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Πλάσμα πλούσιο σε αιμοπετάλια (PRP),
η θεραπεία μέσω της φύσης.

Η θεραπεία με πλάσμα πλούσιο σε αιμοπετάλια (PRP) ανήκει στις θεραπείες ενός νέου κλάδου της ιατρικής της αναγεννητικής ιατρικής "regenerative medicine", στόχος της οποίας είναι να διεγείρει τους φυσικούς μηχανισμούς θεραπείας του ίδιου του οργανισμού για να αποκαταστήσει αθεράπευτες βλάβες.
Οι επιστήμονες προσπαθούσαν για πολλές δεκαετίες να ανακαλύψουν την ουσία η οποία ενέσιμα θα εγχύοταν στο σημείο της ιστικής και οστικής βλάβης για να την αποκαταστήσει, επιταχύνοντας την ανάρρωση ή αποτελώντας την οριστική θεραπεία, αποφεύγοντας έτσι την πρόσκαιρη αντιφλεγμονώδη αγωγή που δεν έλυνε το πρόβλημα η την χειρουργική επέμβαση. Το PRP πιθανόν να αποδειχθεί οτι είναι η λύση αυτή.
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Ξέρουμε οτι ο οργανισμός χρησιμοποιεί ένα συστατικό του ίδιου του αίματος σχεδιασμένο να ενεργοποιεί τον μηχανισμό επούλωσης των βλαβών όταν αυτές προκύπτουν. Το πρόβλημα όμως παρουσιάζεται, όταν πολλές φορές η περιοχή της βλάβης δεν μπορεί να προμηθευτεί αρκετό απο το υλικό αυτό, τους αυξητικούς παράγοντες1, και η διαδικασία είτε προχωράει αργά είτε σταματάει. Αυτό αποτελεί μία από τις βασικές αιτίες που ορισμένες ιστικές βλάβες μεταπίπτουν σε χρονιότητα με συνεχή πόνο και ενόχληση.
Οι αυξητικοί παράγοντες βρίσκονται αποθηκευμένοι σε κύτταρα του αίματος που ονομάζονται αιμοπετάλια, γνωστά για την συμμετοχή τους στην διαδικασία πήξης του αίματος. Όταν τα κύτταρα αυτά ενεργοποιηθούν, απελευθερώνουν μαζικά τους αυξητικούς αυτούς παράγοντες. Το σκεπτικό της θεραπείας με το PRP βασίζεται στην εξής απλή συλλογιστική: εάν παίρναμε μια μικρή ποσότητα αίματος από τον ίδιο τον πάσχοντα και από το αίμα αυτό δημιουργούσαμε ενα υπέρπυκνο διάλυμα πλάσματος με αιμοπετάλια, θα μπορούσαμε ενέσιμα να διοχετεύσουμε κατά αναλογία μια τεράστια ποσότητα αυξητικών παραγόντων στο σημείο της βλάβης, όπου η θεραπεία καθυστερεί ή έχει αδρανοποιηθεί. Αυτό το υπέρδιαλυμα θα ανοίξει τον διακόπτη της ίασης οδηγώντας τα τοπικά αδρανή κύτταρα σε πολλαπλασιασμό και διαφοροποίηση, όπως και θα προσελκύσει και αλλα κύτταρα στην περιοχή ενεργοποιώντας τον βιολογικό μηχανισμό που είχε τελματώσει.
Η πρακτική εφαρμογή της θεραπείας αρχίζει με τη λήψη μικρής ποσότητας αίματος από τον ίδιο τον ασθενή στον χώρο του ιατρείου, οπως ακριβώς γίνεται μια αιμοληψία για αιματολογικές εξετάσεις ρουτίνας (εικ. 1).

Το δείγμα του αίματος τοποθετείται σε μηχάνημα που ονομάζεται φυγόκεντρος (εικ. 2), η οποία το διαχωρίζει μετά απο διπλή κατεργασία στα συστατικά του2,3.

Απο αυτά συλλεγεται το πλάσμα με τα αιμοπετάλια, PRP το οποίο έχει περιεκτικότητα αιμοπεταλίων πολλαπλάσια του αίματος (εικ. 3).

Το PRP αναρροφάται σε σύρριγα (εικ. 4) και ακολούθως ενίεται στο σημείο της βλάβης, υπό υπερηχογραφική καθοδήγηση για απόλυτη ακρίβεια, σε τένοντα, σύνδεσμο , μυ ή μέσα σε άρθρωση. Η όλη διαδικασία γίνεται στον χώρο του ιατρείου, διαρκεί μια ώρα και δεν απαιτεί καμία προετοιμασία πριν, ή περιορισμό μετά απο αυτήν.

