What’s the Difference Between Platelet Rich Plasma and Cell Based Therapies?
Regenerative medicine therapies are increasingly being used for people with painful orthopedic conditions. Commonly used orthobiologics include platelet rich plasma (PRP) and other cell based therapies.
Platelet rich plasma therapy includes the concentration of platelet cells from a patient’s own blood. These cells deliver hundreds of growth factors which facilitate the body’s ability to control inflammation, decrease pain and promote tissue healing.
Adult Stem Cells are found in every tissue in the body. A patient’s own bone marrow and fat tissues contains precursor cells called mesenchymal stem cells that have the ability to develop into new cells and repair damaged tissues. These cells also reduce pain and inflammation.
So What’s the Difference?
Many patients ask, “If both platelet rich plasma and adult stem cell therapy help with healing and inflammation, why choose one over the other?”
The fact of the matter is each treatment offers unique benefits. An experienced regenerative medicine specialist knows that several key factors are important when determining which treatment will provide the best outcome for you.
These considerations include:
· The severity of the medical condition being treated (e.g. mild, moderate or severe)
· The location of the injury (e.g. spine or joint)
· The type of tissue requiring treatment (e.g. bone, tendon, cartilage, disc or muscle)
· The patient’s age and overall health, including any other medical conditions.
Knowing How PRP is Different Than Cell Based Therapies
Many clinics claim to offer stem cells or platelet rich plasma treatments, however, the effectiveness of these treatments and experience level of the physicians varies widely from one clinic to another.
· Treatments that use donated tissues such as umbilical cord blood, amniotic tissue and exosomes are not permitted under current FDA guidelines. These products are NOT to be used in orthopedic conditions, because they have not been tested for safety or efficacy.
Only autologous biologics such as your own blood, bone marrow and minimally manipulated fat are compliant with current FDA guidelines for safety and efficacy.
· Dose matters. The number of cells obtained is determined by the method used. The best results are achieved when your physician uses advanced tissue processing methods to produce highly concentrated platelet rich plasma or mesenchymal stem cells. It takes your physician years to master the skill of cell harvesting for maximal benefit.
· To ensure the safe, effective and comfortable delivery of cells into the damaged tissues, a fellowship trained physician should use advanced image guidance using diagnostic ultrasound or x-ray (fluoroscopy). Physician assistants, naturopathic doctors, chiropractors and nurses do not complete this level of training.
When considering treatment with regenerative medicine, it’s important to understand the pros and cons of the different options. Be aware that treatments vary among different clinics and outcomes are determined by physician experience and the methods used to deliver these treatments. Be sure to ask your physician about their training, experience and whether or not they document their patient outcomes.
When done properly, cell based therapies significantly help patients to heal quickly and completely allowing them to enjoy an active life without pain.
Drs. Christopher J. Rogers and Mary A. Ambach of San Diego Orthobiologics Medical Group have successfully treated thousands of patients with platelet rich plasma and other cell based therapies for more than a decade. Their facility in Carlsbad contains the most advanced Regenerative Medicine technology in San Diego and offers same day treatments with the highest documented levels of safety and efficacy.
The liquid portion of blood called plasma has been used for several years to help patients facing life-threatening conditions such as immune deficiency disorders and organ transplantation. Because it has helped treat so many chronic and rare diseases, it has been referred to as “the gift of life.”[i]
More recently, physicians have discovered that a patient’s own plasma and its’ cells can help expedite the recovery from orthopedic injuries. Platelet rich plasma treatments, known as PRP, use the healing power of platelets to harness growth factors and other proteins that are essential for healing.
How Platelet Rich Plasma Treatment Works
Blood is comprised of red blood cells, white blood cells,platelets and plasma. The plasma contains hormones, electrolytes and nutrients that are needed to nourish cells during the healing process.
