee Osteoarthritis

The study above showed that intra-articular PRP injections are better than HA, ozone, and corticosteroids. Another study recently proved that PRP injections are better than Hyaluronic Acid for knee osteoarthritis.

5. Rotator Cuff Tears

This study proved that Platelet-Rich Plasma injections show benefit earlier than cortisone injections for rotator cuff tears. Another similar study also found that a single dose of PRP is better than steroid for Shoulder impingement syndrome.

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.

Doctors-Ditching-Steroids-For-Platelet-Rich-Plasma-PRP-Injections

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.

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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 hello@drprpusa.com. 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.

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Rheumatologits' Guide To Platelet-Rich Plasma2a
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.

Dentox Platelet-Rich Plasma Botox Training
New Live Botox, Dermal Filler And Platelet-Rich Plasma Training

If you’ve been looking to up-level your facelift strategies with Botox, Platelet-Rich Plasma Training And Dermal Fillers, we have excellent news for you.

The wonderful Dr. Katz has agreed to partner with DrPRP for a series of one-day LIVE intensive workshops (on Saturdays, the next available one is in September) on his latest Dentox X-Lift procedure. It will feature the following:

  1. Botox Training
  2. Dermal Fillers Training
  3. Platelet-Rich Plasma Training
  4. The Dentox Lift Technique Training

Learn more about the training below or click the link below to register.

About Dr Howard Katz

Dr Howard Katz is one of the top experts and visionary in the field of face lifts and dental reconstruction. His name was included on Allergan’s Botulinum toxin (Xeomin, Dysport, Botox) patent applications for dental therapies as well as gel filler (Dermal fillers) formulations and Oraverse anesthetic reversal. You can read more about Dr Howard here.

About the Platelet-Rich Plasma Training

DrPRPUSA is honored to be able to team up with Dr. Howard Katz and the team at Dentox to organize this leading edge training on Platelet-Rich Plasma and facelifts. As Dr Katz is an actual scientist-dentist-clinician named on the intellectual property for Botox and gel fillers, you can expect the best hands-on training like the kind you’ve never experienced before.

DrPRP USA Platelet-Rich Plasma Training

The is one-day intensive program offers everything you need to expand your skill set and boost your bottom line if you’re a doctor, dentist, nurse and other qualified medical professionals in the facelift industry.

It will be featuring DrPRP USA Platelet-Rich Plasma kits and DrPRP Dermal filler makers.

Here’s the registration page and full details >>

Here’s Dr. Howard Katz himself explaining the key highlight of the event:

The training includes:

Hands-On Botox Training

Practice Botox on live patients and become completely confident in properly injecting Botox and related products.

  • Learn the latest FDA-approved procedures for Botox, Dysport and Xeomin from an instructor with more than 30 years experience
  • Get the skills to bring both cosmetic and therapeutic Botox injectables to your practice
  • Gain an understanding of documentation and legal requirements
  • Pick up tips on marketing and promoting your skills for the biggest possible income boost
  • Explore how to get more from your existing clients and bring in new clients too
In-Depth Dermal Filler Training

Learn how dermal fillers can satisfy patients and help prevent and reverse the signs of aging.

  • Explore how you can create natural-looking smoothing and reduce wrinkles with carefully placed injections of dermal fillers
  • Pick up the skills necessary for using Restylane, Juvederm Ultra, Juvederm Ultra Plus and other dermal fillers
  • Understand how choosing the right products leads to be best results
  • Find out how to correct your mistakes and the mistakes of others
  • Gain all the info you need to document, market and expand your practice with dermal fillers

Platelet-Rich Plasma Training Cosmetic

Cutting-Edge Platelet Rich Plasma (PRP) Training

Get ahead of your competition by bringing innovative PRP treatment to your practice for quicker healing and less expensive cosmetic procedures.

