PRP and Stem Cell therapy

Platelet Rich Plasma Therapy

Our blood consists of a liquid component known as plasma. It also consists of three main solid components which include the red blood cells (RBCs), white blood cells (WBCs), and platelets. Platelets play an important role in forming blood clots. They also consist of special proteins, known as growth factors, which help with our body’s healing process. Platelet-rich plasma or PRP is a high concentration of platelets and plasma. A normal blood specimen contains only 6% platelets, while platelet-rich plasma contains 94% of platelets and 5 to 10 times the concentration of growth factors found in normal blood, thus greater healing properties.

Indications

PRP is a relatively new method of treatment for several orthopedic conditions such as muscle, ligament, and tendon injuries; arthritis; and fractures. PRP injections can help alleviate painful symptoms, promote healing and delay joint replacement surgeries.

Procedure

Your doctor will first draw about 10 ccs of blood from the large vein in your elbow. The blood is then spun in a centrifuge machine for about 10 to 15 minutes to separate the platelets from the remaining blood components.

The injured part of your body is then anesthetized with a local anesthetic. The platelet-rich portion of your blood is then injected into your affected area. In some cases, your doctor may use ultrasound guidance for proper needle placement.

Post-Procedural Care

  • It is normal to feel some discomfort at the injection site for a few days after your procedure.
  • You will be prescribed pain medications by your doctor.
  • You may use cold compresses to alleviate your symptoms.
  • You will be instructed to stop any anti-inflammatory medications.
  • You may resume your normal activities but should avoid any strenuous activities such as heavy lifting or exercises.

Risks and complications

There are very minimal risks associated with PRP injections. Some of the potential risks include

  • Increased pain at the injection site
  • Infection
  • Damage to adjacent nerves or tissues
  • Formation of scar tissue
  • Calcification at the injection site

Stem Cell Therapy

Stem cells are undifferentiated cells that have the unique potential of regeneration and differentiation into different types of cells. They act like a repair system replacing cells and tissue lost due to injury or disease. With increasing age however, there is a reduction in the number of stem cells available. Stem Cell Therapy is aimed at increasing the availability of stem cells at areas of tissue damage to enhance healing and regeneration.

What are the benefits of stem cell therapy?

Stem cell therapy has shown promising results in the treatment of various orthopedic, cardiovascular, neuromuscular and autoimmune conditions. In orthopedics, stem cells are used to treat degenerative conditions of the shoulder, knees, hips, and spine such as arthritis. It is also recommended for the treatment of soft tissue (muscle, ligaments and tendons) as well as bone-related injuries. Stem cells have anti-inflammatory properties and can regulate the immune system.

How are stem cells derived?

Stem cells are broadly of two types: embryonic stem cells and adult stem cells. Embryonic stem cells have the ability to regenerate into any cell type (pluripotent). These may be obtained from an embryo at an early stage of development, however deriving stem cells from embryos is a controversial subject. An alternate source of pluripotent stem cells is the amniotic fluid obtained during cesarean sections with prior consent. The amniotic fluid also contains essential growth factors and proteins.

As the embryo develops and forms a baby, stem cells are distributed throughout the body where they reside in specific pockets of each tissue, such as the bone marrow and blood. These are called adult stem cells or somatic stem cells. As we age, they function to renew old and worn out tissue cells. Like embryonic stem cells, adult stem cells can also replicate into more than one cell type, but their replication is restricted to a limited number of cell types. Adult stem cells are commonly derived from the bone marrow and fat. Bone marrow is usually obtained from the pelvic bone. Fat is obtained in a less invasive manner and has a higher concentration of stem cells.

Am I a candidate for stem cell therapy?

You may be a good candidate for stem cell therapy if you have been suffering from joint pain and want to improve your quality of life while avoiding complications related to invasive surgical procedures.

What does the procedure involve?

Bone marrow is usually aspirated from your hip region. Your doctor will first clean and numb your hip area. A needle is then introduced into an area of your pelvic bone known as the iliac crest. Bone marrow is then aspirated using a special syringe and the sample obtained is sent to the laboratory. In the laboratory, the aspirate is spun in a machine for 10 to 15 minutes and a concentrated stem cell sample is separated. Fat is obtained through liposuction and the stem cells are isolated and then purified in the laboratory. Your doctor then cleans and numbs your affected area to be treated and then, under the guidance of special x-rays, injects the stem cells into the diseased region. The whole procedure usually takes less than one hour, and you may return home on the same day of the procedure.

What will I experience post-operatively?

Following bone marrow stem cell therapy, you can return to your regular activities the next day but will need to take it easy and avoid any load bearing activities for at least two weeks. Following fat-derived stem cell therapy, recovery takes just a few hours. You are advised to refrain from taking non-steroidal, anti-inflammatory medications (NSAIDS) for a while as this can affect the healing process.

What are the advantages of Stem Cell Therapy?

Stem cell therapy is an advanced nonsurgical treatment that has the potential to heal tissue without the need for surgery.

The benefits of stem cell treatment over other surgical options include:

  • No rejection because the stem cells are taken from your own body
  • Promotes natural healing of the damaged tissues
  • Effective alternative therapy to surgery
  • Treats severe injuries and degeneration that cannot be repaired, such as degenerative disc disease
  • Is not associated with the potential risks and complications of surgery

What are the risks associated with Stem Cell Therapy?

Some risks factors related to stem cell therapy include infection as the stem cells may become contaminated during the preparation process. The procedure to either remove or inject the cells also carries risk, from introducing an infection to damaging the tissue into which they are injected. Rarely, an immune reaction may occur from injected stem cells.

  • NYU Langone Hospitals link
  • NYU Langone Health link
  • American Academy of Orthopaedic Surgeons link
  • Arthroscopy Association of North America link
  • American Orthopaedic Society for Sports Medicine link
  • American Shoulder And Elbow Surgeons link