Tuesday, July 22, 2008

How PRP works for Tendonitis and Tendon Tears

Platelet Rich Plasma produced by AM at Total Tendon

Platelet rich plasma (PRP) continues its advance as a novel and increasingly valuable treatment for tendon related problems like chronic tendonitis (also medically known as tendinosis). It is important to realize that not all physicians and machines produce clinically valuable (meaning it helps improve your pain and function) PRP. Published peered reviewed data suggests that PRP should contain at least 5 times the number of whole blood platelets.

(See Dr. Mishra's study published in American Journal of Sports Medicine Nov. 2006 for details)

As PRP evolves, it is important to find physicians and surgeons who base their clinical decisions on the literature not on opinion. Also, they should use devices that produce PRP with the appropriate concentrations of platelets. Not all methods are the same.

PRP Website: ApexPRP.com

Platelet rich plasma has been found to work via three mechanisms:

1. Release of Growth Factors increase local cell division (producing more cells)

2. Inhibition of excess inflammation (decreased early macrophage proliferation)

3. Recruitment of circulating or bone marrow derived cells that help repair tissue.

This combination of mechanisms helps heal a tendon. Animal data confirm that PRP helps produce a biomechanically stronger tendon.

All of these statements are based on peer reviewed publications.


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Friday, July 11, 2008

Platelet Rich Plasma and Rotator Cuff Repair

We now have published evidence that PRP is safe and may be useful in arthroscopic rotator cuff repair. This excellent study by Dr. Randelli and his colleagues will lead the way to larger trials.

Autologous platelet rich plasma for arthroscopic rotator cuff repair. A pilot study.

Here is Dr. Randelli's excellent rotator cuff video. (Thanks for sharing it.)

Dipartimento di Scienze Medico-Chirurgiche, Policlinico San Donato, Universita degli Studi di Milano, Milano.

Background and purpose. Arthroscopic repair of rotator cuff tears can produce excellent results. The application of platelet rich plasma during arthroscopic rotator cuff repair is safe, and produces results which do not deteriorate over time. Methods. A total of 14 patients undergoing arthroscopic repair of a rotator cuff tear received an intra-operative application of autologous platelet rich plasma in combination with an autologous thrombin component after tear repair. Following the procedure, patients were given a standardized rehabilitation protocol, and followed for 24 months. Outcome measures included a pain score (VAS) as well as functional scoring (UCLA and Constant scores). Results. Of the original 14 patients, 13 were seen at a final follow-up appointment 24 months after the index operation. Patients demonstrated a significant decrease in VAS scores and significant increases in the UCLA and Constant scores at 6, 12 and 24-month follow-ups compared to a pre-operative score. Conclusion. No adverse events related to this application were noted during the procedure. The application of platelet rich plasma during arthroscopic rotator cuff repair is safe and effective, and produces results which seem to be stable with time. A prospective randomized investigation will be necessary to ascertain the efficacy of platelet rich plasma application to improve or expedite the surgical outcome following arthroscopic rotator cuff repair.

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