  • Learn how a patient’s own blood can be condensed into a powerful tool for cosmetic and therapeutic purposes
  • Ways to enhance bone grafting and tissue grafting, keeping treatments/profits in-house, and greater patient satisfaction from more painless, faster healing results
  • Gain the knowledge you need to use PRP therapy in place of dermal fillers for the same results at lower cost to you
  • Examine the ways to market your new skills while complying with the law
The Exclusive Dentox LIFT

Innovated by Dr. Katz, the Dentox LIFT allows you to perform a non-surgical facelift, with stunning results in under 30 minutes. No general anesthetic is required, there is no scarring, and results last for 1-2 years. Attract new patients, and offer your current patients this treatment to enhance their cheekbones, define a youthful jawline, and smooth their under-eye areas.

PLUS More extras including:

⇒ Proven Marketing Techniques
⇒ Free Staff Member Attendance
⇒ Patient Forms
⇒ 10 Hours Continued Education Credits
⇒ Courses include free access to the live, online Botox and Dermal Fillers refresher programs (4 additional credit hours each).. up to 18 total CE credits!

DrPRP USA Platelet-Rich Plasma Training

I believe this is a unique opportunity not only to learn from one of the nation’s pioneers in the facelift industry, also to meet other cool amazing people who’re rocking it in this space so you can learn from them and drastically improve your practice or clinic bottom line.

Registration is open now – it’s all online takes about 5 minutes of your time – and seats are filling fast 🙂

You can learn more about it all here >>

 

Platelet-Rich Plasma Vs Hyaluronic Acid
Did Platelet-Rich Plasma Just Crush $13 Billion Hyaluronic Acid?

While it didn’t take us by surprise when we saw Platelet-Rich Plasma win yet another bout with Hyaluronic Acid, the scientific community is pretty much over-the-top with this latest result. This is the first time there is really hard, convince-any-hard-core-critics evidence that Platelet-Rich Plasma indeed might be the new accepted non-surgical treatment for symptomatic OA.

This new study was headed by Brian Cole of Rush University Medical Center.

For those who don’t know what that means, here’s a brief summary.

  1. Rush University Medical Center is ranked #4 in the nation by U.S. News & World Report and the highest rated in Illinois.
  2. Dr. Brian Cole is the associate chairman and professor of Department of Orthopedics and chairman of Department of Surgery at Rush.
  3. He is also the Chairman of Surgery at Rush Oak Park Hospital.
  4. He has published more than 1,000 articles and 10 popular textbooks in orthopedics and regenerative medicine.
  5. He is known as one of the “Best Doctors in America” and was NBA Team Physician of the Year in 2009.
  6. He is also the head team physician for the Chicago Bulls NBA team and co-team physician for the Chicago White Sox MLB team.
  7. Dr. Cole also co-hosts Sports Medicine Weekly on ESPN Radio.

As you can see, this is kinda huge.

That’s why we’re celebrating it.

You can read information about Dr. Brain Cole’s study here.

How This Study Was Conducted

This study was performed on 111 symptomatic unilateral knee OA patients over a period of one year. Forty-nine patients were injected with Platelet-Rich Plasma and fifty patients were injected with Hyaluronic Acid, both under ultrasonic guidance. This was repeated 4 times. Both groups did not have any change in WOMAC score but IKDC score in the PRP group was significantly higher.

And as the paper reports, “significant improvements were seen in other patient-reported outcome measures” which they suspect was due to the anti-inflammatory properties of Platelet-Rich Plasma.

Why Was Hyaluronic Acid Injected In The Past

To fully understand the scope of this new study outcome, let’s discuss the role of Hyaluronic Acid in treating Osteoarthritis. As you know, Hyaluronic Acid is a critical substance in the synovial fluid that allows the bones to glide against one another. And lack of Hyaluronic Acid leads to breakdown of synovial fluid causing joint pain and stiffness that’s associated with Osteoarthritis.

So theory is that injecting Hyaluronic Acid into synovial fluid makes it thicker again.

However, what decades of study has shown is that it’s not as simple as that. Hyaluronic acid has a lot of other activities in the joint and the supplemental, bioengineered HA Hyaluronic Acid does not seem to pick those activities up naturally. That’s why doesn’t actually help improve the synovial fluids.