Πολλές επιστημονικές μελέτες έχουν δείξει την δυνατότητα του PRP να επιταχύνει την διαδικασία επούλωσης μυοσκελετικών βλαβών. Τα ενθαρρυντικά αυτά αποτελέσματα οδήγησαν στην εφαρμογή της θεραπείας στις περισσότερες ορθοπαιδικές παθήσεις όπως: μυικές θλάσεις, τενοντίτιδα, χονδροπάθεια και οστεοαρθρίτιδα. Ειδικά εμφανίζει εξαιρετικά αποτελέσματα στην τενοντίτιδα-περιαρθριτίδα ώμου, τις επικονδυλιτιδες του αγκώνα,την τενοντίτιδα καρπού,την τροχαντηρίτιδα του ισχίου, την ιερολαγονιτίδα, την τενοντίτιδα του γόνατου, την τενοντίτιδα του αχιλλειου, την άκανθα της πτέρνης, τα διαστρέμματα και τις μυικές θλάσεις4,5,6. Με καθοδήγηση ακτινοσκοπικόυ μηχανήματος εφαρμόζεται σε παθήσεις της σπονδυλικής στήλης, ενώ πρόσφατες μελέτες έδειξαν την υπεροχή του PRP σε σύγκριση με το υαλουρονικό οξύ για την θεραπεία της οστεοαρθρίτιδας γόνατου και ισχίου7,8.
Λόγω του βιολογικού χαρακτήρα της, η θεραπεία ακολουθεί τα φυσικά στάδια της ιάσης, συνέπεια τούτου δεν εμφανίζει την άμεση ύφεση των συμπτωμάτων οπως γίνεται με τις φαρμακευτικές αγωγές, των οποίων η δράση φθίνει με την διακοπή τους. Σε αντίθεση η θεραπεία με το PRP μπορεί τις πρώτες ημέρες να προκαλέσει μια ελαφρά επιδείνωση των συμπτωμάτων για να συνεχίσει με αισθητή βελτίωση της κλινικής εικόνας ειδικά απο την έβδομη ημέρα, να μεγιστοποιηθεί το αποτέλεσμα μεταξύ της τέταρτης και πέμπτης εβδομάδας ενώ η δράση της διαρκεί απο έξι εώς εννέα συνεχούς μήνες.
Επειδή το PRP παράγεται απο το αίμα του ίδιου του ασθενούς δεν υπάρχει κίνδυνος για αλλεργική αντίδραση ή μετάδοση νόσου. Η ένχυση μπορεί να επαναληφθεί σε μια εβδομάδα και ανάλογα με την βαρύτητα του προβλήματος να φθάσει μέχρι και τις πέντε ενχύσεις. Το πρωτόκολλο θεραπείας όπως και η συχνότητα της, εξατομικεύεται για τον κάθε ασθενή, για την πλειονότητα αρκεί η μια και μόνο ενχύση για θεραπεία.
Αντενδειξείς εφαρμογής του PRP αποτελεί η λήψη αντιπηκτικών, ο χαμηλός αριθμός αιμοπεταλίων στο αίμα, ο αρρύθμιστος σακχαρώδης διαβήτης και η ενεργός νεοπλασία. Βασική προϋπόθεση ειναι να μην λαμβάνονται αντιφλεγμονώδη φάρμακα δέκα ημέρες πριν και δέκα ημερες μετά την θεραπεία, όπως και κορτικοστεροειδή τριάντα ημέρες πριν και δέκα ημερες μετά την θεραπεία, διότι αναστέλλουν την φυσιολογική διαδικασία της επούλωσης.
Συμπέρασματικα ο στόχος της θεραπείας με το PRP ειναι να οδηγήσει στην ίαση μέσω της πλήρους φυσικής αποκατάστασης. Οι επιστημονικές μελέτες οπως και η κλινική εμπειρία δείχνουν οτι οι ασθενείς απαλλάσσονται οριστικά απο οξείες και χρόνιες μυοσκελετικές παθήσεις. Απεικονιστικός έλεγχος με υπερηχογράφημα και μαγνητική τομογραφία δείχνει την οριστική αποκατάσταση της βλάβης επιβεβαιώνοντας την επούλωση του πάσχοντος ιστού. Η άμεση εφαρμογή της θεραπείας αμέσως μετα τον τραυματισμό μπορεί να μειώσει την ανάγκη χειρουργικής θεραπείας κατακόρυφα, όπως και να μειώσει τον χρόνο ανάρρωσης σε σημαντικό βαθμό.

Βασικά σημεία:
  • Το PRP παράγεται από το αίμα του ίδιου του πάσχοντα.
  • Το PRP αποτελεί μια υπέρ συγκέντρωση αιμοπεταλίων και αυξητικών παραγόντων που ενεργοποιούν και επιταχύνουν την διαδικασία της επούλωσης.
  • Μελέτες έδειξαν πολύ καλά αποτελέσματα στην εφαρμογή του PRP για την θεραπεία θλάσεων, τενοντίτιδας, χονδροπάθειας και οστεοαρθρίτιδας.
  • Η θεραπεία γίνεται στον χώρο του ιατρείου και διαρκεί μια ώρα χωρίς προηγούμενη προετοιμασία η περιορισμούς μετα απο αυτήν.
  • Δεν επιτρέπεται η λήψη αντιφλεγμονωδών και κορτικοστεροειδών κατα την διάρκεια της θεραπείας.


Bιβλιογραφία:
1.Borrione P, Gianfrancesco AD, Pereira MT, Pigozzi F (2010). "Platelet-rich plasma in muscle healing". Am J Phys Med Rehabil 89 (10): 854–61.
2. Arora NS, Ramanayake T, Ren YF, Romanos GE (2009). "Platelet-rich plasma: a literature review". Implant Dent 18 (4): 303–10
3. Marx RE (2004). "Platelet-rich plasma: evidence to support its use"Journal of Oral and Maxillofacial Surgery 62 (4): 489–96.
4. Mishra A, Pavelko T (2006). "Treatment of chronic elbow tendinosis with buffered platelet-rich plasma". The American Journal of Sports Medicine 34 (11): 1774–8.
5. Mishra A, Woodall J, Vieira A (2009). "Treatment of tendon and muscle using platelet-rich plasma". Clinics in Sports Medicine 28 (1): 113–25.
6. Andia I, Sanchez M, Maffulli N (2012). "joint pathology and platelet-rich plasma therapies". Expert Opinion in Biological Therapies 12 (1): 7–22.
7. Jang SJ, Kim JD, Cha SS. Platelet-rich plasma (PRP) injections as an effective treatment for early osteoarthritis. Eur J Orthop Surg Traumatol. 2012 Jul 7.
8. Filardo G, Kon E, Di Martino A, Di Matteo B, Merli ML, Cenacchi A, Fornasari PM, Marcacci M. Platelet-rich plasma vs hyaluronic acid to treat knee degenerative pathology: study design and preliminary results of a randomized controlled trial. BMC Musculoskelet Disord. 2012 Nov 23; 13:229.

