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Posts Tagged : PRP Regeneration Therapy

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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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This Company Reverses Menopause With PRP Injections

Infertility doesn’t just affect a woman’s capacity to give birth. It also crushes her hormone levels and her emotional ecosystem. So when you hear the statistics that say one in eight women are clinically infertile, that’s a big hole in society as a whole. The lack of simple treatments for fertility correction hasn’t helped the situation either. But that may just change in the near future. Right now, one company is conducting a clinical trial to prove how simple it can be to regenerate ovaries and even reverse menopause. All it takes is a Platelet-Rich Plasma Injection directly into the ovaries. The results from this trial could change the lives of thousands of women worldwide.

Validation of An Idea Whose Time Has Come

Although menopause and infertility are two separate issues altogether, they’re both a function of a healthy ovary. The healthier the ovary, the less chances of menopause and infertility. Platelet-Rich Plasma has long proven it’s chops as a basic regeneration material capable of restoring tissues to its healthy state. So if the simple PRP injections can restore hair follicles, manage wounds, heal ligaments, repair joints, restore spinal discs and even regenerate bones, can it also be used to rejuvenate women’s ovaries? We have to thank researchers in Greece who’d popularized this novel idea starting in 2015.

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It All Started In 2006

Traditionally, women are thought to have born with a fixed number of eggs. And for long, the scientists believed that the “natural” course would be for the eggs to get depleted over time causing women to start producing lower and lower quantities of estrogen, the primary female sex hormone. Once the eggs are depleted, they enter menopause and lose their ability to conceive. But a study in 2006 shattered this paradigm. It revealed an interesting phenomenon in female mice where the mice continued producing eggs long after menopause. The key idea this research put forth was that infertility was not a function of “running out of eggs.” Instead, it’s a direct consequence of an ovary which had become unhealthy.

That opened up possibilities in the mind of Dr. Jonathan Tilly, who had conducted the research on female mice, and he became determined to find a way to “revive” ovaries. Then one fine day, he heard of a research where women who’d received bone-marrow transplants mysteriously had regained their fertility. The rest as they say is history.

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The Power Of Growth Factors

It didn’t take long for Dr. Tilly to discover that it was the growth factors in bone marrow that was rejuvenating the ovaries –
the same growth factors that were available in Platelet-Rich Plasma. But for some strange reason, he did not follow up on that route with ovarian rejuvenation. His company, OvaScience, instead pursued its EggPC IVF method called Augment – which is a super complex process of producing healthy eggs with the aid of mitochondria taken from EggPC cells. The procedure has not been a big success and they have since been focussing on other treatments since.

Fast forward to 2015 and there was a Chinese study that established that Platelet-Rich Plasma can indeed rejuvenate ovaries. They demonstrated it on five women with thin uterine linings all of whom were able to conceive babies after a treatment based on the intrauterine infusion of PRP. At about the same time, a Greek fertility clinic began testing this idea much more aggressively and found that rejuvenating ovaries with Platelet-Rich Plasma worked for both women in various stages of menopause as well as those who had uterine complications. They began testing the effects of trans-vaginal ultrasound guided PRP injection into the ovaries of women. The primary researcher behind it is Kostantinos Pantos and he and his team had injected Platelet-Rich Plasma for over 180 women between 34 and 51 years of age and the results have been promising.

“Success In Two-Thirds Of Cases”

According to Dr. Pantos, in about two-thirds of the cases, he’s able to identify changes in hormonal patterns, reactivation of menses and egg production. He says, “Women who have been in menopause, whose ovaries aren’t working, who’ve ceased to produce follicles — they’re ovulating.” Once the women start ovulating, Dr. Pantos then sends them to an In Vitro Fertilization (IVF) center for artificial insemination.

Dr. Pantos and his colleague Dr. Sfakianoudis talks about their patient, a 39-year-old from the Netherlands, who had been slowly entering Menopause and had not had a period in four years. She began menstruating again just a month after the PRP injections to her ovaries. ONE MONTH LATER!

In another case, they reversed menopause in a 45-year-old woman who’d been in menopause for 5 years since the age of 40 with just a simple PRP injection on her ovaries.

After several such cases, the greek doctors became convinced that the same essence of Platelet-Rich Plasma which is capable of regenerating damaged skin, muscles, and bones can also regenerate the ovary.

Back home in New York, the famous fertility clinic headed by Dr. Hugh Melnick, also started offering the ovarian Platelet-Rich Plasma treatment.

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“An Astounding 75% Success Rate In Pre-Clinical Trial”

The discovery of the Greek clinic and its adoption by Dr Melnick, caught the attention of the fertility researcher Dr. E. Scott Sills, who after investigation, became convinced that the treatment holds tremendous potential. Here’s a video of Dr. Sills on The Doctors Show telling the audience why he believes in the treatment.

Dr. Sills then partnered with the Greek clinic to initiate the long process of clinical trials. Pre-clinical studies conducted in late 2015 showed that the treatment was successful in 45 out of 60 women – an astounding 75% success rate and the women were between 45 and 64 years of age.

Their success meant that they could initiate a full clinical trial and found a sponsor – a biomedical company named Ascendance Biomedical headed by Aaron Traywick. Their goal is to publish a peer-reviewed journal. And they got two well-known Berkeley scientists Michael and Irina Conboy to be the advisors for the project. The trials will be headed by Dr. Sills at his Carlsbad, CA based fertility research center, Center for Advanced Genetics.

