ALBANY — For the stubborn injuries that don’t appear to be healing, a relatively new technique is available that can help start the healing process.
#The procedure is known as platelet-rich plasma (PRP) injection. It is performed by the doctor obtaining about two teaspoons of blood from a patient’s arm. The blood is spun into a centrifuge in order to separate the platelets.
#After any scar tissue from the injury is broken up, the cells are injected into the affected area with the hope the body’s own healing processes will repair something that was previously unable to heal completely.
#This is done while the physician uses ultrasound technology to visualize the tissue and needle throughout the injection, rather than relying solely on external landmarks.
#“It gives us high accuracy, a high safety profile and puts injections in places risky to do blindly,” said Dr. Kiyoshi Yamazaki with Phoebe Orthopaedic Specialty Group. “(The injection) is a procedure that requires visual guidance.
#“Most people have injuries and have changes in their body over time due to injuries.”
#The idea is to jump-start a healing response to ensure the tissue is repaired properly using growth factors in a person’s blood. The most common areas it might be used for include tendon, ligament, muscle, cartilage and joint injuries. It is often considered an option in cases were pain or disability persist beyond six months despite the use of anti-inflammatories, analgesics, bracing, therapeutic exercise programs, ice or heat packs or corticosteroid injections.
#“It stimulates inflammation and restarts the healing process properly,” Yamazaki said.
#It is also used as a means to avoid or delay surgery, or even augment surgical outcomes, in situations where going under the knife is not initially considered the best option.
#“There are plenty of non-surgical options,” Yamazaki said. “It (PRP) is very specific to the injury, location and patient. What’s nice is that we are not cutting through anything. We break up the scar tissue, and put the blood product in places that need to heal. It is similar to the risk of injection in a joint.”
#It offers another choice to patients in chronic pain who might otherwise get surgery, and for doctors who are at a loss on how to best help them.
#“If you can have more choices, it enhances the ability to treat more patients and more conditions. It is more tailored to the individual,” Yamazaki said. “There is a huge menu of choices. This is not to replace surgery, but it gives other options. Some (injuries) are hard to treat surgically.
#“It allows patient preference … It gives an answer where, in the past, there has been no answer.”
#Matt Goodson, who has a history of being active in 229 Crossfit, started developing shoulder issues. One day, while doing front squats, he went down and his shoulder caved. He took a couple of weeks off before trying to push through it again. He tried three corticosteroid injections over the course of nine months without the desired impact.
#He was eventually able to do PRP earlier this month.
#“The only thing I knew to do next was surgery until I found Dr. Yamazaki, who presented (a number of) non-surgical options,” he said. “He told me about PRP.
#“Basically, it makes your body part Wolverine.”
#Before, he stayed away from physical activity enough for it not to bother him while daily tasks — such as washing dishes — would bring out pain and soreness.
#A week after the procedure, he was told to start getting back into normal routines.
#“I don’t have the pain I used to have,” he said. “I am still very cautious with it. I move slow to make sure I don’t bother it. I don’t have full range of motion yet because it was immobilized for so long.
#“Dr. Yamazaki did tell me that, with any medical procedure, there is no 100 percent chance it will make it 100 percent better.”
#Goodson has the option of having PRP done up to three times. Early on, he felt the first injection had a decent chance of getting him up to 75 percent.
#“I can have it again, and I’m confident if I get a second or third treatment, it will get me over the edge,” he said. “I’ve got eight weeks of physical therapy to do. I’ll make a decision on the second (potential procedure) then.”
#Given the improvement Goodson has already experienced, he said he would recommend it to others who might need it.
#“Even if you get 50 percent better and do it two or three times, I’d push this over surgery any day,” he said. “It already seems like this is helping.”
#As a trainer, he used his personal experience to recommend something else.
#“While doing physical activity … (the tendency is to) push if something hurts. Don’t do it,” he said. “If something happens, do something about it when it first starts.”
#After the PRP injection is over, a brace may need to be worn for a week following. Rehabilitation exercises are often used to maximize the benefits of the injection and the following recovery. Follow up visits are typically done at set intervals of one week, one month, three months and six months.
#Since pain medication has the risk of decreasing the procedure’s effectiveness, the use of anesthetics is often avoided — making the process more painful than some injections. With the stimulation of tissue repair comes swelling and inflammation for the first week, after which a therapeutic exercise program can begin.
#Anti-inflammatory medications and ice packs are not recommended, as it can diminish the effects of PRP.
#“We are giving birth to a brand new tendon. It takes it time to get back into shape,” Yamazaki said. “(It can) return athletic function, and there is no medication involved.
#“It’s counter-intuitive, because you can’t ice the area — because it stops inflammation … we don’t want to stop inflammation this time.”
#While PRP has the advantage of improving quality of life by decreasing the need for surgery or narcotics, in cases where surgery turns out to be the best option, doctors can be more confident that route will work when PRP has already been tried.
#“It enhances the ability for surgeons to their best,” Yamazaki said. “We can be more confident that surgery is the next step.”
#Most insurance companies do not cover PRP.
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