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Studies Stir Debate Over Platelet-rich Plasma Therapy

Three new studies show platelet injections may help several conditions, including osteoarthritis.

By Andy Miller

3/11/10 Battling severe arthritis, Charlotte Marsden had a total knee replacement scheduled for last September. The pain was so bad that Marsden, 61, couldn’t endure walking on concrete floors or on the beach near her Cape May, N.J. home. In a last-ditch effort to avoid surgery, she tried an increasingly popular procedure – platelet-rich plasma therapy, which included injections of her own concentrated platelets, protein-releasing bodies that help heal wounds.

Now, after the platelet therapy, Marsden, says she can again work in her garden, climb steps, ride a bike – and walk anywhere. Platelet injections also eased the pain in her shoulder and big toe.   

“I’m pain-free after 15 to 20 years of suffering,” she says.

The platelet-rich plasma therapy, or PRP, procedure takes a small amount of a patient’s blood and rotates it in a centrifuge to separate red blood cells from platelets. Then the concentrated platelets are re-injected into the damaged area – elbows, knees, shoulders, hips and Achilles tendons. The platelets release growth factors that theoretically help the tissue recover, with the patients ideally improving within a few weeks.

Physicians report that the demand for PRP has soared after pro golfer Tiger Woods received injections to accelerate healing after knee surgery. And two Pittsburgh Steelers, Troy Polamalu and Hines Ward, had the procedure before the team’s Super Bowl victory in 2009.

But despite such positive personal stories and high-profile successes, some orthopaedic surgeons remain cautious about the spread of PRP, saying that not enough substantial research has been done on its effects to push it widely.

A study published in January in the Journal of the American Medical Association, for example, one of the first rigorous tests of this technique, found that PRP injections were no better than placebo shots of salt water for patients with Achilles tendinopathy, a condition that causes pain just above the heel bone.

“It’s clearly hyped too much,” says Stephen C. Weber, MD, an orthopaedic surgeon in Sacramento, Calif.

But others have embraced PRP, saying science simply hasn’t caught up to what they are seeing in their patients.

Platelet-rich plasma therapy represents “the beginning of a seismic change in orthopaedics,” says Rocco Monto, MD, an orthopaedic surgeon in West Tisbury, Mass. “Most of my colleagues have dipped their toes in the water and are finding early success.” 

This week, the debate will likely intensify as the results of four new studies are presented at the annual meeting of the American Academy of Orthopaedic Surgeons (AAOS) in New Orleans. The research at the AAOS conference includes three studies that show more promising results.

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Anita Lokos
29 Jan 2012, 18:47
like so many others I,m looking into PRP for a shoulder tendonitis. I's love to know the code used for Medicare to pay for proceedure.
any Dr's who use ultra-sound as well in South Florida-Miami to Palm Beach area's
thanks..
Andy B
19 Jan 2012, 02:38
@sudee

Dr. Thomashefsky, Ashland Oregon (near Medford) and Santa Barbara is doing this platelet injection treatment.
http://www.drtom.net/
sudee
24 Dec 2011, 19:52
anyone preforming this procedure is either Medford, OR or San Francisco Bay Area of CA. Thank you.
joann cooper
22 Dec 2011, 18:32
I have degeneration of my entire spine due to age an scoliosis, mostly L4/L5 and some disk in the upper back. Would PRP help? Is there a clinic near Cincinnati Ohio or Northern Ky? Does insurance Pay?
Steve
22 Dec 2011, 18:23
I am scheduled for hip replacement surgery in Feb. 2012. I have athritis in my hip and I have been told that I have no cartilage left in the joint. Can PRP give me any relief and delay surgery or avoid it all together? Are there any doctors in Indianapolis area that provide this procedure?
Kevin Maines
16 Dec 2011, 12:59
Kay, We've been using prp therapy for plantar fasciitis here at Southwest Spine and Sports in Arizona with great success. I don't know where you're located but it's probably available nearby.