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Innovium – The World’s First Pilot Trials In Ovarian Rejuvenation

Dr. Sills’ clinical trial, named Innovium, is the world’s first pilot trials in “Ovarian Rejuvenation” using Platelet-Rich Plasma and is limited to just 50 women who’re in menopause and have had at least one failed IVF cycle.  Participants will undergo inter-vaginal ultrasound guided PRP Injections in both of their ovaries and are required to commit to a full IVF session at the facility. By controlling both the Ovarian Rejuvenation therapy and the IVF, Dr. Sills hopes to increase the success rates dramatically.

Managing Director Aaron Traywick has another interesting take on their clinical trials. He says:

“The goal of the trial is not to prove that we can reverse menopause, because over and over again in our treatments, we know that this is the result. We also know that the treatment triggers a whole body response that restores hormones to the levels of youth. Now, we want to see if the rejuvenation is a permanent one, and if we have discovered a connection between the loss of fertility and the damaging effects of aging in the body.”

So the big picture here is the possibility that Platelet-Rich Plasma Injections can reverse the effects of aging. Very promising.

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Restores Hormone Levels To The Levels Of Youth

One of the secondary effects of Ovarian Platelet-Rich Plasma treatments is the change in Hormone levels. Dr. Pantos notes that in those women who had a successful outcome, their hormone levels returned to the level of their youth. According to the Innovium team, during the pre-clinical trial on 60 women, the hormones – Luteinizing Hormone (LH), Follicle-Stimulating Hormone (FSH), Estrogen, and Anti-Mullerian Hormone (AMH) – had returned to youthful levels in all 45 patients for whom the treatment was successful.

This is kinda big deal because it means it’s not just about restoring fertility – Ovarian Platelet-Rich Plasma injections can eliminate or reduce the mood swings, memory loss, lack of focus, irritability, weariness, hot flashes, night sweats, stress, anxiety and depression associated with Menopause. Plus, it can also restore the the water-holding ability and elasticity of the skin. Few can argue that this isn’t a remarkable development in modern medicine.

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Significantly Cheaper Than Existing Methods

What’s even more amazing is the fact that Ovarian Platelet-Rich Plasma Injections are relatively cheap compared to other Stemcell-based and mitochondria-supplementing methods which goes for upwards of $24,000, even some going for more than $34,000. At the time of writing, Dr. Hugh Melnick’s clinic charges only $4000 for the treatment and we believe the price will be substantially more cheaper as more and more physicians start offering it. Therefore the outcome of this clinical trial may well redefine the future of Platelet-Rich Plasma and we could not be more excited. That’s why we encourage our physicians friends to get on board as soon as possible so they can contribute to the development of this novel procedure.

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Another Trial By University of California San Francisco

This isn’t the only clinical trial either. There is another one by UCSF where they are attempting to validate the results of intrauterine Platelet-Rich Plasma injections for overcoming Asherman’s Syndrome and thin endometrial lining. Although the study does not deal with Menopause, it’s a vote of confidence for PRP Injection’s ability to rejuvenate ovarian tissues.

Get On The Bandwagon

The future of Platelet-Rich Plasma is only looking brighter. Right now, with all these wonderful research going on, those who sit on the sidelines refusing to enter the field and start scoring with Platelet-Rich Plasma are going to miss out. But for those believers, there couldn’t be any time more perfect than now. You could be one of the pioneers of this treatment – and who knows, perhaps you’ll be discovering new uses of PRP Injections. This is a treatment which is defined by its simplicity and low set up cost. All you need is a centrifuge and a PRP Kit. Start offering Platelet-Rich Plasma treatments today. And yours could be one of those pioneering medical centers in this field.

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The Orthopedic Surgeons Guide To Platelet-Rich Plasma

According to the famous sports medicine expert, Brian J. Cole, M.D., M.B.A., a good orthopedic surgeon is one who works hard to prevent his/her patients from going under the scalpel. To this end, he advocates a lot of contemporary thinking and treatments like Platelet-Rich Plasma rather than the usual MRI-driven surgical procedures. And we’re seeing more and more orthopedic surgeons who are following the cues of the people like Dr. Cole and are genuinely astounded by the sheer number of surgeries they could avoid by a little poking around with alternative treatments.

“The art of medicine consists of amusing the patient while nature cures the disease.”
~Voltaire

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A Little Late to The Regenerative Game?

Generally speaking, orthopedic specialists have been hesitant in adopting regenerative therapies. They’ve been relying on visual technologies like MRI machines a tad bit too much and hence accustomed to “seeing” in order to believe it. But regenerative therapies like Platelet-Rich Plasma doesn’t work that way. One has to believe in it to see the results. You can’t half-heartedly try PRP injections and give up if it doesn’t work. In our opinion, that’s what separates a passionate orthopedic surgeon from a “just doing my job” orthopedic surgeon. The former has a lot of belief in the rather invisible but non-surgical options. As the saying goes, “All surgeons know how to operate, a good surgeon knows when to operate, but a great surgeon knows when not to operate.”