Platelet-Rich Plasma Vs Hyaluronic Acid

A $13 Billion Dollar Industry To Be Taken Over By Platelet-Rich Plasma?

Reports by industry analysts pegs the worldwide Hyaluronic Acid market (majority) to over $13 Billion. The market is divided into four sections according the application of HA 1) dermal fillers 2) osteoarthritis 3) ophthalmic and 4) vesicoureteral reflux. In THREE of these FOUR divisions, Platelet-Rich Plasma is already proven as a worthy substitute.

Let’s take a look:

  1. With the help of this instrument, Platelet-Rich Plasma produces dermal fillers that can match Hyaluronic Acid fillers.
  2. Osteoarthritis, as per our discussion here, stands to gain more with Platelet-Rich Plasma than Hyaluronic Acid.
  3. For dry-eyes, Platelet Rich Plasma seems to be effective when other treatments are not. (Around 40 million people suffer from dry eyes in the U.S.)
  4. Only for vesicoureteral reflux, that Platelet-Rich Plasma has not been proved. But PRP has been found effective for urinary incontinence, so I suspect it’s a matter of time we’ll see the evidence emerging to support PRP for this.

I’m not saying Platelet-Rich Plasma will immediately capture the Hyaluronic Acid market.

At least now now.

But there is hope that we could see the market replace a huge portion of bioengineered Hyaluronic Acid with Platelet-Rich Plasma. Think about it. Instead of spending unnecessary money on HA, your patients can now choose a wholesome treatment that actually gives amazing “side effects” to their body.

What It Means For OsteoArthritis Patients

If you’re a doctor, what this means is that you can stop using hyaluronic acid injections altogether, and instead confidently suggest Platelet-Rich Plasma for your patients. Even if insurance does not cover Platelet-Rich Plasma injections, it is a far more optimum treatment than the bioengineered Hyaluronic Acid.

I believe it’s only a matter of time that the insurance companies will realize why it’s actually cheaper and more effective to do Platelet-Rich Plasma than Hyaluronic Acid.

Platelet-Rich Plasma Vs Hyaluronic Acid

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

Platelet-Rich Plasma For Bone Healing
Platelet-Rich Plasma For Bone Healing: Myth or Fact?

Platelet-Rich Plasma has a proven record for healing soft-tissues and other living tissues. But can it actually heal the bones itself?

This could mean PRP, when applied to an affected area whether it’s an elbow joint or knee or back bone area, actually heals everything within it’s reach including the bones. Is that really why PRP actually works?

Let’s examine.

Platelet-Rich Plasma For Bone Healing

Bones are not just lifeless matter attached to living tissues. It’s as much living as the tissues themselves. And just like the tissues, it’s constantly changing too. The old bone cells are broken down and replaced with new ones in a three-part process called bone remodeling the involves resorption (digestion of old bone cells), reversal (new cells are birthed) and formation (new cells turn into fully formed bones).

This process, just like any other biological processes in the body, requires hormones and growth factors. Some of the names include parathyroid hormone (PTH), calcitriol, insulin-like growth factors (IGFs), prostaglandins, tumor growth factor-beta (TGF-beta), bone morphogenetic proteins (BMP), and plain old cytokines. For this discussion we need to remember only one thing: a large cytokines and growth factors are involved in bone remodeling process.

Which means we accelerate the bone remodeling process by supplying these cytokines and growth factors as suggested by studies like this, this, this, this, this and this.

Why Platelet-Rich Plasma?