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Σάββατο, 28 Δεκεμβρίου 2013

Metta World Peace says he'll have platelet-rich plasma procedure on knee


ORLANDO, Fla. - Metta World Peace said he will undergo a platelet-rich plasma procedure on his left knee Jan. 6.
World Peace, who tore his left meniscus last season with the Lakers, said he considered flying to Germany to have it done, as former teammate Kobe Bryant did. But World Peace said he learned he could have the PRP procedure done in New York, and the process already has begun.
In PRP, a doctor withdraws about 50 cubic centimeters of blood, spins it in a centrifuge and injects it directly into the injured area. World Peace said he's already had his blood taken and "the spinning stuff" has started.

Σάββατο, 21 Δεκεμβρίου 2013

Platelet-Rich Plasma (PRP)

During the past several years, much has been written about a preparation called platelet-rich plasma (PRP) and its potential effectiveness in the treatment of injuries.
Many famous athletes — Tiger Woods, tennis star Rafael Nadal, and several others — have received PRP for various problems, such as sprained knees and chronic tendon injuries. These types of conditions have typically been treated with medications, physical therapy, or even surgery. Some athletes have credited PRP with their being able to return more quickly to competition.
Even though PRP has received extensive publicity, there are still lingering questions about it, such as:
  • What exactly is platelet-rich plasma?
  • How does it work?
  • What conditions are being treated with PRP?
  • Is PRP treatment effective?

Παρασκευή, 13 Δεκεμβρίου 2013

Tottenham's Jan Vertonghen will use blood-spinning technique to speed up recovery

T
ottenham will use blood-spinning technique PRP to try to get Jan Vertonghen back to fitness in quick time.
Vertonghen suffered ankle ligament damage during Tottenham's 2-1 win over Fulham last week, and given that Vlad Chiriches and Younes Kaboul are currently injured, Spurs need their top centre-back to return as soon as possible.

Questions & Answers -- Platelet-Rich Plasma (PRP): Recommendations for Treating Bone and Joint Injuries

Interview with the Authors: Questions & Answers

Orthopaedic surgeons Scott R. Rodeo, MD and Freddie H. Fu, MD answer questions about PRP treatment.

Question: Before patients “decide” they want PRP treatment bone and joint injuries/pain, what are some questions that they should be asking?
Fu: Patients should be asking what the available scientific evidence is to support the use of PRP in treating their injury. They should also ask if there is any risk of complications associated with PRP treatment.
Rodeo: Another issue is whether the cost of the PRP treatment is covered by their insurance carrier, as this can become quite costly.

Platelet Rich Plasma Treatments Beneficial for Tendinosis

(HealthDay News) – For athletes with Achilles or patellar tendinosis, platelet rich plasma (PRP) infiltrations are beneficial, according to a study presented at the annual meeting of the Radiological Society of North America, held from Dec. 1 to 6 in Chicago.
Alice La Marra, MD, from the University of L'Aquila in Italy, and colleagues examined the impact of PRP in 50 athletes with degenerative Achilles tendinosis and 30 with degenerative patellar tendinosis.

Τετάρτη, 11 Δεκεμβρίου 2013

Jordan Farmar has torn hamstring

EL SEGUNDO, Calif. -- Los Angeles Lakers guard Jordan Farmar will be out roughly four weeks after tearing his left hamstring.
The Lakers announced the backup point guard's injury Monday. The team also said Pau Gasol has a mildly sprained right ankle.
Farmar left Sunday night's game against Portland after playing just 56 seconds. He had an ultrasound examination Monday.

Researchers identify evidence-based uses of platelet-rich plasma in orthopedic surgery

Researchers of a study which outlined the evidence-based uses of platelet-rich plasma found that the therapy is efficacious in the treatment of lateral epicondylitis, but other indications require additional research.

Σάββατο, 30 Νοεμβρίου 2013

The efficacy of platelet-rich plasma in the treatment of symptomatic knee osteoarthritis- Οστεοαρθρίτιδα γόνατος.

Arthroscopy. 2013 Dec;29(12):2037-48. doi: 10.1016/j.arthro.2013.09.006.
University of Toronto Orthopaedic Sports Medicine Program, Women's College Hospital, Toronto, Ontario, Canada; The Hospital for Sick Children, Toronto, Ontario, Canada.

The purpose of this systematic review was to synthesize the available Level I and Level II literature on platelet-rich plasma (PRP) as a therapeutic intervention in the management of symptomatic knee osteoarthritis (OA).
A systematic review of Medline, Embase, Cochrane Central Register of Controlled Trials, PubMed, and www.clinicaltrials.gov was performed to identify all randomized controlled trials and prospective cohort studies that evaluated the clinical efficacy of PRP versus a control injection for knee OA.

Platelet-Rich Plasma for the Treatment of Chronic Plantar Fasciopathy in Adults - Άκανθα πτέρνης

Foot Ankle Spec. 2013 Nov 27. [Epub ahead of print]
School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin.
Plantar fasciopathy (PF) is a common source of pain and disability that is often refractory to conservative management. There are no uniformly effective standard-of-care treatments for chronic recalcitrant PF. Corticosteroid injection is considered a viable treatment option when traditional therapies fail, but is limited by suboptimal long-term efficacy and potential adverse effects. Platelet-rich plasma (PRP)

Πέμπτη, 28 Νοεμβρίου 2013

Jared Dudley has platelet-rich-plasma injection in knee

This really isn't a big deal but with all the talk about Derrick Rose's most recent knee injury and with the mystery surrounding Kobe Bryant's medical trips to Germany I thought it was interesting to see that Jared Dudley had platelet-rich-plasma injected into his sore knee. (As a disclaimer, I'm not a doctor, not an orthopedist, everything I know is from stuff readily available on the web.)

Κυριακή, 24 Νοεμβρίου 2013

Injection Therapy for Hamstring Injuries - θλάση των ιγνυακών


Hamstring injuries seem to be a plague for NFL wide receivers this season, especially for the Cowboy’s wide receiver Miles Austin.  Dallas Cowboys wide receiver Miles Austin didn’t practice on Wednesday according to a report by ESPN's Todd Archer, due to a hamstring injury he has been battling this season.