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And no doubt, one of the key treatment options in Orthopedics that ends up actually saving a lot of patients from going under the knife (and has since become a powerful force in medicine) is Platelet-Rich Plasma. Of course, we’re biased but there is probably no other medical discovery in the modern medical history that has as much an impact on the medical industry as Platelet-Rich Plasma. Physicians now prescribe it as first-line treatment for a variety of medical conditions. And although Plastic surgeons are leading the way in pioneering its application, we believe the nature of PRP is such that it will eventually be of massive benefit in Orthopedics than any other field.

Another reason is runners. They constitute a good portion of the orthopedic surgeon’s patients. These patients do not have life-threateningly serious conditions. They might have minor pain or discomfort that prevents them from enjoying their daily run. They just want to be able to run again. The great news is, a single shot of Platelet-Rich Plasma can do wonders for them.

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Evidence-Based PRP Treatments In Orthopedics

Although few physicians question the efficacy of Platelet-Rich Plasma for joint diseases like knee arthritis, there are well-meaning physicians who resist recommending it to their patients lest they end up wasting the patient’s money. We regularly receive enquiries from such physicians asking for “hard evidence” of PRP’s efficacy. We know that skepticism is natural. And that’s why we’re doing our best to educate physicians so they can come to their own conclusion about Platelet-Rich Plasma.

The truth is there has been more evidence than we can handle.

Let’s take a look at a few of them.

Arthritis

Platelet-Rich Plasma is huge in arthritis. Earlier this year, researchers from Shanghai, China published a review of the 14 existing randomized controlled trials related to PRP treatment of knee-OA that comprised a total of 1423 participants. And they concluded that Platelet-Rich Plasma could be more efficacious than HA, ozone, and corticosteroids in terms of pain relief and functional improvement at 3, 6 and 12 months follow-up. This justifies why some physicians are confident enough to use PRP injections as first-line treatments for all osteoarthritis cases.

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And just recently, Spanish researchers took the next step. They tested an advanced method of Platelet-Rich Plasma infiltration for treating severe hip osteoarthritis and found that the technique extended the distribution of PRP and improved its efficacy. Simultaneously, another Spanish study established that a single PRP injection can be effective in treating late-stage knee OA. This is really really great news. Because if you’re physician dealing with arthritis patients, you probably have never seen any treatment that is this simple which has long-term therapeutic effects like that.

However, on the standardization of the PRP treatment itself, there has been no major progress except that most of the research agrees that a concentration of 1,000,000 platelets per µl (or 5X-7X above baseline) is required for therapeutic effect. This can be obtained through buffy-coat based double-spin process similar to the one followed by Dr. PRP Kits.

Some researchers have suggested using Leukocyte-poor PRP for Osteoarthritis but there isn’t enough evidence to support the notion that having less leukocytes enhances OA treatment results. In fact, there are some RCTs like this that used leucocyte-poor PRP that have failed to produce significant results while leukocyte-rich PRP had a beneficial effect as evidenced by this study.

Bone regeneration

Bone regeneration is a little-known field of medicine where Platelet-Rich Plasma has been quietly performing well. In a 2014 study, researchers concluded that there is little doubt that PRP can be beneficial for bone regeneration. But the mechanism through which PRP was able to achieve this is still largely unknown. Recently, researchers in Japan has discovered that a combination of Bone Marrow Stem Cells and PRP appeared to enhance bone formation in mice. Another RCT by Iranian researchers suggested using PRP along with autologous bone graft for long bone non-union fractures.

Platelet-Rich Plasma has also been compared with bone marrow aspirate (BMAC) concentrate by Japanese researchers and they found that PRP has almost the same capability for bone regeneration as BMAC. This is significant considering the simplicity of PRP extraction vs BMAC extraction.

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There is another meta-analysis by Korean researchers that looked at the effect of Platelet-Rich Plasma on Sinus Bone Graft. Again, the study concluded by saying PRP is beneficial.

Muscle, ligament and tendon regeneration

Historically, tendons are known to respond well to Platelet-Rich Plasma. And this review of current literature confirms the fact. This review also concluded that Leukocyte-Rich PRP (the normal PRP) was more ideal for intratendinous injections.

Platelet-Rich Plasma also has a long history with tennis elbow and Rotator cuff injuries. Researchers in China looked at 8 randomized controlled trials (RCTs) that involved 511 patients with tennis elbow and came to the conclusion that PRP is a more ideal treatment than steroids.

But PRP’s relationship with Rotator cuff injuries suffered a setback last year when a Chinese review concluded that PRP is not beneficial. Prior to that, AAOS had reported that it might be beneficial.

Spine regeneration

Intervertebral disc degeneration is one of the leading causes of lower back pain and is usually the one of the most expensive conditions to be treated – mainly due to the complexity of the condition. In one case we know, a patient with degenerative disc condition in both his lumbar and cervical spine – he had both a degenerative bulging disc at L4 and a sacroiliac joint dysfunction – was still pain-free 2 years after his doctor administered 2 PRP injections. But for this post, let’s put anecdotes aside and look at latest studies like this by Chinese researchers which seems to support the notion that PRP is indeed beneficial for retarding intervertebral disc degeneration.

Another study by researchers in New York also found that PRP is beneficial in the treatment of degenerative intervertebral discs.