Autologous Platelet-Rich Plasma (PRP), being completely “whole and natural” can more closely simulate a highly efficient in-vivo situation that anything else out there that are made up of artificial recombinant proteins. In PRP, we are taking advantage of the biological benefits of growth factors whose functions we know as well as those we do not know of yet. From the 15+ factors we know are in PRP including platelet derived growth factor (PDRF), transforming growth factor-beta (TGF-beta), platelet factor 4 (PF4), interleukin 1 (IL-1), platelet-derived angiogenesis factor (PDAF), vascular endothelial growth factor (VEGF), epidermal growth factor (EGF), platelet-derived endothelial growth factor (PDEGF), epithelial cell growth factor (ECGF), insulin-like growth factor (IGF), osteocalcin (Oc), osteonectin (On), fibrinogen (Fg), vitronectin (Vn), fibronectin (Fn) and thrombospontin-1 (TSP-1)… we’re actually supplying a “holistic” set of nutrients for healing that cannot be mimicked by those obtained artificially.

Platelet-Rich Plasma For Bone Healing

Organic Fertilizers For The Body

The PRP difference is like adding chemical fertilizers versus organic fertilizers on plants. Chemical fertilizers are rich in essential nutrients that we know are needed for crops. On the other hand, organic fertilizers supply nutrients not only to the plants but also to the soil, improving the soil structure and tilth, water holding capacity, reduces erosion as well as promote slow and consistent release of nutrients to the plants itself.

Clearly, organic fertilizers are better, aren’t they?

Platelet-Rich Plasma are like organic fertilizers for our body.

Bonus: Strong Antimicrobial Properties

It seems that the Platelet-Rich Plasma’s healing function has synergistic function to anti-microbial properties. A new study confirms that using Platelet-Rich Plasma in surgeries may have the potential to prevent infection and to reduce the need for costly post-operative treatments.

That’s a nice bonus for the organic fertilizer of our bodies. Perhaps, there are more. So why wouldn’t anyone not take advantage of them?

The scope of Platelet-Rich Plasma is growing as the scientific community continues to unearth its inherent properties. PRP is an unignorable, and unavoidable component of healing.

Platelet-Rich Plasma For Stretch Marks
What’s True About Platelet-Rich Plasma For Stretch Marks?

Cindy is a career woman. So when she became pregnant for the first time, she was confused about which aspect of her life had higher priority – her work or taking care of her growing body. Not wanting to drown in that confusion, she kept herself busy with her work all day while snacking every little free time she had. This meant she was putting on a lot of weight, fast. Occasionally, her more experienced sister would remind her to apply Bio Oil on her growing tummy before bed, but she was too exhausted to actually do it. Except maybe for a few nights.

It wasn’t until after she delivered her baby that she realized her folly – her belly now looked like a road map.

What Works For Stretch Marks?

Sure, there are a variety of topical treatments, the ones with cocoa butter are the trend, but they’ll hardly affect severe stretch marks. They perform better when used as preventive measures. Because fully developed stretch marks are rarely skin deep. The stretching occurs on the layer underneath the surface called dermis. And the inability of the surface layer (epidermis) to keep up with the stretching is what’s causing the appearance of deep roads of stretch marks.

One way to “cure” stretch marks or at least the appearance of stretch marks is to make the skin surrounding the stretch marks a level closer to the stretch mark itself. This can be done by various minimally invasive “scarring” technologies like microdermabrasion, microneedling and CO2 fractional laser.

But You Said Platelet-Rich Plasma For Stretch Marks, Didn’t You?

Yes. But you see, platelets can only supply growth factors wherever healing is initiated. So unless healing is initiated or is still ongoing (not in the case of a fully developed stretch mark), the injected Platelet-Rich Plasma may not be able to produce it’s excellent results.

That’s why in forums you can hear a lot of advice from doctors who claim Platelet-Rich Plasma can’t help stretch marks. In fact, that’d be the first thing I’d say if someone asked me.

However, what if we could artificially initiate the healing? Not only in the outer epidermis layer, but also in the underlying dermis layer too? Now, that’s an excellent opportunity to put the growth factors in Platelet-Rich Plasma to good use, wouldn’t you agree?

Platelet-Rich Plasma For Stretch Marks

Actually that’s exactly how hundreds of thousands of happy men and women get rid of their stretch marks, around the world.

