Monday, March 29, 2010

Platelet Rich Plasma and Abdominal Strains

Cliff Lee from the Seattle Mariners was recently treated with PRP for an abdominal strain.  This is a novel but potential valuable application for platelet rich plasma. Presently, there is no data to suggest it may work for this problem.  Basic science and preclinical work, however, suggest it may be helpful. 

I must applaud the doctors who made this choice because if it does help Mr. Lee return to the mound without surgery they will have helped many other athletes and physicians.  I would recommend, however, this case be documented in the medical literature so we all can follow the specifics.

As new potential applications arise, we must be aware of the value created by the researchers, physicians and patients who make that initial decision to try something that no one else has done. 

Total Tendon

Sunday, March 14, 2010

Platelet Rich Plasma Debated at AAOS meeting in New Orleans

 Dr. Taco Gosens and Dr. Allan Mishra at AAOS New Orleans 2010

The concept of using platelet rich plasma for orthopedic applications was vigorously debated at the recent AAOS meeting in New Orleans.  Dr. Gosens presented his prospective randomized trial of 100 patients with chronic tennis elbow.  They found PRP was significantly better than cortisone at one year.  This has been published in the American Journal of Sports Medicine in Feb. 2010.  See Abstract

Dr. Gosens and his colleagues used PRP in a form that contains both concentrated platelets and white blood cells in an unactivated (no addition of thrombin or calcium) composition.  The details of this are critical as other forms of PRP may not have the same efficacy.  As the debate about PRP continues it will be paramount for researchers, clinicians and patients to understand that not all PRP is the same.  Presently, the lay press is trying to state that PRP either works or does not work.  This is too simple.  We need more studies such as the one presented by Dr. Gosens to understand when and where to apply PRP and in what form.  We may conclude from his study that unactivated platelets in combination with concentrated white blood cells is more effective than cortisone for chronic elbow tendinosis.  That is important.  More soon on the other data presented at AAOS on PRP. 

WebMD Article        

Total Tendon
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