Over 100 active clinical trials on Platelet-Rich Plasma

What we’ve presented here is only a fraction of the literature available. As you can see, this is an interesting time of development for Platelet-Rich Plasma. It continues to be of great interest to medical researchers and the patient population. Though the scientific community is torn apart by the lack of standardization and “hard evidence” for PRP treatments, patients are showing huge interest in it even though they have to pay out-of-pocket for these injections. And the reason why patients are voting with their wallets for this treatment is because 1) it’s simple and highly practical and 2) lot of anecdotal evidence. The research community is trying hard to catch up to these patients’ belief – there are currently over 100 active clinical trials on Platelet-Rich Plasma – and we believe it’s only a matter of time before they succeed in their quest. The lack of funding is only major hurdle the research community has to overcome before they uncover the full therapeutic effects of Platelet-Rich Plasma. And we’re excited and so should you because it’s great news for your patients.

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But for now, there’s plenty of evidence to suggest that Platelet-Rich Plasma treatments can be a standard regimen for treatment of musculoskeletal disorders. In the coming years, you will see more standardization in PRP preparation, concentration, pre-activation, injection volume, injection frequency and post-injection protocols.

The Cost Effectiveness of Platelet-Rich Plasma

One other thing to keep in mind, when weighing on the pros and cons of offering Platelet-Rich Plasma to your patients is the cost-effectiveness. Yes, you may not want to waste your patient’s money. But Platelet-Rich Plasma is something that has enormous upside with a relatively low downside. This is especially true when compared to surgical intervention. Average cost of the highly invasive arthroscopic debridement, for example, is $5000. But the same results may be obtained by 3 shots of PRP that costs $1000. The amount of improvement reported by patients undergoing both is similar – about 50%. That’s $20 for every percentage point improvement vs $100 for every percentage improvement in the case of arthroscopy. Even if the patients have to pay out-of-pocket for PRP injections, that’s not a good reason why they should not try Platelet-Rich Plasma.

Check out our Platelet-Rich Plasma kits here.

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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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5 Ways Platelet-Rich Plasma Is Relieving Pain in America

Few things are as life-shrinking as chronic pain. Health economists report that chronic pain costs our nation more than $635 billion each year in medical treatment and lost productivity – more than cancer, heart disease and diabetes. Painkillers have been the only relief medication in modern history. That’s changing with Platelet-Rich Plasma. It has been emerging as one of the key players in pain management.

In any life that’s exclusively ruled by pain, Platelet-Rich Plasma has the power to bring back pleasure and normalcy. It’s certainly a better option for those who’re getting by on four or five Advils a day and wondering what the long term consequences would be.

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First of all, Platelet-Rich Plasma injections are completely safe. The PRP, prepared by centrifuging the patient’s blood in a special blood tube, works in a two step way. First the injections, often guided by ultrasound, breaks up the tissues and second, the growth factors in the PRP helps rebuild the entire tissue. This produces a healing effect and reduces pain.

Here are five common types of pain that can be healed with Platelet-Rich Plasma.

1. Arthritis pain

It’s been well-proven that a few shots of Platelet-Rich Plasma can produce a huge effect for Arthritis patients. It has the potential to…

  • Inhibit inflammation and thus slowing down degeneration
  • Stimulate cartilage formation
  • Kickstart the production of lubricating fluid

These activities in the affected site ends up reducing the pain sensation.

As a long term effect, Platelet-Rich Plasma injections tend to preserve the joints in more than 70% of the cases – as reported by a landmark study in 2013. Recent studies have shown similar results too. They discovered that a two or three injection treatment over a period of 4-6 weeks with Platelet-Rich Plasma does more benefit that similar injection treatments with either Corticosteroids or Hyaluronic Acid. Moreover, the cartilage degeneration was significantly slowed even for patients in advanced stages of Osteoarthritis.

The researchers also conclude that repeating the injections after 6 months ensured better results.

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2. Neurological pain

Platelet-Rich Plasma is one heck of a wonder treatment whose healing potential seems to be expanding everyday and seems like it’s only limited by the physician’s imagination. The latest of those new discoveries is in the field of nerve regeneration and the resulting neuropathic pain. Nerve fibers consisting of neurons are very delicate structures and not much has been discovered about its operating mechanism. But recently, platelet rich plasma have been shown to promote the restoration of nerve fibers.

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In a study performed at Hasanuddin University in Indonesia, Platelet-Rich Plasma was successful in nerve regeneration for patients with leprosy peripheral neuropathy – a situation where all traditional treatments have failed. Which means PRP injections are effective in restoring sensations when it has been lost. This is remarkable news.

Then there is another study conducted in Greece the shows very encouraging mid-term results regarding PRP for treatment of Carpal tunnel syndrome.

All of this is proof that Neuropathic pain can be alleviated by Platelet-Rich Plasma. This paper by a researcher at the University of Puerto Rico analyses how Platelet-Rich Plasma has been able to eliminate neuropathic pain. He reports that PRP’s ability to promote axon regeneration is the key.

Here’s a video from a Rejuv Medical where a patient explains how she had PRP Injections for Nerve treatments and how it changed her life remarkably.

3. Chronic back pain

Chronic back pain and sciatica are mysterious conditions and physicians generally have a hard time figuring out what’s causing them. They first thing they do is to scan the lower back area for defects. When they find one, they’ll recommend surgery to correct that defect even though they have no idea if that defect is indeed the culprit of the pain. When they can’t find any defects, they end up being puzzled and sent the patient away with a bunch of Advils.