Enter PRP Microneedling

PRP microneedling is nothing but swapping Vitamin C that’s used in traditional microneedling with Platelet-Rich Plasma. This is traditionally called Platelet-Rich Plasma facial – due to the fact that you’re essentially spreading blood components over your face. This is a particularly effective treatment for the face. But it can provide even better results for stretch marks (probably the most effective treatment for stretch marks.)

Here’s why this particular combination really works:

1. Getting to the root of the situation

With micro-needling, what we’re actually doing is punching some holes on both the outer epidermis layer and the inner dermis layer of the skin. These holes are so micro that it restores back to normal within minutes or hours. However, during the time it’s open a healing response is triggered. The very act of triggering a healing response in the inner dermis layer means there’s going to be some improvement on the stretch marks – as that’s where the source is. That’s probably why doctors recommend micro-needling for stretch marks over any other treatments. The procedure also removes unwanted, half-dead cells from the outer skin causing the stretch marks to appear less deep.

2. Accelerated Healing With PRP

PRP’s job is to accelerate the healing response triggered by the micro needles, and it must do so during the time it’s open. So immediately after the micro-needling, a concentrated gel of PRP is applied. And massaged well enough for the platelets to actually seep through the holes. These platelets first stop the micro-bleeding caused by the microneedles and then the growth factors in the platelets trigger the production of a substantial amount of collagen. Now, collagen’s primary role is replacement of dead skin cells. Which means, it’ll replace all the dead, broken and torn skin cells in the entire area. The result is fresh new skin in the areas of the stretch mark causing it to actually shrink in size and look more rejuvenated.

Why Platelet-Rich Plasma?

Platelet-Rich Plasma is a powerful healing component. That’s why it was invented in the first place. In 1987, surgeons found that autologous platelet-rich plasma and red blood cell concentrates diminishes the cost of healing for cardiac surgery — meaning faster, efficient and natural healing for patients. Now, the same force that heals a cardiac surgery also can also cause rejuvenation of our body — whether it’s the skin or any other organ in the body. We’re only beginning to peel layers of healing potential found in Platelet-Rich Plasma. A 2015 chinese study about growth factors in PRP says it can even heal bones. They’re not the only ones. Here’s another study of PRP for bone grafts and they found it helps too.

So it’d be outright foolish to not use such a potent, natural healing agent for skin rejuvenation purposes. And micro-needling seems to be just what Platelet-Rich Plasma needs to exercise its healing powers. It’s much better than stockpiling tons of topical products that might “cure” stretch marks — scar creams, retinoids, and peptides.

Platelet-Rich Plasma For Stretch Marks

The More Earlier The Better

In healing, studies show platelets have much better efficiency when they are introduced right after the wound initiation. The same is the case for stretch marks. As soon as you see those marks, it’s better to head straight to the clinic and get a Platelet-Rich Plasma + Micro-needling session to heal it. The longer you wait, the more harder it gets to wipe them off. So stop experimenting with topical creams – they’re meant to be used as preventive measures.

Here’s a video from The Doctors show about the procedure.

The video talks about Megan who had unusually worse scars and stretch marks as a result of pregnancy and multiple surgeries. After dabbling with a couple of topical creams, laser therapy and microdermabrasion, she was quick enough to see the virtue of micro-needling combined with Platelet-Rich Plasma. The video is about her 4th treatment and so far the results look amazing. Her doctor, Dr. Semira Bayati, says her quick decision to switch to PRP is what made the treatment effective.

Platelet-Rich Plasma Centrifuge
Platelet-Rich Plasma Centrifuge Process For 1 Million/uL Concentration

No one can deny the evidence of the growing popularity of Platelet-Rich Plasma. For instance, in 2011, we only had about 460,000 hits on Google for PRP. That number has almost grown 10x now (2015) with close to 4,000,000 (4 million) hits on Google for PRP.

If that’s not exponential growth, I don’t know what is.