Παρασκευή, 22 Νοεμβρίου 2013

Successful Use of Platelet-Rich Plasma for Chronic Plantar Fasciitis - Πελματιαία απονευρωσιτιδά - Άκανθα πτέρνης


Martin J. O'Malley, MD

Associate Attending Orthopaedic Surgeon, Hospital for Special Surgery
Assistant Professor of Orthopedic Surgery, Weill Cornell Medical College
J. Turner Vosseller, MDColumbia University College of Physicians and Surgeons, New York

Yang Gu, BSGeorgetown School of Medicine, Washington DC

Abstract

Background:

There are limited data on the use of platelet-rich plasma (PRP) for treating chronic plantar fasciitis.

Questions/Purposes:

The purpose of this study was to document the clinical outcomes of patients who were treated with PRP injections for plantar fasciitis to determine the degree to which injections were able to decrease the visual analogue scale (VAS) pain scores and improve patient reported functional scores.

Πέμπτη, 21 Νοεμβρίου 2013

The healing power of blood: Platelet-rich plasma therapy enhances recovery times

Tiger Woods and Kobe Bryant supposedly used it to get their stellar bodies back in action. Angelina Jolie is said to have depended on it to erase fine lines threatening her stellar face.
These superstars depended on platelet-rich plasma therapy, also known as protein-rich plasma or PRP, still considered experimental, but not for want of success in the fields of orthopedics, dentistry and even aesthetic treatments.

Κυριακή, 17 Νοεμβρίου 2013

Should Your Lateral Meniscus Tear Recovery Include Surgery? Lateral Meniscus Tears don’t Cause Arthritis, but Surgery Might. Ρήξη μηνίσκου

Article by Regenexx

When patients get a knee MRI and see they have a lateral meniscus tear, it rocks their world. Often the first thing they think of is surgery. After all, doesn’t surgery fix the tear? So why wouldn’t your lateral meniscus tear recovery plans include surgery? Because the research doesn’t support that surgery will help you, but instead may hurt you. Let me explain.

Σάββατο, 16 Νοεμβρίου 2013

Platelet-rich plasma: An option for tendinopathy



By Ricardo E. Colberg, MD, and Kenneth Mautner, MD
About 40% of all sports-related injuries involve tendons.1 Patellar tendon injuries, for example, are the most common knee injury in jumping sports.2 Achilles tendon injuries occur 10 times more frequently in runners than in age-matched nonrunners.3 However, sedentary people are also at risk of developing tendon injuries.1,4 Up to one third of Achilles tendinitis cases have been reported in patients who do not perform vigorous physical activity.5
Lower extremity tendon injuries frequently progress to chronic tendinopathies.

Platelet Rich Plasma: The Ace that Started Nadal’s Epic Comeback!


Rafael Nadal has been characterized as one of the most skilled, explosive, and athletic tennis players the game has ever seen. But such a dynamic style of play had caused the Spanish phenom to be sidelined for 7 months with potentially career-ending knee tendinitis.  Many fans and tennis analysts believed that it was physically impossible for the aging 27 year old to combat his body’s breakdown and return to even a shadow of his former self. 

Platelet-Rich Plasma in the Management of Articular Cartilage Pathology: A Systematic Review.

 Clin J Sport Med. 2013 Nov 13. [Epub ahead of print]

Source

*Division of Orthopaedic Surgery; and †Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada; and ‡Women's College and Toronto Western Hospital; and §Women's College and Mount Sinai Hospital, University of Toronto Orthopaedic Sports Medicine, Toronto, Ontario, Canada.

Abstract

OBJECTIVE::

Using systematic review methodology, we endeavored to answer the following questions concerning the treatment of osteochondral pathology: (1) what pathologies have been treated in vivo with the use of platelet-rich plasma (PRP); (2) what methods of PRP preparation and delivery have been reported; (3) what assessment tools and comparison group have been used to assess its effectiveness; and (4) what are the clinical outcomes of its use.

The Blood Injections That Might Transform Orthopedics

Chris Waddell has been an élite athlete for more than two decades. He has won twelve medals in downhill skiing, including five golds, in four Paralympic Games events; he was a world-record-holding wheelchair track sprinter; and, in 2009, he became the first paraplegic to climb Mt. Kilimanjaro,

Κυριακή, 10 Νοεμβρίου 2013

Is Platelet-Rich Plasma an Effective Healing Therapy?

platelet-replacement-therapy-athlete-injiriesAthletes such as Tiger Woods and the Pittsburgh Steelers's Hines Ward have undergone platelet-rich plasma therapy, but is there evidence that the treatment really speeds the healing of injuries?


Torn tendons, muscles and ligaments plague athletes in many types of sports. In attempts to help heal the wounded tissue, some athletes, both amateur and professional, have turned to platelet-rich plasma (PRP) therapy.

Σάββατο, 9 Νοεμβρίου 2013

Photoactivated platelet-rich plasma therapy for a traumatic knee chondral lesion.

BMJ Case Rep. 2012 Dec 17;2012. pii: bcr2012006858. doi: 10.1136/bcr-2012-006858.

Source

Lifecare Prahran Sports Medicine Centre, Melbourne, Victoria, Australia. julien.freitag@me.com

Abstract

To evaluate the effect of combining photoactivation therapy with platelet-rich plasma injections in the treatment of a traumatic chondral lesion of the knee. A 38-year-old man presented with left-knee pain and swelling following a basketball injury. MRI demonstrated a full-thickness lateral tibial plateau chondral flap with subchondral cyst formation and marrow oedema. The patient underwent a course of photoactivated platelet-rich plasma (PAPRP) injections.

Τετάρτη, 6 Νοεμβρίου 2013

What is Prolotherapy with Platelet Rich Plasma

Platelet Rich Plasma – Prolotherapy using your own growth factors

PRP-blood-draw
The appropriate amount of blood is drawn from the patient.
At Caring Medical, we specialize in proliferative injection therapies, known as Prolotherapy. While these regenerative medicine treatments have been around for many decades, one of the exciting additions, in recent years, is Platelet Rich Plasma (PRP). PRP works great for a number of conditions, particularly labral tears of the hip and shoulder, as well as degenerated meniscus and meniscus tears.

