By Nathan Wei
Ever since the dawn of time, people have searched for the elusive Fountain of Youth. This quest even cost Ponce de Leon his life. So... does the Fountain of Youth exist? Maybe so.
Very recently, a new field of medical specialty has been born... the specialty of regenerative medicine. Physicians from multiple fields such as rheumatology, orthopedics, physical medicine and rehabilitation, and sports medicine have collaborated to develop new techniques to speed the healing process.
After all, if an earthworm can regenerate the other half of its body if it is cut in two or a salamander can regenerate a lost leg, why can't human beings do something similar. Well, it turns out they can. The healing of a cut with the formation initially of a scab and then a scar is a close cousin to that.
First used extensively in athletes who needed to return to the playing field as quickly as possible, PRP has quickly become an important tool used to treat soft tissue injuries as well as arthritis.
It turns out that platelet-rich plasma (PRP) can speed up the healing process.
So what is PRP?
1. PRP is an ultra-concentrated preparation of blood, a patient's own blood. Because it is a blood product, there has been concern that it is a form of blood doping. Nothing could be further from the truth. Here's why...
2. The concentrate contains a large number of platelets and very few red blood cells. Platelets are responsible for the production of an initial clot during wound healing. They also contain many growth factors.
3. Growth factors from platelets are released when they come in contact with an acute injury.
4. Not all PRP is the same. There are multiple manufacturers of devices that claim to make the ideal platelet concentrate. But studies have shown a wide variability in the number as well as the quality of platelet concentrate.
5. PRP has been used to treat multiple conditions including tendinosis, arthritis, and bursitis. Also, ligament injuries can respond to PRP.
6. PRP needs to be given immediately after acute injury is induced. This is done with a procedure referred to as fenestration, "peppering", or tenotomy.
7. PRP must be administered using special guidance in order to ensure accuracy. This guidance is best provided by using diagnostic ultrasound.
What is truly important is that the person administering the PRP should be skilled and experienced.
What's also important is that in order to bring PRP treatment into the mainstream, well-designed studies need to be done in order to confirm its efficacy.
Nathan Wei, MD, FACP, FACR is a rheumatologist and Director of the Arthritis Treatment Center http://www.arthritistreatmentcenter.com. He is a Clinical Assistant Professor of Medicine at the University of Maryland School of Medicine and consultant to the National Institutes of Health. For more info: http://www.arthritistreatment-and-relief.com
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