In a spine health forum, a patient explains his situation which was similar. His physician suspected the tears in L4-L5 spine segment to be the causing the pain. But there were minor tears and bulges everywhere, so the physician was confused. The patient ended up having to take 8 Advils a day. Unable to continue with that, the patient skeptically tried Platelet-Rich Plasma injections. He went from not being able to sit back in office or drive in a car (even with those medications) to stopping the medications altogether and going on a family trip overseas. Talk about a dramatic shift in life experience!

Another patient on the same forum describes how she had PRP injection for chronic pain in the cervical spine, and it’s been pain-free for two years.

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These kind of stories are supplemented by occasional clinical studies like this where the patients not only had experienced near complete pain relief but also were able to sustain those results for 2 years. This is remarkable for a degenerative disease, aka, a condition that worsens as time goes by. Here are another study conducted in China and another one by Japanese researchers.

4. Joint Pain

In addition to back and knees, almost all other joints are being treated by Platelet-Rich Plasma now. As the science of PRP evolves, the treatment is vigorously gaining popularity with more and more patients demanding it from their physicians. After all, the procedure is incredibly straightforward and is easily understood by most. The physicians hardly need to talk before the patient accepts eagerly.

Hence the doctors are now quick to prescribe Platelet-Rich Plasma for any case of chronic bursitis – in areas like fingers, elbow, toes, hip, shoulders, neck, wrist, ankle, and hip – and the results are almost always positive.

In fact, Platelet-Rich Plasma can be – and must be – prescribed for more than 50% of the musculoskeletal issues that are usually treated with surgery or steroid injections.

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5. Post surgical pain

Surgical pain relief is one of the newer areas where Platelet-Rich Plasma is gaining ground. This is primarily to take advantage of the wound-healing and bone regeneration aspects of PRP, but pain-relief is a very evident beneficial side-effect. Some medical perfusionists advice Platelet-Rich Plasma after almost all surgeries including Neurosurgery, Tumor removal surgery, Oral and Maxillofacial Surgery, Head and Neck Surgeries, Reconstructions and Cosmetic Surgery, Orthopedic/Spinal Surgery, Hand and Foot Surgery, Bone Graft Surgery, Cardiothoracic Surgery and Bariatric Surgery.

By cutting short the time it takes to heal from the wounds of surgery, Platelet-Rich Plasma plays a pivotal role in assisting patients get productive as early as possible. And when done in conjunction with surgery, Platelet-Rich Plasma injections are almost always paid for by the insurance provider covering the surgery.

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The beginning of the end of orthopedic surgery?

At a time when big hospitals are racing towards a possible automation of orthopedic surgeries, there are some physicians who believe that the rise of Platelet-Rich Plasma together with the rise of stem cell technology marks the beginning of the end for 80% of the orthopedic surgeries. They say science is finally waking up to the fact that human intervention is not the most efficient way of dealing with musculoskeletal issues. Rather, it’s best to provide the necessarily biologics in the form of PRP and stem cells so that the body can invoke it’s own healing.

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I hope you agree – because today’s regenerative medical trends are certainly pushing the medical industry in that direction.

If you haven’t started offering Platelet-Rich Plasma – or would like to know some general protocols, we would love to share them with you. Just call us at (844) 377-7787 or email via hello@drprpusa.com.

TOP PRP TREATMENTS DRPRP DOCTORS
Dear Doctor, These 7 PRP Treatments Are Hot In Your State

It takes 15-20 minutes to draw 20cc of the patient’s blood, mix it with a small amount of citrate and spin it using a special prp kit and a matching centrifuge for producing the Platelet-Rich Plasma you need for most PRP treatments.

That’s what it takes to produce a multi-potential healing aid to speed up your patients’ recovery.

And it’s definitely the best free healing agent that contains growth factors, and platelets which stimulate the influx of macrophages, stem cells and other repair cells.

The Advantages of Doing PRP, The Right Way

Of course, you can create your own PRP easily by putting the blood in a test tube and spinning it in a generic table top centrifuge and no one can tell the difference. However, it may not have any platelets and probably no tissue healing proteins.

If you do it right way, using the right equipment, you can generate PRP with 7x the normal platelet concentrations. This is called Enhanced PRP. You can also use adipose tissue or collagen fibers to hold the PRP material and form a PRP matrix to amplify the effects.

The 5 Type Of Treatments That Are Hot Right Now

People who are new to Platelet-Rich Plasma may have a hard time believing in the scope of healing it offers. The best 5 treatments are the following:

1. PRP Facial Treatments

A whole lot of skin centers thrive just because they are one of the first ones to offer Platelet-Rich Plasma treatments. This is kind of a treatment that doesn’t need much convincing since there’s no side effects and no down time. Popular prp treatments for face include wrinkle reduction, eye bag and dark circle reduction, skin rejuvenation, gum lift (PRP with collagen sponge is injected after removing stitches in the gum), rosacea reduction, lip augmentation (using a combination of fat and PRP, brought to the limelight by Kylie Jenner and Charlotte Crosby), and vitiligo correction (PRP injection in combination with narrowband-ultraviolet B (NB-UVB) phototherapy improves re-pigmentation).

An especially generic and popular treatment is a combination of Platelet-Rich Plasma and Microneedling. When applied, this novel treatment can produce the effect of botox, lipo or facelift for far less cost.