Thanks,
Kevin Maines
Justin
03 Dec 2011, 19:34
Any place in New York state doing stem cell treatments for osteoarthritis in knees?
chris
28 Nov 2011, 19:24
My daugther has severe pain in her joints from JRA and we are trying natural healing methods first...obviously some days are tough but we would love to be case studies using this procedure for JRA and rheumatoid arthritis as I have that as well. I am more concerned for her being so young but we live in Central New York area (Verona NY near Syracuse NY)and would love to find a doctor who will try this on either her or both of us. Please let me know if you have any ideas. Thank you.
Theresa Hicks
21 Oct 2011, 13:04
I have lower back pain on L4/L5, I have had the blocks and trigger point injections and they help some. We have a Dr. here in Birmingham, AL that is doing some PRP, but not on the back at this time. I also have IC, interstiual cystitus and have DMSO treatments, which help some. I would like to find a Dr. that uses this treatment on the back and ?possibly? in the bladder since that is soft tissue. I would volunteer to be one of the first. I will fly anywhere in the US or if need be, outside the country. I am extremely active and own a horse farm, this is not a hobby, it is a lifestyle. HELP!
Nancy Magistri
08 Sep 2011, 22:43
I have had spinal fusion about 12yrs ago.
This was successful. I'm full of osteoHave stenosis and siactica etc. Osto began years ago.
Injections into my spine didn't bring relief. My hardware in the spine has not moved. It was checked with a mylogram. The nerves in my legs are now being effected and I'm walking with a cane. This makes me very unsteady at times and stairs are awful.
Are these new injections been tried with spinal problems?
elvia gonzalez
13 Aug 2011, 22:03
i would like a referral to best prp therapy doctor in NYC.i have herniated disk L4 & L5.
Thanks
Greg
06 Aug 2011, 14:08
Is there a doctor in the Raleigh-Durham North Carolina area that practices in PRP theropy
Aaron
02 Jul 2011, 10:06
Can someone help to refer a Doctor in the Raleigh, Durham, Carry North Carolina area that provides the PRP Therapy? Thanks. Although it's a fairly new procedure I would like to know if anyone locally has performed the procedure more than others.
Terri
06 Mar 2011, 08:37
After having surgery on one shoulder, I treated the other shoulder and one knee with PRP and fat graft. The PRP has healing properties. By adding some of your own fat, you gain stem cells to grow new tissue. You many need more than one treatment, but the recovery is quick and it has kept me out of surgery and on the tennis courts.

One of my other tennis player friends had a rare clavicle injury treated as well as her back. It has taken them a while to figure out the back, but have recently given her relief from her long time pain.

If you are in the midwest, you can contact craneclinic.com for treatment. They are very honest about whether they think you can be helped. They are now also using bone marrow in addition to PRP and fat.
Dr. Hendrickson
27 Feb 2011, 00:04
"A study published in January in the Journal of the American Medical Association, for example, one of the first rigorous tests of this technique, found that PRP injections were no better than placebo shots of salt water for patients with Achilles tendinopathy, a condition that causes pain just above the heel bone."

That's interesting and in my opinion not the best placebo for this trial. As effective as is not the same as not effective. Maybe saline solution has a healing effect on the tissue.
sportsdocfm
23 Feb 2011, 19:55
Hi Jennifer,

There is anecdotal evidence for relief of discogenic pain by PrP and other biosupplementation such as stem cell therapy. I personally do not do spine procedures, but I do recommend Michael Scarpone, D.O. who trained me in sports fellowship. He is one of the pioneers and does offer CT-guided injections. You may want to contact him for at least some guidance.
Jennifer
13 Feb 2011, 01:01
Has anyone had any relief from lower back pain with PRP? I have chronic lower back pain secondary to multiple lumbar muscle strains and a herniated L4/L5 disc. I have tried everything from physical therapy to specially designed shoes. I am currently trying to avoid surgery and am willing to pay out of pocket for the injections. Any input is welcomed~Jennifer
NJ
01 Feb 2011, 13:19
I just had the PRP done on my hip last evening by Dr Edward Magaziner in East Brunswick, NJ. He has several articles and videos online.

