Posts Tagged ‘blood spinning therapy’

Platelet-Rich Plasma Therapy: Sports Medicine’s Silver Bullet?

Friday, April 30th, 2010

by Deanna Michalopoulos

If there’s one popular thing Tiger Woods has done this year, it’s platelet-rich plasma therapy—a “blood spinning” treatment that may accelerate healing in areas, such as tendons, that heal more slowly. Earlier this month at the Masters, Woods revealed that he used PRP to speed up healing in injuries to his left knee and right Achilles tendon. He’s not the only super athlete to promote the procedure: Last year Pittsburg Steelers receiver Hines Ward hopped onto the field just two weeks after spraining the medial collateral ligament in his right knee—and credited PRP for mending him in fast-forward. With his help, the Steelers won the Super Bowl.

It’s not surprising that the promise of superhero recovery along with informal endorsements from athletic superstars themselves have sparked a buzz that’s sending Average Joes and Janes to their docs with questions about it. But buzz isn’t served without a share of controversy: A flurry of studies released this spring have offered up conflicting results on its effectiveness.

But last weekend, comprehensive PRP research presented at the Current Concepts in Sports Medicine Symposium at Hospital for Special Surgery in Manhattan, seemed promising. “Studies were presented from both sides of the spectrum, but I’m certain that sometime soon PRP will be the most effective and fastest way to achieve soft tissue healing,” says Oliver Jay Realino, Director of Physical Therapy at Biokinetic. What’s this game-changing treatment about? Check out the basics, upsides and unknowns of PRP below.

What Is Platelet-Rich Plasma Therapy?

The doc takes a few tablespoons of blood from an injured patient. He’ll spin the sample in a centrifuge, which separates the red blood cells from the high concentration of platelets rich with proteins that promote cell growth. The platelets are then injected directly into the injury site—the idea being that these proteins will speed up the recovery of injuries that are typically slow to heal.

What the Skeptics Say

Studies aren’t solid. In the January issue of the Journal of the American Medical Association, research was published saying that PRP used to treat patients with a chronic Achilles tendon disorder was no more effective than a placebo.

Another study presented at the annual meeting of the American Academy of Orthopaedic Surgeons (AAOS) in New Orleans in March said that PRP didn’t significantly improve pain management in arthroscopic rotator cuff repair.

No one has nailed down the protocol. “Some people use it every week for three weeks; some people use it two times for five weeks,” Dr. Don Johnson, of the Department of Orthopaedic Surgery at the University of Ottawa, was quoted in the L.A. Times.

What the Enthusiasts Say

Actually, science does support this. There seems to have been a windfall of research in favor of the carousel technique. At the symposium, Scott A. Rodeo, MD, a orthopedic specialist and scientist for HSS, gave a lecture on PRP. He was involved in research that showed that mice with rotator cuff tendon injuries that were treated with PRP showed slightly improved collagen maturity and organization.

Then there are the other three studies presented at the annual meeting of the AAOS that showed promising results when PRP is used to treat knee injuries, chronic tennis elbow and, wouldn’t you know it, chronic Achilles tendonitis.

Researchers are even exploring how PRP fares outside the realm of sports injuries. A study published in the Journal of Oral Implantology found that PRP has a positive effect on bone density immediately following tooth extraction in the first week after surgery. (The control group showed a decrease in bone density.)

You’ll always accept yourself. “The great thing about PRP is that you are using your own tissue, and people do not have adverse reactions to their own tissue,” says C. Halpern, M.D., sports medicine physician at Hospital for Special Surgery. Count another for Team PRP.

The Verdict?

More time and research will tell whether this is the next widespread treatment for major injuries or whether it’s a fading ineffective fad bolstered by a Super Bowl win. Dennis Cardone, associate professor in the Department of Orthopedic Surgery at NYU’s Langone Medical Center, spoke to NPR about platelet-rich plasma therapy and came to its defense:

“ … it’s certainly something that we never had to offer a patient or athlete before. So, we never had anything that we could safely inject into a tendon. So, this is the first time with some of these chronic tendon problems that – often patients would fail all the types of conservative therapy that we had to offer, this is the first thing short of taking them to the operating room where we can actually inject or – and/or kind of manipulate the tendon in an office setting.”