Κυριακή, 3 Νοεμβρίου 2013

Platelet-Rich-Plasma Injections | Ottawa Senators Player Milan Michalek Credited Therapy For Recovery From Knee Injury

Veteran NHL player Milan Michalek faced a decision after last season ended: surgery to repair his injured knee, or an innovative, non-invasive treatment known as platelet-rich plasma therapy. Following the examples set by superstar athletes like Tiger Woods, Kobe Bryant and A-Rod, Michalek chose the latter, traveling to Germany to receive treatment for a week. By September, Michalek told journalists he was “100% and ready to go,” and he has played thus far this season without reporting pain or re-injury.

Platelet-Rich-Plasma (P.R.P.) Shots | Bill Nye the Science Guy Got PRP Therapy for “Dancing With The Stars” Injury


After suffering a leg injury during a fall on “Dancing With the Stars,” Bill Nye the Science Guy received an innovative treatment known as platelet-rich plasma therapy (PRP) in the hope of returning to the stage in the subsequent week. Return he did, and he brought with him a layman’s explanation of PRP, the kind of science-made-simple description his legions of fans know him for.

Carpal Tunnel Surgery Recovery: Does Cutting the Ligament Have Consequences? (Σύνδρομο καρπιαίου σωλήνα)

Carpal tunnel surgery has become a standard surgical treatment for carpal tunnel syndrome, a problem that occurs when the median nerve gets chronically pinched at the wrist. The surgery is simple, cut the ligament that normally covers the carpal tunnel to give the nerve more breathing room. However, does cutting the transverse carpal ligament (TCL) impact carpal tunnel surgery recovery? Does it have other long term consequences? Is the ligament there for a reason? Regrettably, taking the quick fix approach by cutting the ligament may have issues.

The Regenexx procedure used to treat disc bulges. (Δισκοπάθεια)

Regenexx PL-(Platelet Lysate)-Platelets slowly release their growth factors in a timed release fashion to help healing. However, there are times when the physician wants all of the growth factors contained in platelets immediately available to the area to prompt healing. In addition, there are areas of the body where using Platelet Rich Plasma (PRP) may cause too much inflammation. As a result, our physicians create Regenexx-PL by cracking open the platelets to allow all of the growth factors to be immediately available to your body.http://www.regenexx.com/wp-content/uploads/2012/10/Regenexx-PL-Infographic-Steroid-Epidurals-vs.-Regenexx-PL-Disc.pdf

Πέμπτη, 31 Οκτωβρίου 2013

The Running Doc discusses the differences between PRP and Orthokine treatment to help speed healing


Dear Running Doc:
I read last week that Kobe Bryant has again (for the second time) travelled to Germany to get a "PRP" procedure. Upon further reading, they called it an Orthokine procedure.
I checked around with some major sports medicine groups and can't seem to find someone doing this procedure in America.
Is it the same as PRP? If not, why Germany? Is something fishy? Is Kobe getting a "free pass" from the press, fans, and the NBA?

Τετάρτη, 30 Οκτωβρίου 2013

Does Platelet-Rich Plasma Treatment Work?

On his latest trip to Germany, Kobe Bryant made national news when he checked in to get a Platelet-Rich Plasma (PRP) treatment, a controversial therapy that processes the patient's blood to speed up the healing process. But it wasn't his first time undergoing this rehab method, nor was he the first athlete to try it. Like Tiger Woods, who used the treatment in 2010 to overcome knee troubles, the aging Laker has used the injections to help heal ankle and knee injuries suffered last season. But just how effective is the treatment?

Τρίτη, 29 Οκτωβρίου 2013

Autologous blood derived signaling proteins (sp) for tendon and muscle therapy in sports medicine. Higher concentration of growth factors (gf) and cytokines in orthokine vs in acp.

Source

Bonn-Rhein-Sieg University of Applied Sciences, Department of Natural Sciences, Von-Liebig-Straße 20, 53359 Rheinbach, Germany.

Abstract

Regenerative SP in blood preparations are popular for tendon and muscle injuries [Wehling et al. Biodrugs 2007;21(5):323-332, Nguyen et al. PM&R 2011;(3):226-250, Schippinger et al. JSSM 2011;10:439-444]. They are used for local injection treatment. There is inconsistency in platelet-rich plasma (PRP) preparations (3x-7x platelets, variable other cells content).

Δευτέρα, 28 Οκτωβρίου 2013

Platelet-rich plasma prevents blood loss and pain and enhances early functional outcome after total knee arthroplasty: a prospective randomised controlled study.

Source

Department of Orthopaedic Surgery, Post graduate Institute of Medical Education & Research, #123-C, Old Type V, Sector 24A, Chandigarh, India, agg_adityadoc@yahoo.co.in.

Abstract

PURPOSE:

The purpose of this study was to determine whether platelet-rich plasma (PRP) might prevent blood loss and postoperative pain and expedite wound healing following total knee arthroplasty (TKA).

Κυριακή, 27 Οκτωβρίου 2013

Sacroiliitis – A Common Cause of Back Pain & Sciatica - ιερολαγονιτίδα


The sacroiliac joint is formed at the borders of the sacrum and the hip (pelvic) bones – the iliac crests. This is a long vertical joint, about the length of the side of your hand. This joint is held together by multiple ligaments, with many nerve pain fibers contained in these ligaments. The sacrum is at the base of the spine and is subject to a great deal of stress. When the sacroiliac joint becomes inflamed a condition known as Sacroiliitis develops. Sacroiliitis can be caused by heavy lifting, straining your back or trauma, such as falling. The pain is quite unique but can mimic low back pain or sciatica. One has to be looking for Sacroiliitis as the incorrect diagnosis of sciatica can be made. Patients do not understand why they have leg pain and yet normal MRI lumbar spine scans and EMG studies. The pain is coming from inflammation of the pain structures within the joint itself.

