Platelet Rich Plasma vs. Corticosteroid
Long term reduction in Pain
American Journal of Sports Medicine 2010
|WHAT DOES PRP TREAT:|
|Muscle tears||Tendon injuries||Ligament injuries|
How It Works
Platelets in the blood are an integral part of forming clots, which stop bleeding. However they have another vital role in healing. They contain chemicals called growth factors, which have been shown to cause cells to multiply and form new tissue. PRP contains a much higher concentration of platelets than normal blood. This means that higher concentrations of growth factors are being released into the injured area, which accelerates and enhances healing. When compared to cortisone injections, PRP shows better results over a longer period of time. While the effects of cortisone are rapid, they are often followed by a decline in the patient’s condition. PRP, however, shows slower but greater long-term improvements and less injury recurrence. Your doctor will assess your condition and determine whether you are a suitable candidate for PRP treatment.
A nurse will take your blood (as in a normal blood test), and spin it in a centrifuge, which separates the blood into its various components. The bottom layer consists of red blood cells, while the top layer consists of plasma and platelets. This top layer is the platelet rich plasma (PRP) that is removed for the treatment. The PRP is then photo-activated using Adi-Light technology. This entire process takes about 30 minutes. The PRP is then injected directly into the injured area.
Benefits for the Patient
Light activation of PRP has been shown to:
Before PRP Treatment
You should eat and drink healthily before a procedure. Avoid fatty foods, coffee and alcohol. Anti-inflammatory drugs (e.g. cortisone, nurofen, celebrex) should not be taken for 2 – 3 days before or after the treatment.
After PRP Treatment
Following treatment, you should rest and avoid running. After a knee procedure you should minimize walking. Expect gradual improvement in your condition over a week or so.
PRP is taken from your own blood, so there is no risk of disease transmission or allergic reaction. PRP may cause a temporary increase in pain and swelling. There can be a localized pressure effect from the injection of fluid.
Length of Treatment
The usual course of treatment for knees involves three treatments one week apart. Other injuries may only require one treatment. Your doctor can discuss your treatment with you in more detail.
Photoactivated Platelet-Rich Plasma Therapy for a Traumatic Knee Chondral Lesion
Lifecare Prahran Sports Medicine Centre, Melbourne, Victoria, Australia.
Freitag J, Barnard A, Rotsein A.
To evaluate the effect of combining photoactivation therapy with platelet-rich plasma injections in the treatment of a traumatic chondral lesion of the knee. A 38-year-old man presented with left-knee pain and swelling following a basketball injury. MRI demonstrated a full-thickness lateral tibial plateau chondral flap with subchondral cyst formation and marrow oedema. The patient underwent a course of photoactivated platelet-rich plasma (PAPRP) injections. Patient outcome measures included the numerical pain rating scale and the Western Ontario and McMaster Universities Arthritis Index 3.0 (WOMAC). Following treatment, the patient reported improvement in both pain and function as measured by the numerical pain-rating scale and WOMAC. MRI showed resolution of subchondral bone marrow bruising/oedema. No complications were noted. In this case report, PAPRP injections demonstrated improvement in all recorded outcome measures. Recognising the limitations of a single case report, the results highlight the need for more formal controlled trials to determine the potential use of PAPRP in the treatment of chondral lesions.
[PubMed - in process]
Perhaps the next generation of urilizing our own body’s to self heal may utilize a low level laser applied to PRP or platelet rich plasma or bone marrow aspirate (BMAC). After the PRP is prepared and is an a syringe, it is then placed in a device that helps communicate the the cells & steer them towards an anti-inflammatory pathway.
The company AdiStem Ltd., which operates laboratories worldwide, has been researching how monochromatic light of various frequencies and intensities affects populations of mesenchyme stem cells and white blood cells in animals as well as in humans.
Photomodulation and photoactivation using low-level light is used to stimulate and control growth factors (the key component of PRP) in living cells. These lights block the pro-inflammation activity of proteins called cytokines. These Cytokines have been identified as key players in osteoarthritis and chronic tendon injuries and wounds.
Selecting the optimal photomodulaiton wavelength and bandwidth are critical in creating the ideal results. This light stimulation of cells results in the production or inhibition of ATP, which provides the cell with energy and proliferation.
The LED device activates mesenchyme stem cells and the modulation of cytokine release.
Peripheral Blood White Blood Cells
Figure 1. Results in four patients after a 10-minute exposure to AdiLight-2. Elisa assay for
plasma interleukin 1 receptor antagonist peripheral WBCs before (left) and after (right).
Internal medicine specialists throughout the USA and Europe have been utilizing this therapy via photoactivation for many years. White blood cells, exposed to AdiLight-2 for 10-minutes show an anti-inflammatory cytokine response. (See Figure 1). We postulate that using the Adistem light therapy on prepared PRP may potentially result in less post injection pain and quicker recovery by guiding the cells to an anti vs pro-inflammation pathway. We find that some patients have more pain post treatment vs. others & this adjunct allows us to steer patients towards a more speedy recovery. More research is underway to better understand how laser light therapy may further assist our cells to heal.
“We are entering into an era of biologic treatment, which is incredibly ideal, where you can use your own cells to try to help repair your other cells, rather than using a substance that is artificial,” Dr. Halpern said. “The downside is next to zero and the upside is huge.”… read more