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2. PRP Hair Loss Treatments

The growth factors in Platelet-Rich Plasma can reverse non-genetical, early-stage hair loss patterns. There is a huge market for this procedure and very little practitioners offering it. It’s one of the areas for Platelet-Rich Plasma that has a huge unrealized potential. Clients also have seen successful results in cases of thinning hair and even beard regrowth.

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3. PRP For Arthritis And Cartilage Repair

More than $6.4 billion worth of Arthritis treatments were performed in the US in 2013 alone. That number is poised to hit $9 billion by 2020. And study after study are showing how PRP can not only reduce arthritis symptoms but also regenerate the knee cartilage, something which no other mode of treatments have been able to do.

PRP treatments for Temporomandibular Joint Osteoarthritis (TMJ) is one of the most in-demand ones.

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4. PRP for Anti-Aging

There are several high end products and complicated procedures that are popular in the Anti-Aging market. None can rival Platelet-Rich Plasma in it’s effectiveness and simplicity. Hence there is a high demand for Anti-Aging-related PRP treatments. PRP combined with Microneedling procedure can be used for acne scars, open pores, stretch marks, hand rejuvenation, Lichen Sclerosus (skin condition in vulva), melasma and breast augmentation.

Another popular treatment is injections of fat mixed with PRP to improve the appearance of cellulite on hip and butt.

5. PRP for Pain Relief And Musculoskeletal Healing

Okay, so this is a very broad category where PRP is considered as the first-line treatment. Most talked about treatments in this category are for Achilles Tendonitis, Rotator Cuff, Tennis elbow, MCL Tear, Meniscus Tear, Plantar Fasciitis, Patellar Tendonitis, Piriformis Syndrome (Severe Buttocks Pain), ACL Tear, Failed Spine Surgery, Back Pain, Lower Back Pain, Hip and Pelvic Disorders, Degenerative Disc Disease, Golfer’s Elbow, Acromio-Clavicular Joint Pain, Labaral Tear, Bursitis, Neuropathic Pain Relief (Nerve Regeneration -Platelet Lysates are used where inflammation is an issue), Spinal Stenosis or Neck Pain, Avascular Necrosis (Osteonecrosis) Or Dying Bones.

Unlike the PRP treatments in the other categories, almost all of these PRP treatments in this category are placed under ultrasound guidance directly onto the affected tissue. Patients often see really good results in as little as two weeks.

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6. PRP For Infertility

The treatment known as Ovarian Rejuvenation where Platelet-Rich Plasma is directly injected to the patient’s ovaries to reverse menopause or heal fertility issues. This treatment can also result in sexual regeneration. However, this is different from those treatments where PRP is injected into vagina for treating incontinence, looseness, dryness and lack of drive.

Another treatment is for reduction of Vaginal Atrophy symptoms using a combination of Lipofilling and PRP.

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7. PRP treatments for COPD (Chronic Obstructive Pulmonary Disease)

Recently, physicians are also using PRP for treating lung problems such as allergies, asthma and COPD. The Platelet-Rich Plasma is mixed with with saline and inhaled through the nebulizer for regeneration of lung tissues.

It takes 1-2 months for the treatment to take full effect – but patients are seeing great results. One patient with COPD had his best lung condition in 7 years just 2 months after the treatment. Considering that COPD is a huge issue affecting the lives of more than 700,000 Americans every year, this is major feat.

Honorable mentions

PRP for Dry Eyes: This is one of those health categories where Platelet-Rich Plasma surprised everyone with the results. This treatment is catching up fast although PRP hasn’t become the de-facto treatment.

Erectile Disfunction: This is a widely popular treatment with mixed results. The treatment is popular because of it’s low-risk profile and potential high up side (literally!)

The Future Is Looking Bright

In summary, the trend for PRP is strong – and is here to stay. It’s not a one-trick pony. After all, it’s a natural healing mechanism. And the whole procedure takes a maximum of 60 minutes for the patients with zero recovery time.

That’s why thousands of clinics and major medical establishments are making it a standard treatment for many of the medical conditions they specialize in.

We are already seeing huge the demand for PRP treatments. We receive enquiries from patients who can’t find doctors doing PRP treatments in their area – and often times they are willing to travel for the treatments. This shows how bad the demand is.

So are you offering PRP treatments or are you missing out on this easy, life-saving treatment?

Jump on board with the best PRP Treatment accessories. 🙂

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Is Amniotic Fluid A Ready-Made Alternative To Platelet-Rich Plasma?

There is no doubt that PRP is the king of orthobiologics. Nothing else can match it’s minimal side effects, it’s ease of preparation, cost efficiency and quick treatment times. However, there is one other orthobiologic substance that is showing some promise as a ready-made alternative, Amniotic Fluid.

The Amniotic Fluid had been capturing the imagination of orthobiologic scientists as early as 1938 – it’s an excellent source of highly proliferative, low immunogenic regenerative material. They also contain other nutrients, collagen, hyaluronic acids and growth factors in abundance making them ideal for promoting regeneration.

It even has stem cells with B7H4 that promotes wound repair and shows promise for growing robust, functional blood vessels as demonstrated by scientists at Rice University and Texas Children’s Hospital.