This is growth despite the industry trying to subdue it by not supporting further research. And without any support whatsoever from insurance companies for the patients. So this trend isn’t from people looking for free procedures. Everyone knows they are going to have to pay. You can only imagine what it would become when the procedure finally gets covered by medicare and other insurance providers.

Time will tell.

However, there aren’t many doctors who specialize in PRP Injections. You know the #1 query in Google for PRP is from people looking for doctors. Our inboxes are flooded with such requests to locate physicians for PRP Injections.

So why do most doctors hesitate to jump in on the bandwagon?

Platelet-Rich Plasma Centrifuge

Objections To Overcome If You’re A Provider

There are two objections to address here.

FIRST, you need basic training to get started in PRP. Especially if you’re in the orthopedic field, you need training on ultrasound guided injections.

The SECOND and the easiest step is to invest at least a $1500 in a centrifuge and kits.

However, it’s also a catch 22. As a physician, you won’t get to the step 2, unless you’re confident about step 1.

So I’m going to try answer a question I’m seeing about step 1.

Platelet-Rich Plasma Centrifuge

Platelet-Rich Plasma Centrifuge Process For Maximum Concentration

There are two methods for preparing Platelet-Rich Plasma.

1. The PRP Method

This is slightly complicated. It involves a first spin in a centrifuge to separate the RBC. This involves spinning and then physically transferring the supernatant plasma with platelets into another tube.

Then a second centrifugation to further concentrate those platelets.

Platelet-Rich Plasma Centrifuge

Here’s how PRP methods works.

1. Draw whole blood in ACD tubes.

2. Without chilling the blood, put it in a centrifuge for slow speed (soft spin). This separates plasma from RBC.

3. Transfer the plasma into another non-ACD tube.

4. Centrifuge it at a higher speed (hard spin). This concentrates the platelets at the bottom of the tube.

5. The bottom 1/3rd is Platelet-Rich Plasma. Remove the other two thirds, which is Platelet-Poor Plasma. And shake the tube so that platelet pellets at the bottom of the tube gets mixed for an even concentration of Platelet-Rich Plasma.

Platelet-Rich Plasma Centrifuge

2. Buffy Coat Method.

This is the simplest method. The whole blood is centrifuged at high speed (hard spin) to result in a buffy coat layer that separates the white blood cells and platelets from the Red Blood Cells.

Here’s how the Buffy Coat method is done.

1. Draw whole blood in ACD tubes.

2. If you need to store the blood, maintain about 20°C to 24°C.

3. Put it in a centrifuge and spin it at a ‘high’ speed. This results in three (3) layers. Bottom RBC layer, middle platelets and WBCs and the top PPP layer.

4. Remove the top layer, and take the middle layer and discard the bottom layer. You can further centrifuge this at low speed for separating the WBCs.

It’s way easier than this with DrPRP system.

Here’s how the Buffy coat method is done with Dr. PRP.

Platelet-Rich Plasma Centrifuge

How To Use DrPRP Platelet-Rich Plasma Kit

1. Draw 18cc of blood in a tube with 2cc ACD. (Note: ACD-A Anticoagulant Citrate Dextrose Solution, Solution A, is the only anticoagulant product approved by the US-FDA for the use in preparation of Platelet-Rich Plasma)

2. Inject the drawn blood to Dr.PRP kit through the upper injection port of Dr.PRP Kit until the blood level reaches the 20cc scale marked on the kit. (For easier injection, tilt the kit.)

3. First centrifugation. Insert the DrPRP kit into the centrifuge buckets. And add a counter weight on the opposing bucket (This is simply another device with equal mass to balance the spin.)

4. Spin it for 3200 pm for 4 mins. This will separate the whole blood into plasma and red blood cells. *For subjects taking aspirin, antihypertensive drugs, those with cardiac disease, anemia, or during menstruation, the centrifugation should be done for 4 min at 1,000 RPM.

5. If after 4 minutes, if the plasma layer lies above the line as shown below, then spin it again at 3200 rpm for 1 more minute.

