Wednesday, May 27, 2009

Platelet Rich Plasma and Cartilage Restoration

Platelet rich plasma was debated in a scientific session at the International Cartilage Research Society Meeting in Miami Florida this week. Dr. Allan Mishra, Dr. Vannini, Dr. Randelli and Dr. Johnson all spoke about PRP. It was moderated by Dr. Alberto Gobbi.

The discussion after these presentations centered around what type of PRP to use for what indications. It is clear that we need better data. The best published clinical data for tendon related injuries and disorders right now supports the use of PRP that is concentrated to 4-5x baseline platelets with an increased concentration of WBCs. See PRP Reference List.

Most studies so far have NOT been well controlled. However, Dr. Randelli (from Milan, Italy) presented the preliminary results of his prospective randomized controlled trial showing how PRP at a concentration of 4-5x baseline with increased WBCs DECREASES pain after arthroscopic rotator cuff repair and may improve healing in small and medium sized tears. Excellent work.

Several papers, posters and presentations at the meeting supported the use of PRP for cartilage restoration. Level one human data (randomized controlled trials), does not yet exist.

More soon.


Thursday, May 14, 2009

New York Yankee and Platelet Rich Plasma

New York Yankee outfielder Xavier Nady may be using Platelet Rich Plasma (PRP) to treat an ulnar collateral ligament injury in his elbow. This is another example of PRP going more mainstream. It will be important to follow his progress and potential return to play to better evaluate the role of PRP in this injury. Read more of the story.

Total Tendon

Friday, May 08, 2009

Platelet Rich Plasma presented at the NFL Sports Meeting

Platelet rich plasma was discussed today at the NFL Sports Medicine meeting in San Francisco. It was presented in the "alternative" therapies session. No data or specific recommendations were outlined. It is clear we need to actually study the use of PRP in elite athletes before drawing any specific conclusions. It is also important for clinicians and patients to understand that not all PRP is the same. When studies are designed and evaluated, actual platelet counts and white blood cell counts should be included. Only then will we be able to truly define the value of the formulation of PRP derived from any specific machine.

Total Tendon

Sunday, May 03, 2009

Emerging Trends in Tendinopathy

AM with Dr. Robert Nirschl at AMSSM Meeting in Tampa

Dr. Kim Harmon, president of the American Medical Society for Sports Medicine organized an amazing group to discuss tendinopathy in Tampa last week. Dr. Robert Nirschl, the Godfather of tennis elbow spoke about his pioneering work in surgery. Dr. Hakan Alfredson from Sweden discussed the value of eccentric exercises for chronic tendinopathy. Dr. John McShane outlined the value of percutaneous tenotomy and Dr. David Connell from London spoke about the use of blood and stem cells for severe cases. AM presented the case for using platelet rich plasma for tendon related problems.

Overall, it was one of the best sessions ever presented on the topic. Great work and thanks to Dr. Harmon for bringing us all together.

Total Tendon
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