Sacroiliitis Diagnosis is made by a careful history and complete neurological exam. Patients with Sacroiliitis can be diagnosed by having a normal neurological exam with an abnormal musculoskeletal exam. Palpation over the sacroiliac joint almost always reproduces the patient’s pain exactly. The neurological exam fails to show any evidence of nerve root compression, “pinched nerve.” The sacroiliac joint is frequently inflamed on both sides, perhaps fifty percent of the time.
Typical symptoms include pain and stiffness in the lower back, frequently worse on getting out of bed in the morning. Walking exacerbates the pain. The pain can radiate into the hip, lower back or down the back of the leg. A limping gait is not uncommon. With a normal neurological exam, diagnostic studies are frequently not needed.
Treatment consists of various ways of relieving inflammation. Anti-inflammatory agents can be helpful in some cases. Physical therapy can help relieve the lower back and buttocks spasm that can be associated with Sacroiliitis. Many cases are severe enough to require and cortisone nerve block. In our practice, Sarasota Neurology, this nerve block is effective about 80% of the time. In patients who has persistent sacroiliitis pain, platelet rich plasma (PRP) is ideal therapy. PRP is injected directly into the sacroiliac joint. The graft adheres to the injured tissues inside the joint. The standard response of inflammation, proliferation and remodeling occur over a 6 week period, usually with excellent results and pain relief. Long lasting pain relief can be expected. This treatment is very safe with an extraordinarily low complication rate. Ask your doctor if you may be a candidate for PRP therapy.

Σάββατο, 26 Οκτωβρίου 2013

Platelet Rich Plasma Prolotherapy as First-line Treatment for Meniscal Pathology (ρήξη μηνισκού)

Animal research together with five patient case reports demonstrate that platelet rich plasma prolotherapy (PRPP) is effective in the treatment of MRI-documented meniscal tears.
Meniscus injuries are a common cause of knee pain, accounting for a large number of surgeries in the U.S. annually. While surgical treatments range from total to partial meniscectomy, meniscal repair and even meniscus transplantation, all have a high long-term failure rate with the recurrence of symptoms. The most serious of the long-term post-surgical consequences is an acceleration of joint degeneration.

Παρασκευή, 25 Οκτωβρίου 2013

Gov. Dayton will undergo a medical procedure at Mayo to help his ailing hip

Gov. Mark Dayton will have a medical procedure Wednesday at the Mayo Clinic in Rochester to help speed recovery of a torn hip muscle.
The governor's office said the procedure, a Platelet Rich Plasma (PRP) Injection, will take one hour, after which he'll return by car to the governor's residence in St. Paul.

Πέμπτη, 24 Οκτωβρίου 2013

Gov. Dayton openly discusses PRP injection to treat hip muscle Read more: Gov. Dayton openly discusses PRP injection to treat hip muscle

Gov. Mark Dayton is scheduled to receive a Platelet Rich Plasma (PRP) Injection on Wednesday at the Mayo Clinic designed to promote healing of a torn muscle in his left hip area.
On Tuesday, Dayton held a wide-ranging press briefing in which he openly discussed the procedure, which lasts about one hour and is done under local anesthesia.

Κυριακή, 20 Οκτωβρίου 2013

A look at PRP Treatment for Epicondylitis


Epicondylitis: this is a misnomer, as there is no inflammation! First some basic anatomy. Tendons that move the wrist and fingers attach at the elbow into the ‘epicondyle’ of the arm bone (humerus). This is the anchor point for wrist movement. In other words the reason you have elbow pain from epicondylitis is because of wrist

Σάββατο, 19 Οκτωβρίου 2013

Can PRP Injection (Platelet-Rich Plasma) Effectively Treat Chronic Running Injuries?

 Guest blog by John Davis (RunnersConnect)

In the past decade, several emerging treatments for chronic overuse injuries have been getting a lot of attention in the running community.  Chief among these is platelet-rich plasma injections or PRP, a procedure that attempts to use cells from your own blood to restart the healing process.

Τρίτη, 15 Οκτωβρίου 2013

Platelet-Rich Plasma Injection Is More Effective than Hyaluronic Acid in the Treatment of Knee Osteoarthritis.



 Acta Chir Orthop Traumatol Cech. 2013;80(4):278-283.

Source

Department of Orthopaedics and Traumatology, Faculty of Medicine, Ondokuz Mayýs University, Samsun, Turkey.

Purpose of the study There is increasing use of platelet-rich plasma (PRP) in orthopaedics as it is a simple, cheap and minimally invasive technique. This study aimed to compare the effects of the use of PRP and hyaluronic acid (HA) injections in the knee of patients diagnosed with and being followed-up for degenerative arthritis. Materials and Methods This prospective study included 90 patients with complaints of knee pain with findings

Σάββατο, 12 Οκτωβρίου 2013

Dr. Bill Releford | P.R.P. Injection | Shin Splint Treatment

Shin splints can literally become an athlete’s Achilles heel. This very common symptom, suffered mainly by athletes, can be triggered be several conditions. No matter precisely what the reason, the outcome can be unbearable pain and in most cases extended months of recovery and rest. Using a revolutionary new Platelet-Rich Plasma (PRP) therapy, Dr. Bill J. Releford can substantially reduce the painful manifestations of shin splints, speed the therapeutic process, and get athletes on their feet once again – rapidly.
“An athlete came to see me after suffering from painful shin splints for more than a year. He spent several months on the sidelines, unable to enter in competition,” said Dr. Releford. “After just one series of PRP injections, the sprinter was back on the track, without any pain, and put in a solid performance.”
A doctor of podiatric medicine, Dr. Releford is the medical director and founder of The Releford Foot and Ankle Institute and Beverly Hills PRP. He finds PRP injections beneficial in his practice and uses them to treat sports-related and orthopedic injuries, and many other conditions.
PRP therapy is non-surgical. By injecting a small, concentrated amount of a patient’s own blood into injured tissue, PRP therapy “supercharges” the healing process and reduces or even eliminates pain.
About Platelet-Rich Plasma Therapy
PRP therapy is an innovative, non-surgical approach that uses healing components derived from a small, concentrated amount of a patient’s own blood. Injected into damaged tissue, PRP therapy has the potential to “supercharge” the healing process. PRP has been successfully used in orthopedics and sports medicine to treat joint and tendon pain, ankle sprains, heel pain, non-healing wounds, plantar fasciitis, poor circulation, diabetic neuropathy, and many other conditions, as cited in the Journal of Orthopaedic Research (Jan. 2006). Recently, PRP therapy has made headlines due to its successful use by professional athletes like Tiger Woods, Kobe Bryant, Alex Rodriguez, and Rafael Nadal.http://www.prweb.com/releases/2013/10/prweb11201532.htm

