Dr. Theodore Shybut, Orthopedic Surgeon, San Fernando Valley, Valencia, Santa Clarita, CA / Patient Info / PRP & Stem Cell Therapy

PRP & Stem Cell Therapy

Platelet Rich Plasma (PRP) Injection

Platelet-rich plasma (PRP) is a newer modality of treatment for the management of many orthopaedic conditions including sport injuries. RBC (red blood cells), WBC (white blood cells), plasma, and platelets are the major components of blood. Platelets are small discoid blood cells with granules containing clotting and growth factors which are released during the healing process. On activation, the platelets accelerate the inflammatory cascade as well as healing by the release of the granules containing growth factors. Platelets have an average lifespan of 7–10 days.

A normal blood specimen contains only 6% platelets whereas platelet rich plasma (PRP) contains a much higher concentration of platelets. A PRP injection is generally recommended in the treatment of tendon or muscle injuries with a success rate of about 70% to 80%. Four to six weeks may be required for complete healing.

Special precautions are required in individuals with low platelet count, bleeding disorders, those on blood thinning medications or anti-inflammatory medications, individuals allergic to local anesthetic agents, those with active infections and women who are pregnant or breast feeding.

Procedure

Your doctor will first draw 10 ml of blood from the large vein in your elbow. The blood will be centrifuged or spun to separate the platelets from other blood components. The entire process takes about 10 minutes. The platelet rich portion of the blood is then extracted.

The injured part of the body is anesthetized with a local anaesthetic and PRP is injected into the affected area under ultrasound guidance.

After the procedure

Following the procedure, you can resume your daily routine activities but avoid strenuous activities such as heavy exercise or lifting.

You may experience some pain during the injection which may last for a couple of days. Cold compresses and pain medication may be prescribed for pain relief. Anti-inflammatory medications are to be avoided for up to 48 hours after the injection, as they can affect the platelet function.

Risks and complications are rare but can include infection, nerve or blood vessel injury, scar tissue formation, and calcification at the injection site following a PRP injection.

Call your doctor immediately in case of persistent pain or the development of any adverse reaction after the injection.

Stem Cell Therapy

Introduction

Stem cell therapy in Orthopaedics is used to help in the repair of damaged tissue by harnessing the healing power of undifferentiated cells that form all other cells in our bodies. The process involves isolating these stem cells from a sample of your blood, bone marrow or adipose tissue (fat cells), and injecting it into the damaged body part to promote healing. Platelet-rich-plasma (PRP), a concentrated suspension of platelets (blood cells that cause clotting of blood) and growth factors, is also used to assist the process of repair.

Disease overview

Aging, exercise, sports and injuries cause excessive wear and tear of the body. As we age, the process of repair is slowed down due to reduced production of mesenchymal stem cells (repair cells). This causes the joints’ elastic tissue to become stiff and lose its elasticity, thereby increasing its susceptibility to damage. This problem can be treated with stem cell therapy, where your own body’s cells can be used to repair and promote healing of degenerated or injured joints.

Indications

Stem cell therapy in Orthopaedics is currently being used in conditions such as:

  • Osteoarthritis (degenerative joint disease)
  • Chronic tendonitis (inflammation of the elastic tissue that connects muscle to bone)
  • Bone fractures

Degenerative vertebral discs

Procedure

Stem cells from your blood, bone marrow or fat cells are harvested to treat your joint pain. The treatment plan will depend on your individual condition, but generally, one stem cell injection is administered initially and an injection of PRP is given after four to six weeks. The steps involved in stem cell therapy include:

  • Your doctor will apply a local anesthetic to the area from which cells will be taken (stomach or hip).
  • About 30-60cc of bone marrow stem cells or about 20cc of adipose-derived stem cells is extracted.
  • The stem cells and platelets are then separated from the rest of the blood by spinning it in a centrifugal machine.
  • Healthy stem cells and growth factors are then injected directly into the damaged area.

Post-procedural care

Numbness will persist in the injured area for about an hour; once it lessens you should prevent the area from further injury. Anti-inflammatory medications should be avoided for at least 4 weeks. You can use ice for 10-20 minutes every 2-3 hours if required. Your doctor may prescribe medications to relieve pain. Inform your doctor if you experience bleeding, increased pain, infection or fever.

Risks and complications

As with any procedure, stem cell injection involves potential risks and complications. The common complications at the injection site include infection and bruising. Soreness may occur at the site from where the stem cells were removed.

Advantages

Advantages of stem cell therapy are:

  • The therapy reduces pain and provides long lasting relief from chronic tendinitis and osteoarthritis.
  • The therapy uses the body’s own cells for repair therefore there is no chance of rejection.

Stem cell therapy is a revolution in relieving joint pain without the need for invasive surgical interventions. It is especially helpful in sports medicine enabling you to return to your sport much earlier than with surgery.