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pa4ortho
05-25-10, 10:33
there is a new treatment that is becoming popular ahead of the science, however some of the science is starting to look good. We have started using one of the several versions of this based on improved outcomes in pattelar, achilies, lateral epicondyle, rotatorcuff tendinosis.
its being used by alternative providers for a much broader range of indications but the data is still being developed. djd, dry eyes, migraines, etc...
Whats interesting from a austere medicine standpoint is that this is really easy to make from the patients own serum with a simple centrefuge and pipette.
there are several ways of preparing various versions of this but the simplist would involve simply drawing a sample of about 13cc of the patients blood. if you spin it imediately you dont use any edta or other anticoagulant in the tube. centrefuge for about 2-3 min. spin more if needed to seperate the layers. you should see a layer of 2-3cc of serum on the top layer. there is a barely perceptable layer and the packed red cell layer makes up the rest. draw up as much of the plasma as you can without getting red cells. Inject the plasma into the tendon at the point of maximum tenderness. its full of platelets and growth factors that stumulate a healing response and re vascularization. the revascularization is the big deal in the above tendinopathys. I will keep an eye on this and post as new indications start showing promise.

pa4ortho

Reasonable Rascal
05-27-10, 12:47
Very interesting find indeed. Would be quite interested in further reports.

RR

pa4ortho
08-23-10, 15:29
article summary from orthopedics today july 2010
PRP research looks promising for chronic tendinopathy that have failed other conservative treatment options
Its hard to study due to variability in different proccesses to extract the prp.
no consensus on dosing or administration as of yet. 1 or 2 injections is used. more is not better and may be a problem.
its holds alot of potential but the science is lacking

data suggests it helps in
lateral epicondylitis
achilies tendinosis
plantar fasciitis
patellar tendinosis
osteoinduction in demineralized bone graft

no evidence of benifit in
osteoarthritis
chondral injury
neurologic injury

mixed results in rotator cuff surgery so far

this "product" is plagued by hype and false claims from the alternative comunity and a few docs who want to atract business by ofering something unique with unfounded promises.

pa4ortho

Reasonable Rascal
08-25-10, 03:36
Following this with interest. As simple as it is I can see where the back-alley practitioners would be interested in it. Simple and cheap and they can charge as much as the market will bear, one would presume.

RR

pa4ortho
10-20-10, 13:23
initial reports from research currently being done showes decreased pain when injected q 4 days deep in surgical (shoulder) wounds. incresed rate of healing.
time will tell as this reaserch gets done.
pa4ortho