What’s the secret to Rafael Nadal’s rapid recovery from his knee injury?

SHANGHAI — There’s no doubt that Rafael Nadal’s 2013 season has been incredible; he’s reached the final in 13 of 14 tournaments, and he reclaimed the No. 1 ranking this week for the first time since June 2011. However, everyone is searching for answers as to how the Spaniard has been able to play at such a high level so soon after returning from a seven-month injury layoff, which started after he lost in the second round at Wimbledon in 2012.

Σάββατο, 5 Οκτωβρίου 2013

Platelet-rich plasma for managing pain and inflammation in osteoarthritis.

Nat Rev Rheumatol. 2013 Oct 1. doi: 10.1038/nrrheum.2013.141. [Epub ahead of print]

Source

Regenerative Medicine Laboratory, BioCruces Health Research Institute, Cruces University Hospital, Plaza Cruces S/N, 48903 Barakaldo, Spain.

Abstract

Osteoarthritis (OA) is a common disease involving joint damage, an inadequate healing response and progressive deterioration of the joint architecture. Autologous blood-derived products, such as platelet-rich plasma (PRP), are key sources of molecules involved in tissue repair and regeneration. These products can deliver a collection of bioactive molecules that have important roles in fundamental processes, including inflammation, angiogenesis, cell migration and metabolism in pathological conditions, such as OA.

Kobe Bryant has left Lakers camp for Germany to get more platelet-rich plasma therapy on knee

Kobe Bryant was not at Lakers training camp Thursday because he was back in Germany getting more platelet-rich plasma therapy on his right knee, reports Adrian Wojnarowski of Yahoo Sports.
The Lakers would only confirm Thursday at practice that he had gone overseas for a mystery medical procedure

Σάββατο, 28 Σεπτεμβρίου 2013

A Promising Treatment for Athletes, in Blood

Two of the Pittsburgh Steelers’ biggest stars, Hines Ward and Troy Polamalu, used their own blood in an innovative injury treatment before winning the Super Bowl. At least one major league pitcher, about 20 professional soccer players and perhaps hundreds of recreational athletes have also undergone the procedure, commonly called platelet-rich plasma therapy.
Peter DaSilva for The New York Times
Dr. Allan K. Mishra, examines a tube containing platelet rich plasma used to mend tendons and ligaments without surgery.
Experts in sports medicine say that if the technique’s early promise is fulfilled, it could eventually improve the treatment of stubborn injuries like tennis elbow and knee tendinitis for athletes of all types.

Platelet-Rich Plasma for Arthroscopic Repair of Large to Massive Rotator Cuff Tears A Randomized, Single-Blind, Parallel-Group Trial


 
Background: Platelet-rich plasma (PRP) is expected to have a biological augmentation potential in the healing of various diseases and injuries, including rotator cuff tears. However, few evaluations have been performed specifically for large to massive tears.
Purpose: To assess the efficacy of PRP augmentation in patients undergoing arthroscopic repair for large to massive rotator cuff tears.
Study Design: Randomized controlled trial; Level of evidence, 1.
Methods: A total of 48 patients scheduled for arthroscopic repair of large to massive rotator cuff tears were randomly assigned to receive either PRP-augmented (PRP group) or conventional treatment (conventional group). In the PRP group, 3 PRP gels (3 × 3 mL) were applied to each patient between the torn end and the greater tuberosity. The primary outcome measure was the retear rate assessed by magnetic resonance imaging (MRI) or computed tomographic arthrography (CTA) at a minimum of 9 months after surgery. Secondary outcome measures included pain, range of motion, muscle strength, overall satisfaction, functional scores, and the change in cross-sectional area (CSA) of the supraspinatus.
Results: The retear rate of the PRP group (20.0%) was significantly lower than that of the conventional group (55.6%) (P = .023). Clinical outcomes showed no statistical difference between the 2 groups (all P > .05) except for the overall function (P = .043). The change in 1-year postoperative and immediately postoperative CSA was significantly different between the 2 groups: –15.54 ± 94.34 mm2 in the PRP group versus −85.62 ± 103.57 mm2 in the conventional group (P = .047).
Conclusion: The application of PRP for large to massive rotator cuff repairs significantly improved structural outcomes, as evidenced by a decreased retear rate and increased CSA of the supraspinatus compared with repairs without PRP augmentation. While there was no significant difference in clinical outcomes except the overall shoulder function after 1-year follow-up, better structural outcomes in the PRP group might suggest improved clinical outcomes at longer term follow-up. 

Blood therapy popular with pro athletes makes way to Cincinnati

A process that uses a patient’s own blood to help speed the healing process is now being offered to treat tendon and ligament injuries as well as degenerative joint arthritis by doctors who specialize in orthopedics and sports medicine at the Christ Hospital Health Network.
A blood separation system extracts platelet-rich plasma from a patient’s whole blood sample, according to Christ Hospital spokesman Michael Beauchat.

The Effect of Platelet-Rich Plasma on Clinical Outcomes in Lateral Epicondylitis.

Arthroscopy. 2013 Sep 20. pii: S0749-8063(13)00853-0. doi: 10.1016/j.arthro.2013.07.272. [Epub ahead of print]

The Effect of Platelet-Rich Plasma on Clinical Outcomes in Lateral Epicondylitis.