Platelet-Rich Plasma Centrifuge

6. Once you get the boundary line between plasma and RBC layer below the edge, you can push the blue rod up to close of the separation of the plasma and RBC. After you push, tighten the knob at the bottom to lock it.

7. Now place the kit back in the centrifuge bucket for the second round of centrifugation. (If you’ve taken the counter-balance off, do remember to place it back.) This time spin it for 6 minutes at 3200 rpm.

Platelet-Rich Plasma Centrifuge

8. We’re done. Carefully take out the DrPRP Kit in its upright position so as not to mix up the resulting contents in the upper chamber of the kit. The top portion of it is PPP and the bottom 4cc is the PRP. So draw out the entire contents of the upper chamber except for the last 4cc.

9. Shake the last (bottom) 4cc, which is Platelet-Rich Plasma, for the plasma pellets to mix evenly. Draw it into a syringe and inject it on the patient in the area that’s needed.

Note: If you follow this procedure, you should see a concentration rate anywhere from 4 to 8 X base count, which is the highest yield you can get for Platelet-Rich Plasma.

Platelet-Rich Plasma Centrifuge

Standardise It For The Future Of Platelet-Rich Plasma

Standardization of this procedure means you’re getting the foundation ready for the future of this remarkable treatment. The above steps can be used for All of these Platelet-Rich Plasma variations, mainly:

1. Pure Platelet-Rich Plasma (P-PRP): This one has no leucocytes and a low-density of fibrin network.

2. Leukocyte PRP (L-PRP): This one has leukocytes and a low-density of fibrin network.

3. Pure platelet-rich fibrin (P-PRF): This one has no leucocytes and a high-density fibrin network.

4. Leucocyte platelet-rich fibrin (L-PRF): This one has leucocytes and a high-density fibrin network.

Platelet-Rich Plasma Centrifuge

By strictly following this procedure, we stand to make Platelet-Rich Plasma therapy more effective and we can hope that eventually the insurance companies would not only authorize its use, but even require it as a first line treatment for many conditions especially in their early stages.

Platelet-Rich Plasma Injections Protocol
Platelet-Rich Plasma Injections: Protocol Guide

Almost all sports medicine doctors would agree that there’s no harm in trying Platelet Rich Plasma Injections (PRP Injections) for their patients. After all, there are hundreds of thousands of cases of positive results. All it needs is research to prove it’s worth. Currently there are many independent researches going on from private funding like the one conducted by Dr. Kimberly G. Harmon M.D., director of the Primary Care Sports Medicine fellowship at University of Washington. She just recently received a gift to support her research from UW alumni who I’m guessing firmly believes in Platelet-Rich Plasma (PRP).

While the process of extracting PRP is fairly simple — there are many variants as long as platelets are above baseline levels with at least seven growth factors — many physician are still unsure about what they can and can’t do when it comes to this marvelous procedure. So today I want to take the time to shine light on the fine print.

Platelet-Rich Plasma Injections Protocol

PRP: Protocols, Technique and Safety Endorsements

Protocol/Technique

Usually, the procedure requires the physician/surgeon and an assistant or two to help with the preparation of graft, the maintenance of sterile technique and saving the ultrasound images (if relevant).

Pre-Procedure Considerations

  • There should always be a specific indication associated with a physical exam with confirmed imaging studies such as an ultrasound, Cat Scan, or an MRI before treatment.
  • Proper patient education and a discussion must be had with the patient as well as a signed informed consent prior to the procedure.
  • Contraindications reviewed prior to procedure.

Graft Preparation

  • The patient is to positioned in a comfortable seated or reclining position.
  • Sterile single needles and syringes must be used with proper handling and disposal.
  • Using an aseptic procedure, the proper amount of blood is then drawn from the vein for the PRP procedure.
  • If the blood cannot be obtained from the site the first, time a new site must be used to prevent early activation.
  • Using a sterile technique, transfer the tube of venous blood to the centrifuge. Platelet Rich Plasma should be acquired using a separating device created for autologous blood. Preference is always given to a closed system that will prevent exposure of the blood and its cellular modules to the open air, and permits minimal use of the tissue.

