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Thread: "New" Therapy for healing injuries

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    Host Will Brink's Avatar
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    "New" Therapy for healing injuries

    This is not really that new. It was being practiced by your more "alternative" types for the past few years or so, but has now gotten the attention of more traditional/mainstream types. If it's being used in Boston - the center of the universe for traditional conservative western med - then it's no longer "alternative" :rolleyes:

    New Therapy Heals Painful, Nagging Injuries
    PRP Harnesses Blood's Healing Power


    BOSTON -- Tendon and ligament sprains and strains are among those most common and the most difficult-to-treat injuries that plague millions of Americans each year. But now a revolutionary new treatment may change how fast patients heal.

    Elif Sachs, of Somerville, is one of them. "There was like a 'crack,' and Monday morning I couldn't walk," she said.

    The world-class fencer endured severe lower back pain for more than a year before doctors correctly diagnosed the source.

    "I was just depressed, and in pain all the time," said Sachs. "I couldn't compete in Division 1 events anymore."

    NewsCenter 5's medical editor Dr. Timothy Johnson reported Monday that doctors haven't had many effective treatment options, until now. Scientists have discovered a promising way to harness the power of an injured person's own blood to jump-start healing.

    Sharon Caw is a more typical baby boomer, but like Sachs, she struggled with debilitating knee pain. "I really couldn't walk more than five minutes and I was using crutches," she said. "They suggested total knee replacement, which shocked me."

    Now rehabilitation specialists are discovering that a fix for a laundry list of ailments -- from elbows, knees and shoulders to hips, ankles and lower backs -- might be surprisingly simple, affordable and safe.

    In a treatment known as PRP, or platelet rich plasma therapy, doctors draw a little of the patient's own blood, then spin it in a special centrifuge to separate the platelets. Just a teaspoon of the concentrated, healing cells is then injected into the site of the injury.

    "Once those healing cells are in there," said Dr. Joanne Borg-Stein, of Spauling Rehabilitation Hospital, "they start making whatever the connective tissue is, the tendon, or the ligament, and they start secreting more chemicals that tell the body, 'OK, it's time to start making these tendon and ligament structures again.'"

    Patients say the procedure itself can be very uncomfortable. There is often bruising and swelling at the site of the injection but within days or weeks, chronic painful ligament, tendon and muscle injuries disappear.

    "The pain started going away. So where I was at, like 70 or 80 percent of my limit for pain, it went down to 30 percent, and that's huge," said Sachs.

    Two members of the Pittsburgh Steelers had platelet rich plasma therapy before the 2009 Super Bowl. Doctors say a single treatment can help professional athletes heal three times faster than normal, returning them to competition sooner.

    But PRP's potential for the vast majority of baby boomers and weekend warrior-type athletes may forever change rehabilitation medicine.

    "I've been in practice for 20 years and this is definitely the most exciting thing that has happened," said Borg-Stein.

    "I'm not using crutches, I'm not using the cane, I'm not using a knee brace, and I'm not taking daily pain meds," said Caw. "I'm just amazed at the result."

    Borg-Stein said PRP has been used on only a small number of patients. Doctors are eager for long-term studies, but said that because a patient's own blood is used, it's generally considered safe and there is a low risk of rejection.

    The cost or PRP at Spaulding Rehabilitation Hospital is about $500. The therapy is not currently covered by health insurance.

    New Therapy Heals Painful, Nagging Injuries - Health News Story - WCVB Boston
    Last edited by Will Brink; 11-10-2010 at 02:16 PM.
    Veni,vidi,vici” - Julius Caesar

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    Host Will Brink's Avatar
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    However, not all find PRP effective:

    Scientific American:

    Is Platelet-Rich Plasma an Effective Healing Therapy?: Scientific American

    Below a recent study in JAMA: which did not find an effect for Achilles tendinopathy.

    This may translate into this approach not being effective for Achilles tendinopathy specifically, or simply not effective period.

    Platelet-Rich Plasma Injection for Chronic Achilles Tendinopathy: A Randomized Controlled Trial -- de Vos et al. 303 (2): 144 -- JAMA

    This is another article you should consider reading too:
    not new, no performance benefit - David Epstein - SI.com

    The Scientific American article suggests clinically there appears to be positive effects, but more clinical studies needed.

    Finally, a place for a big intel dump on the topic:


    Multiple Platelet-Rich Plasma articles were published in this month’s American Academy of Orthopaedic Surgeons (AAOS) NOW. With over 400,000 citations in a Google search, Platelet-Rich Plasma has become an important and highly discussed treatment. The sum of the articles illustrate it is not yet possible to categorically conclude PRP is beneficial for all conditions related to tendinopathy. However, based on current clinical results, top Orthopedic surgeons are optimistic and believe PRP should continue to be developed, debated and offered to patients for a variety of indications.

    What is Platelet-Rich Plasma and why is it an attractive option for patients with soft-tissue injuries?

    When an injury occurs, blood platelets release growth factor within the clot that stimulate the recruitment of healing cells to the site and promote their proliferation. These factors also reduce inflammation and stimulate new cell creation. Following a normal blood draw, PRP involves separating these blood platelets from red and white blood cells, concentrating the amount of blood platelets in higher doses, and injecting them directly into the site of injury. “The concept is attractive because the patient’s own blood is used, limiting the potential for disease transmission,” writes Barbara D. Boyan , PhD and author of AAOS cover article “PRP in Orthopaedics.”

    Platelet-Rich Plasma has important implications as it represents a less painful and rigorous treatment for patients with various soft-tissue conditions considering surgery, a more cost-effective means of healing relative to surgery, and the potential of using patients’ own cells for healing. Freddie M. Fu, M.D. is one member of the AAOS panel of experts who clarified the importance of PRP. Dr. Fu writes, “All these factors (various healing cells) are already within our bodies during the natural healing response, which has developed over millions of years of evolution. I really want to know how we can improve our own biologic response, especially in an acute injury setting or during healing.”

    Cont:

    http://huntsvilleprp.wordpress.com/
    Veni,vidi,vici” - Julius Caesar

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