Effective treatment of joint arthritis and damaged muscles and tendons has forever been a treatment dilemma, until the introduction of platelet rich plasma/ regenerative medicine. Age, injury, repetitive strain and mechanical overload cause micro- tears and eventually partial and complete tears in tendons, as well as the progressive degradation of articular cartilage in joints. Healing is poor in tendons and joints and surgical options often become the end-point of treatment after conservative options have been exhausted. Until the introduction of regenerative medicine/PRP, treatment principles have primarily been focused on pain management (chasing the pain treatment approaches), which is like putting out the “engine light” without treating the “engine problem”. Movement based exercise and restoring proper mobility to joints and muscle/connective tissues in conjunction with PRP treatment is fundamental to healing. This way, the targeted tissues can be loaded efficiently to stimulate a healing response by way of mechanoreceptors in tendons and connective tissues. This also ensures that the tendons, muscles and joints are not continually overloaded due to poor movement patterns or neighboring regions being stiff or immobile.
Platelet rich plasma (PRP) has created a paradigm shift in the way these chronic conditions can be effectively treated and tissues regenerated using the body’s own natural pharmacy. Bio-active proteins that are concentrated in platelets can be introduced into damaged joints and tissues to stimulate tissue regeneration and repair. Common conditions such as Tennis/Golfer’s Elbow, Plantar Fasciitis, Jumpers/Runners Knee, Rotator Cuff Tears (partial thickness), muscle tears, knee and hip osteoarthritis etc. can be treated effectively with PRP. A recent meta-analysis of 10 Level 1 clinical trials using PRP for the treatment of hip and knee osteoarthritis strongly support the benefits using PRP injections into the arthritic joint(s). A recent meta-analysis of 100 level 1 clinical trials have strongly proven positive outcomes for the treatment of Tennis elbow with PRP.
Traditionally, cortisone injections have been used to treat these painful conditions, however there is only short term relief of symptoms from cortisone and the relapse rate is very high (the Band-Aid approach). Corticosteroids/Cortisone are catabolic (they weaken bone, joint cartilage and tendons) with repeated use and can accelerate the degenerative changes in the long-term.
Your body is its own pharmacy: Platelets are small discoid blood cells, produced by the bone marrow, with a lifespan of 7-10 days. They can be harvested from the patient by doing a simple blood draw and then the platelets are concentrated using a state of the art centrifuging system. Platelets are separated from red and white blood cells by centrifugation and the platelet rich plasma/PRP is then harvested as the regenerative/ healing material to stimulate a supra-physiologic release of growth and healing factors into the damaged tendon/ muscle/or joint that is being treated. These bio-active molecules kick start the body’s biological repair mechanisms for tissue healing and regeneration. Growth factors and cytokines attract macrophages (white blood cells that remove necrotic tissue), mesenchymal stem cells, and osteoblasts to enhance tissue regeneration through angiogenesis (new blood supply), extracellular matrix production (connective tissues) and collagen synthesis (the building blocks of tendons & cartilage). By stimulating the healing cascade this procedure has profound effects on the inflammatory, proliferative, and remodelling phases of tissue healing.
I have over 35 years of experience as a Sport Medicine specialist in the treatment of muscle and skeletal conditions in the active population, and have been using PRP for over 10 years. The PRP treatment uses the highest standard of care by using ultrasound guided imaging injection technique to accurately treat the affected tissue or joint.
Currently, scientific research in every medical specialty is exploring this new frontier of regenerative medicine and this is paving the way for biological resurfacing of joints, regeneration of vital organs etc.
Dr. Rob Gauvreau, Optimize Physiotherapy & Sport Medicine/ Re Gen MD
