Orthopaedics of Tomorrow: Improved Healing From Your Own Blood?
What do Tiger Woods, Major League Baseball pitcher Cliff Lee and NFL stars Hines Ward and Troy Polamalu have in common with hundreds of local amateur athletes?
They’ve all used their own blood in an innovative new orthopaedic treatment, and now the everyday athlete can, too – for a price that’s far cheaper than the surgical alternative. But, does the new treatment, known as Platelet-Rich Plasma (PRP) Therapy, really work?
The jury is still out.
The straightforward method to foster healing may improve treatment of relatively common problems among athletes, such as tennis elbow and patellar tendinitis (tendonopathy); but many doctors caution more rigorous studies need to be done before the therapy can be rightfully deemed as a proven method to treat the injuries.
Randy S. Schwartzberg, M.D.
“The platelets have very potent healing factors that are released when they’re injected into the site,” says Orlando Orthopaedic Center’s Randy Schwartzberg, M.D., one of the only orthopaedic specialists currently offering PRP therapy in Central Florida. “The platelets have not been scientifically proven to help athletes heal faster from acute injuries; we’ve seen the success rate and discomfort level vary from patient to patient in the acute injury setting.”
Reports indicate that success levels of PRP range from 60 to 80 percent, depending on the injury or problem.
To perform the procedure, blood is drawn from a patient’s veins – usually in the arm. Then, the blood is drawn into a specially designed double barrel syringe and spun in a centrifuge for roughly five minutes, depending on the centrifuge system being used.
This spinning motion will cause the plasma layer, which is incredibly rich in the healing platelets, to rise to the top, effectively separating red blood cells from the platelets that release potent chemicals and factors involved in the healing process. The plasma-rich blood is then drawn into an inner syringe and injected into the problem site for the patient.
“What this does is catalyze the body’s natural instincts to repair either the muscle, tendon or ligament tissue in the area,” says Schwartzberg. “Some reports indicate that the technique may help regenerate damaged tendon fibers, which will help to decrease the amount of rehabilitation time as well as, potentially, the need for some surgeries.”
Still, he cautions that the PRP procedure is not proven to work on all cases, or even in the same way, in every patient. “The support in the literature is still just a small amount and more conclusive work needs to be done to clearly determine the efficacy of PRP for various situations,” says Schwartzberg.
Even still, patients are requesting and receiving treatment at Orlando Orthopaedic Center’s downtown and Oviedo offices as an alternative to surgery. “PRP is nonsurgical and it uses a patient’s cells to help the body heal itself. Thus, it’s an exciting procedure to be able to inject a patient’s own platelets into sites that are traditionally difficult to get to heal,” says Schwartzberg.
Because the platelets are injected into sites where the body’s blood supply is having difficulty effecting healing, the platelets can catalyze the healing aspect of the blood without the clotting response often associated with platelets.
As for areas that have been surgically repaired? They may benefit from the procedure as well. “Some sites are just more difficult to get to heal, such as rotator cuff repairs and meniscus repairs,” he says. “PRP may provide a solution to help speed and possibly improve the process.”
Using PRP is far less invasive, and far more affordable, for patients who go through with the treatment in lieu of the surgical alternative. PRP is considered to have the potential to change orthopaedics as a specialty. “If it is proven to be scientifically viable, insurance companies may require PRP before surgery. This would change not just sports medicine, but orthopaedics as a whole,” says Schwartzberg.
Length of treatment varies depending on the patient and the area that PRP is attempting to heal. “Because it’s relatively new and does not have plentiful studies, the number of injections for a given problem is empiric,” says Schwartzberg. “Typically, one to three injections are utilized, but that’s not a hard and fast rule.”
As the therapy continues to grow in popularity, Schwartzberg, along with many doctors around the country, see PRP having its biggest affects on local amateur athletes. “It’s relatively affordable and it may get the athletes back to the sports they love faster,” he says. “It can be a literal game changer.”