I have pins in hip from an injury from several years ago and have had SI injections which did help for a while but not much. The Dr suggested I try PRP. After reading so much about it I'm finally seeing a light at the end of the tunnel. I will be going for several more injections for the next several months and I will follow up.

Best wishes to you all!
dockuk
13 Jan 2011, 14:26
I have had two medial menisectomies on my left knee, after I tore my ACL 25 years ago. I elected to not have it repaired at the time because of the invasiveness of the open procedure at the time. I recently had to give up running because of the pain. I am researching PRP, but wonder about the necessity of repairing the ACL first or concurrently. I live in Birmingham, AL, a town known for great orthopods! Any suggestions?
Lynda C.
05 Jan 2011, 22:59
I have damage from abdominal pelvic surgeries (6) including 3 c-sections, non-malignant tumors of the uterus, ectopic pregnancy and a cyst. Would this therapy heal some of the damage? I/have a lot of pain as this pouch is non metabolizing fat clipped off from my pelvis. It seems to be putting pressure on some nerves causing muscle, nerve, joint, and back pain?
sujata
14 Dec 2010, 22:56
I am from India. My mother, me and my sisters are all suffering from osteoarthritis. The results of the PRP therapy experiments that i read up on, fascinate me and I hope there is some place in India where this treatment is available. I haven't succeeded in finding any information about such a place here. could I be enlightened if anyone knows where one can go in India for this treatment?
Judy W
08 Dec 2010, 13:03
How did Dorcas White's doctor code for the PRP? My doctor told me no insurance will cover including Medicare..
Clem Ling
03 Dec 2010, 21:51
I have trigger fingers (the right 2,3,4) for about 3 years.
I have had cortisone injection a year ago and no improvement is noticed.
I would like to see a doctor who practiced PRP for my conditions in the Bay Area.
Also, is PRP covered by Medicare.
Gonzalo Oriolo
29 Nov 2010, 23:46
This is simple !!!

BONE MARROW ASPIRATE = STEM CELLS CONCENTRATED
PLATELET RICH PLASMA = SOFT TISSUE HEALING
BONE MARROW ASPIRATE = BONES TISSUE

IF YOU HAVE PROBLEMS ON BONES = BONE M. ASPI.
IF YOU HAVE PROBLEMS ON LIGAMENTS, TENDONS, OR OTHER SOFT TISSUE = PRP !!!!

gonzalo_oriolo@hotmail.com

Gonzalo Oriolo
29 Nov 2010, 23:42
If you're interested in PRP and live in the bay area, contact me: gonzalo_oriolo@hotmail.com

Camillel Dattero
23 Nov 2010, 21:27
My husband.Michael R. Dattero DPM pratices in Westchester County,NY and would like to find out who in the New York Area, either in New York City or in Westchester County could give him more information about PRP Theraphy
Thank you,
Camille Dattero
jdMal29
28 Oct 2010, 06:49
There is a doctor in Northern VA with extensive experience in PRP. He is currently treating my shoulder with this therapy. He is name is Dr. Robert Wagner and he practice with Capitol Spine & Pain. He has multiple locations, but I see him in Fairfax at the Javier Ln. office.
Dorcas White
07 Sep 2010, 00:31
I had PRP in both my thumbs, in December 2009. I had been receiving cortisone injections; however, they were helping very little. I was only able to sleep a few hours each night. My Internist said that I had to go ahead and get my joints replaced, because I was taking way too much pain medication.

I told my hand surgeon that I wanted to try PRP, before having surgery, thinking I would probably have to fly to NY or FL to get it done, but I asked anyway. He talked with the other orthopedic doctors in his group and they agreed to allow me to be their first PRP patient......they had been considering making it available to their patients before I asked.