Image Guidance PRP Therapy

  • Real time imaging guidance using ultrasound CT, or fluoroscopy should always be used when performing a PRP injection.
  • If ultrasound is going to be used, the subsequent considerations need to be decided on in advance: For lengthy procedures, PRP injections near the spine and intra-articular injections sterile gel is recommended.
  • Always use sterile probe covers. Cleansing the probe before and after the PRP procedures and observance to sterile technique is sufficient.
  • Guided images and ineradicable markings of the site of the probe position and the needle entry always needs to be made before cleaning the skin where the probe and needle will be inserted.
  • Always apply a bandage or a dressing after the procedure to protect the entry site from germs.

Post-Injection

  • The patient should be monitored for any post PRP procedure complications such as vaso-vagal.
  • The patients should be given their post procedure directions and precautions and any questions should be answered before they leave, they should also have emergency contact information.
  • Patients should also be instructed about the immobilization and any post procedure activity that is allowed and/or not allowed.
  • Post PRP procedure pain prescriptions need to be given to the patient before discharge and any questions they may have about the medication(s) should be answered at this time. The patient also needs to be instructed to avoid NSAIDs till they have healed, are pain free, has full function has returned to the area being treated (or at least to the limited area being treated.
  • Per OSHA guidelines contaminated areas must be disinfected, before the next patient uses the room (area.)
  • The PRP procedure must be documented in detail, which includes a procedure note that contains the following information: date, pre and post procedure diagnosis, name of the procedure, physician/surgeon(s), any assistants, whether or not anesthesia was used, and if so what type, short-term indication of the procedure, a description of the graft preparation, a description of the procedure that includes any/all guidance and instruments used.

Platelet-Rich Plasma Injections Protocol

Follow-up

  • Patients are normally re-examined in 2-6 weeks after the PRP procedure to follow-up on pain, use, the injection site and to discuss any concerns and any future course of action.
  • The patient response of the treatment should be recorded using authenticated outcome measures.
  • Any complications responses and all other relevant information should be logged into in the ICMS tracking system.
  • The consideration for another PRP injection should be the center of the discussion and the patient will be able to make a decision based on the outcome.

Safety

  • With every medical procedure universal precautions must be used including before, during and after the procedure.
  • Risk of infection – PRP is antimicrobial and provides effective protection against most bacterial infections except for Klebsiella, Pseudomonas, and Enterococcus.
  • With the graft being made entirely out of autologous it basically eliminates the apprehension for the transmission of disease unless the graft became contaminated.

Risks to Patient from the Procedure

  • Infection
  • Bleeding
  • Nerve damage
  • Pain
  • Lack of result
  • Loss of limb and death are very rare but possible.

Platelet Rich Plasma: Indications 

Musculoskeletal complaints, require a complete history and exam to find a diagnosis.  Often times, diagnostic studies may be needed and reviewed to understand why prior treatments failed. PRP is usually considered an optional treatment for chronic and subacute conditions.  Commonly, healing slows down or stops all together at the 6-12 weeks’ period following an acute or traumatic injury.  If the patient has not had any improvement for over the first six weeks, it’s probable the healing period has stopped.

Platelet-Rich Plasma Injections Protocol

Platelet Rich Plasma: Contraindications

  • Septicemia
  •  Platelet dysfunction syndrome
  •  Localized infection at the procedure site
  •  Hemodynamic instability
  •  Critical thrombocytopenia
  •  Patient not willing to take the risks involved with the procedure

Relative Contraindications:

  •  Regular use of NSAIDs within 48 hours of the PRP procedure
  •  HGB of < 10 g/dl
  •  Platelet count of < 105/ul
  •  Systemic use of corticosteroids within 2 weeks
  •  Recent illness or fever
  •  Cancer – particularly hematopoietic or of the bone
  •  HGB < 10 g/dl • Platelet count < 105/ul
  • Corticosteroid injection at treatment site within 1 month
  • Tobacco use
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

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