But the Amniotic Fluid that we’re talking about today does not contain any live stem cells because of the cryoprocedure used for storing it. But this actually our advantage since the FDA does not allow for stem cells to be present in any amniotic based product at this time.

How Amniotic Fluid Allografts Are Produced

Our doctors love this – it’s like readily injectable PRP. So your patients gain almost all the benefits of Platelet-Rich Plasma without having to go through the process of extracting it yourself.

This Amniotic Fluid that is used as Allograft product is harvested from pre-screened mothers who had consented to donating their Amniotic Fluid at the time of c-section delivery. The fluid is then tested again in a laboratory before preparing them in a neat, ready-to-use format that can be instantly utilised for a wide variety of healing needs.

The one thing that makes Amniotic Fluid an excellent allograft is its low immunogenicity – it does not express the Class II antigens – making it unlikely to cause an immune response in other humans. Plus, these tissues are known to be anti-inflammatory, anti-microbial and anti-adhesive just like Platelet-Rich Plasma.

And did I mention they are multipotent cells? The best candidate for use as regenerative medicine.

While Amniotic Fluid does not have the advantage of being fully autologous like Platelet-Rich Plasma, the huge amount of collagen, elastin and fibronectin in Amniotic Fluid Allograft make it an excellent orthobiologic substance for skin regeneration. It also contains the usual growth factors PDGF, VEGF, EGF, FDF and TGF-B.

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Allogen™ Amniotic Fluid Allograft

AlloGen is a new Amniotic Fluid product by New Life Regenerative Medicine that can be used intraoperatively or through injection therapies to improve chronic pain, sports injuries, arthritis, difficult to treat wounds and even the signs of aging.

Our doctors use it with Platelet-Rich Plasma to enhance the effect of the therapeutic injection. You can also combine it with hyaluronic acid, or bone marrow aspirates.

The product comes in two forms Allogen for use in hospital procedures and Allogen LI as an injectable for in-office procedures.

Allogen LI can also be used for cosmetic enhancement in conjunction with other facelift procedures.

The specifications of Allogen
Name: Allogen™
Category: Human Cell Tissue Product (FDA 361)
Constituents: Growth Factors
Cytokines
Collagen
Fibrinogen
Hyaluronic Acid
Messenger RNA
Protein
Source: Amniotic Fluid of pre-screened, consenting mothers during planned cesarean section
Shelf Life: 2 years when kept frozen at -65°C degrees to -85°C
Patient criteria: Same criteria as Platelet-Rich Plasma – most patients are eligible.
Packaging: Aseptically processed, packaged and cryopreserved (not sterile) stored on dry ice.

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We’re Excited About The Potential Of This

We believe this is an excellent alternative to Platelet-Rich Plasma for those who don’t want to invest in the equipment and kits used for PRP Injections. And for those who’re new to regenerative medicine, this provides a stepping stone towards Platelet-Rich Plasma and possibly stem cells.

We are confident that once you get hooked to the potential of regenerative medicine, you’ll never do another procedure for sports injuries, tendon/ligament repair, chronic wounds and arthritis without it.

And possibly that will save a few of your patients from having to go under the knife.

Contact Us To Get Started With Allogen

Use the contact form below for a friendly no-obligation consultation to see if Allogen can really help in your field of speciality practice. We have so much research information, practice tips and specialty-specific advice to share with you.

You can also call us at (844) 377-7787.

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PRP Injection Insurance Corticosteroid
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.

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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.

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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.

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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.

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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.

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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.

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21 Pro Athletes Saved By Platelet-Rich Plasma In 2016

When Los Angeles Ace Garrett Richards ended up with a disastrous lengthwise tear along his ulnar collateral ligament last May, the high-profile hurler was staring at the famed Tommy John surgery and the disappearance of a good two years of his pitching career.

He wanted neither.

So he sought an alternative option.

And through that option, he’s back starting the season this year, just six months later.

Not surprisingly, Platelet-Rich Plasma had a major role in that. (He had stem cells injection and then PRP)

The year 2016 has been extremely good for PRP – it’s popularity is catching like wildfire. We feel that a tipping point has reached where even weekend warriors who’re unfamiliar with Orthobiologics, instantly demand Platelet-Rich Plasma for conditions like partial ligament tears.

We wanted to find out why this trend is happening.

The answer we suspect is – the numerous successful cases of pro athletes who’ve dodged surgeries like Tommy John with nothing but Platelet-Rich Plasma and rest. This is huge. Because for years, Tommy John surgery is said to have saved the careers of hundreds, if not thousands, of professional athletes around the world.

Tommy John is not only recommended for Ulnar Collateral Ligament tears – not doing it is considered a “career suicide.” That and a tough, year-long road to recovery, we might want to add.

Fortunately now, there’s at least one alternative – PRP.

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Platelet-Rich Plasma Cuts Downs Healing Time By 50%

We’ve had physicians who say they’re seeing hamstring strains that typically has about a six-week healing window heal completely in three-weeks. They are astounded. Typically natural treatments should have LONGER healing window than traditional treatments. But here, we’re talking about hundreds of cases where it’s actually cut down by 50% or more – and this is the most natural (and simple) of all treatments.

PRP just concentrates the body’s own healing resources to where needs it most!