I have only had the one injection in each of my thumb joints. It is a miracle! I have absolutely no pain at all! 1 never imagined the results would be this good. I do take it easy on my hands. I ask my husband to open stubborn jar lids; I gave-up riding a bicycle; I don't do anything that hurts, but I still painted all the woodwork in the house, sew, and do just about anything I want to do.

I can't believe how good my hands feel now, but if they begin to ache again, I will be right back for another PRP treatment. I take absolutely no pain medication.

By the way, Medicare paid for my PRP!!!!!! Evidently, it all depends on how it is coded.

I received my treatment at Woodlands Sports Medicine, in The Woodlands, TX.

Thanks to all the PRP patients who wrote on forums such as this about your experiences with PRP. I would never have tried it without you.
Moises Irizarry-Roman, MD
29 Aug 2010, 18:41
Hey Lydia Minguela and everyone else on the forum.
I am a sports medicine physician based at Mercy Hospital in Miami.
To answer some of the questions yes, it is used with good results for plantar fasciitis in addition to osteoarthritis and the so called 'tendinitis' of various joints. I do not know who uses it in PR, but we do in Miami.
Samuel Cunningham
02 Aug 2010, 19:40
I have 24 year old herring rod in my back
gail
26 Jul 2010, 08:52
My dad has severe osteoarthritis of his knee, Xray shows bone on bone. His orhtopedic surgeon in ct does cell therapy in his office but his PA says he won't do it on my father. My dad is 91yo and in alot of pain, other injections have not worked. Are there any articles out there that would help change his mind. Gail
LYDIA MINGUELA
11 Jul 2010, 07:01
I WOULD LIKE TO RECEIVE THIS THERAPY I HAVE DEGENERATIVE CHANGES IN MY FEET,FASCITIS PLANTAR AND OSTEOARTHRITIS AND THE CARTILAGES
OF MY FEET ARE IN DEGENERATION IAM SUFFERING CRONIC PAIN AND IAM DISABLE I CANT WALK. PLEASE TELL ME WHO IS PRACTICING THIS THERAPY IN PUERTO RICO. IF INEED TO TRAVEL TO USA I WILL DO IT THANKS
Cindy
30 Jun 2010, 17:29
Do you know of any doctors using this therapy on the east coast, specifically the Virginia area?
EM Martinez
08 Jun 2010, 22:59
BJ, I am located in Santa Fe, who did your injection? I'm looking for a referral. Thank you.
BJ Foster
26 May 2010, 17:49
I was diagnosed with OA in 2000. I was recommended for a knee replacement. I have had 3 treatments done in Santa Fe NM and may go back for one more. My daily pain level has gone from 7-10 to 0-3. I ran last week with no pain during or after my run! I have paid the cost out of pocket and it is the best $3600.00 I ever spent! It may not work on all injuries or all people, but thank God it worked on me!
JD
01 May 2010, 07:16
To locate a Doctor who performs PRP Injection Therapy in Your Area - go to www.prpinjectionconnection.com
Kay
22 Apr 2010, 19:24
Has anyone had any positive results with PRP for plantar fasciitis, have it in both feet for over 3 years
rat gemma
20 Apr 2010, 15:35
any info out there proving prp helps osteoathrirtis of the hip,thanks,ray
vince
17 Apr 2010, 10:26
I have been delaying basal joint(thumb arthritis) surgery both right and left for nearly two years.Is PRP the "silver bullet"I have been waiting for, or should I "bite the bullet" and have surgeries?
alicia
14 Apr 2010, 15:11
Are there any doctors that use this method for Rheumatoid arthritis and not only for osteo arthritis; and if so are there any practicing doctors in the New York area?
nichole
14 Apr 2010, 09:43
where are the doctors located who are willing to try this therepy for remothorid arhritis
Shraddha
13 Apr 2010, 08:59
Hi, I would like to know how big is the global PRP market and how big is the US PRP market?
Dips
26 Mar 2010, 04:12
Hi, what I would like to know is if all the success being claimed for the usage of PSP in hair regrowth has some medical backing??

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