Source

Department of Orthopaedics, Norfolk and Norwich University Hospital, Norwich, England. Electronic address: zafar.ahmad@doctors.org.uk.

Abstract

PURPOSE:

To evaluate the evidence for application of platelet-rich plasma (PRP) in lateral epicondylitis.

METHODS:

We carried out a systematic review of the current evidence on the effects of PRP in lateral epicondylitis on clinical outcomes. We performed a comprehensive search of the PubMed, Medline, Cochrane, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and Embase databases using various combinations of the commercial names of each PRP preparation and "lateral epicondylitis" (with its associated terms), looking specifically at human studies. Data validity was assessed and collected on clinical outcome.

Σάββατο, 21 Σεπτεμβρίου 2013

Πλάσμα πλούσιο σε αιμοπετάλια (PRP), η θεραπεία μέσω της φύσης.


Η θεραπεία με πλάσμα πλούσιο σε αιμοπετάλια (PRP) ανήκει στις θεραπείες ενός νέου κλάδου της ιατρικής της αναγεννητικής ιατρικής "regenerative medicine", στόχος της οποίας είναι να διεγείρει τους φυσικούς μηχανισμούς θεραπείας του ίδιου του οργανισμού για να αποκαταστήσει αθεράπευτες βλάβες.
Οι επιστήμονες προσπαθούσαν για πολλές δεκαετίες να ανακαλύψουν την ουσία

Platelet-Rich Plasma in the Pathologic Processes of Cartilage: Review of Basic Science Evidence

Purpose

The purpose of this study was to systematically review the basic science evidence for the use of platelet-rich plasma (PRP) in the treatment of pathologic processes of cartilage, both as an adjunct to cartilage repair and as a conservative management strategy for osteoarthritis, with the intent of determining the effect of PRP and whether a proof of concept for its use has been established to facilitate further investigation at a clinical level.

Πέμπτη, 12 Σεπτεμβρίου 2013

Russell Crowe injures his feet running


Russell Crowe has injured his feet running.
The exercise mad actor's intense daily workouts have taken their toll on his body and left him with injuries in both Achilles tendons and a bruised big toe.

The healing power of blood

Tiger Woods and Kobe Bryant supposedly used it to get their stellar bodies back in action. Angelina Jolie is said to have depended on it to erase fine lines threatening her stellar face.
These superstars depended on platelet-rich plasma therapy, also known as protein-rich plasma or PRP, still considered experimental, but not for want of success in the fields of orthopedics, dentistry and even aesthetic treatments.

Δευτέρα, 19 Αυγούστου 2013

Further Evidence that the PhotoActivation of PRP (PAPRP) is a Novel and Effective Treatment for Osteoarthritis and Knee Pain


A 40 Patient Clinical Trial using AdiStem PRP PhotoActivation is being planned in Australia following two initial case studies published in the “British Medical Journal”. One was on a 50 year old woman in Melbourne with left knee osteoarthritis and the other on a 38 year old man with traumatic chondral lesion of the left knee. 

 

Melbourne, Australia (PRWEB) July 22, 2013
A 40 Patient Clinical Trial using AdiStem PRP PhotoActivation is being planned in Australia following two initial case studies published in the “British Medical Journal”. One was on a 50 year old woman in Melbourne with left knee osteoarthritis and the other on a 38 year old man with traumatic chondral lesion of the left knee.

Κυριακή, 4 Αυγούστου 2013

The treatment of intractable plantar fasciitis with platelet-rich plasma injection.

 

Source

Wrightington Hospital, Hall Lane, Appley Bridge, Wigan, Lancashire WN6 9EP, United Kingdom. Electronic address: drvjeet@yahoo.com.

Abstract

BACKGROUND: Whilst most cases of plantar fasciitis can be settled with existing conservative treatment, a few intractable cases can be difficult to resolve. New biologic treatments have been proposed for a variety of soft tissue problems.

OBJECTIVE: Evaluate the effectiveness of platelet rich plasma (PRP) in chronic cases of plantar fasciitis.


PATIENTS AND METHODS: Patients with plantar fasciitis not responded to a minimum of 1 year standard conservative management were offered PRP therapy. Injections were performed in theatre as a day case. Roles-Maudsley (RM) scores, Visual Analogue Scores (VAS), AOFAS scores and 'would have injection again' were collated pre-operatively, three and six months.


Πέμπτη, 1 Αυγούστου 2013

High ankle sprains can be treated in a variety of ways, including rest, a cast, surgery or PRP

High ankle sprains, such as this one suffered by Dirk Nowitzki of the Dallas Mavericks, can be treated in a variety of ways, according to the Running Doc, including rest, a cast, surgery or PRP.

Dear Running Doc: Football training camps are rapidly approaching.
Before the last Patriots Super Bowl, my favorite player, Rob Gronkowski, sustained a high ankle sprain. Since then I have heard more and more about this injury. And my boyfriend, who tripped and sprained his ankle, had this diagnosed last week. Please tell me more about this injury so I can better understand it. Bonnie G. Boston, NY.

Platelet-rich plasma significantly improved tennis elbow symptoms

 

Mishra AK. Am J Sports Med. 2013;doi:10.1177/0363546513494359.

  • July 10, 2013
Leukocyte-enriched platelet-rich plasma effectively and safely treated patients with lateral epicondylar tendinopathy in a recent study.
In a randomized control trial, Allan K. Mishra, MD, of the orthopedic surgery department, Menlo Medical Clinical, Stanford University Medical Center, and colleagues studied 230 patients with chronic lateral epicondylar tendinopathy (tennis elbow) who were treated over 5 years at 12 centers. The patients, symptomatic for at least 3 months and unresponsive to conventional therapy, were divided into two groups: platelet-rich plasma recipients (PRP; n=116) or active controls (n=114). Venous whole blood at initiation was used to prepare the PRP that contained concentrated platelets and leukocytes.