The 50% cut in healing time is just a bonus actually. For both pro athletes and weekend warriors, preventing being cut on and having surgery is their No. 1 priority. They don’t want to just jump on right into a surgery. So even if Platelet-Rich Plasma took TWICE the time to heal, it would have been a popular option anyway… for avoiding surgery.

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Garrett Richards says “[my condition] has only gotten better since it happened, so I’m a believer.”

“I’m sore in all the right spots — everywhere I’m usually sore, and should be sore,” he adds with a smile. “It’s nice to know that I’ll be able to start the season this year and kind of pick up where I left off.”

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With that said, let’s look at what may be the real reason for growth in PRP adoption in 2016 – the huge number of high-profile pro athletes who’ve had Platelet-Rich Plasma injections in 2016.

21 Biggest American Pro Athletes Who’ve Had PRP In 2016

This USA-only list is not all-inclusive and I’m sure we have omitted a lot. But this list should give you an idea of how popular this treatment really is.

  • 1. As we mentioned above, Garrett Richards had platelet-rich plasma injection for healing the pitcher’s partially torn elbow ligament. He’s confident of his comeback without Tommy John.
  • 2. Stephen Curry had Platelet-Rich Plasma for a grade 1 MCL sprain during Game 4 of the team’s first-round series against the Houston Rockets in 2016.
  • 3. In November, Los Angeles Lakers’ D’Angelo Russell got a platelet-rich plasma injection to alleviate pain in his left knee. After having the injection on Nov 23, he missed 11 games to pave way for full recovery.
  • 4. Philadelphia 76ers Jerryd Bayless also got his PRP to heal his wrist in November. But one thing he didn’t do after Platelet-Rich Plasma was rest. He continued playing so healing didn’t happen. And he was under immense pressure to stop the season and do surgery to get well for the next season, which is what he eventually did in December.
  • 5. New York Mets catcher Travis d’Arnaud received a platelet-rich plasma injection in his ailing right shoulder. His was a strained rotator cuff. Today, word is out that he is 0-for-5 in his attempt to throw out base stealers this season.

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  • 6. Boston Celtics All-Star point guard Isaiah Thomas received a platelet-rich plasma injection Wednesday for a groin strain during the first half of his team’s loss to the Houston Rockets. He had the injection into his thigh muscle.
  • 7. Another New York Mets player Asdrubal Cabrera received platelet-rich-plasma injection in New York to accelerate healing of the strained patellar tendon of his left knee.
  • 8. The Washington Nationals star Stephen Strasburg received Platelet-Rich Plasma for his strained flexor mass in his right elbow. And now he’s back in the game for 2017 spring training.
  • 9. Philadelphia Phillies Aaron Nola, the 23-year-old right-hander, received a platelet-rich plasma injection to treat his strained right-elbow ligament. This season, he is quoted to have said that his elbow is “100 percent” healed.
  • 10. The Detroit Pistons point guard Reggie Jackson had platelet-rich plasma (PRP) injections to treat left knee tendinosis and a ulnar collateral ligament sprain in his right thumb that was bothering him for quite some time.
  • 11. San Francisco Giants center fielder Angel Pagan received a platelet-rich plasma injection for patella tendinitis in his right knee, something he believes was the result of his diving catches against the wall.
  • 12. Cleveland Indians right-hander Danny Salazar had platelet-rich plasma injection for a mild strain to his flexor musculature of his forearm.
  • 13. Red Sox’s Koji Uehara: Receives PRP injection for his pectoral injury before signing a one-year, $6 million contract with the Chicago Cubs.

Platelet-Rich Plasma Pro Athletes Injection-5

  • 14. New York Mets’ Steven Matz received platelet-rich-plasma injection to avoid surgery in his left shoulder. He believes 2017 will be a turning point for him and aims to do at least 30 starts next season.
  • 15. Texas Rangers slugger Josh Hamilton had platelet-rich plasma injection during his spring training. He later had to under surgery and then again given Platelet-Rich Plasma for healing him this year. The good news is, in February this year, an MRI scan of his left knee showed no structural damage.
  • 16. San Diego Padres’ right-handed relief pitcher Jon Edwards had platelet-rich plasma (PRP) when a right elbow MRI showed wear on his ulnar collateral ligament. Today, he’s in for his team’s spring training.
  • 17. Baltimore Orioles ace Chris Tillman had platelet-rich plasma injection on his right shoulder in December.
  • 18. Cleveland Cavaliers guard Mo Williams, the 13-year veteran, received a platelet-rich plasma injection in the knee before helping the team win the NBA finals.
  • 19. Atlanta Falcons defensive lineman Adrian Clayborn had platelet rich plasma injections to help him get back to the field faster than anticipated after he had a surgical procedure for a meniscus tear and a torn medial collateral ligament in his left knee. His doctor hopes PRP will help regenerate the lost tissue and allow the knee to heal faster while preventing scar tissue.
  • 20. Washington Wizards center Ian Mahinmi underwent platelet-rich plasma treatment on both knees during his after-surgery rehabilitation process as he aggravated the patellar tendinitis on his right knee (which he had surgery for) and suffered a bone bruise in his left knee.
  • 21. Colorado Rockies’ Gerardo Parra received a platelet-rich plasma injection for an injury he had been trying to overcome for months. He injured his left ankle in a collision with Trevor Story on June and had the Platelet-Rich Plasma in October.

Platelet-Rich Plasma Pro Athletes Injection-6

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

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