During platelet rich plasma treatment, the patient’s own blood is drawn and placed in a centrifuge machine where the platelets are separated and concentrated. This results in a PRP solution that contains up to 10 times more platelets than that typically found in blood.[ii] With its super-charged healing capabilities, platelet rich plasma can be used to treat a number of orthopedic conditions, including:
· Joint arthritis (knee, shoulder, hip, thumb or spine)
· Injured tendons like rotator cuff tendon, Tennis elbow and Achilles tendon
· Ligament sprains in the wrist, ankle or sacroiliac joints
· Carpal tunnel syndrome
· Degenerated discs, mild spinal stenosis and sciatica
Not All PRP Treatments Are the Same
When it comes to platelet rich plasma treatment, one size does not fit all. Several factors can influence the success rate of treatment:
· The patient must receive an accurate diagnosis.
· Image guidance with ultrasound or fluoroscopy (x-ray) for targeted delivery to the injured tissues is necessary.
· The PRP formulation must be customized to the specific injury being treated.
· The initial injury severity must be considered.
When administered appropriately and in the right formulation for the specific injury, most patients begin to experience results within four to eight weeks after platelet rich plasma treatment. About 10% of patients will feel relief within days.
PRP treatments are performed on an out-patient basis in the physician’s office. There is no need for hospitalization or lengthy rehabilitation. The entire procedure takes less than an hour and patients may typically resume normal activity within days.
Dr. Christopher Rogers of San Diego Orthobiologics Medical Group performed one of the first PRP treatments in San Diego in 2009. He and Dr. Mary Ambach are experts in the field of regenerative therapy for orthopedic injuries. They have successfully treated thousands of patients with PRP and other orthobiologics.
Colleen is an active patient in her 60s who suffered from a partial tendon tear after a traumatic injury to her ankle. Her podiatrist placed her in a boot for weeks, but she continued to have pain and her injury was not healed. She consulted with Dr. Mary Ambach and was successfully treated with Platelet Rich Plasma Therapy (PRP).
Dr. Ambach is a very gracious and supportive doctor. I have had an amazing experience with her and am on the way to 100% recovery.
Nancy is an active woman in her 50s who suffered from shoulder pain after undergoing rotator cuff surgery. Dr Ambach treated her with Platelet Rich Therapy (PRP) and now Nancy has full range of motion and is living pain free!
I spent year dealing with chronic pain and flair ups. The PRP with Dr. Ambach and then my work with Megan at Evolve Physical Therapy has been life changing.
Tom Pernice, Jr., an American professional golfer who plays on the PGA Champions Tour, had injured his shoulder.In fact, he had a full thickness tear of his rotator cuff tendon, an injury that often requires surgery.The pain continued for months despite physical therapy and other medical treatments.
Pernice’s colleague, Dr. Greg Rose, co-founder of the Titleist Performance Institute (TPI), recommended that he consult with Dr. Chris Rogers at the San Diego Orthobiologics Medical Group.Dr. Rogers evaluated the large, retracted tendon tear with high-resolution ultrasound imaging.Conservative care had not been effective and the current standard of care would include an arthroscopic surgical repair.Given that Pernice was preparing to start the tour season, he preferred to avoid surgery and a potentially long recovery.At that time, Dr. Rogers shared his experiences using a patient’s own cells to stimulate tendon healing.
For more than 12 years, Dr. Rogers has used platelet rich plasma (PRP) to heal small tendon tears with good results.PRP uses cells from a patient’s own blood to stimulate healing.For larger tendon tears, regenerative cells obtained from a patient’s own adipose (fat) tissue via a mini liposuction procedure would often give good results.Dr. Rogers shared that he had treated several patients with similar injuries, but Pernice’s injury was severe and the tendon had retracted away from its insertion on the bone.After careful consideration of his options, Pernice elected to give cell based therapy a try.
In May 2019, only a few weeks after his treatment, Pernice had already noticed decreased shoulder pain and improved range of motion.After eight more weeks of physical therapy, he was able to compete and won the Legends of Golf at Big Cedar Lodge.“Surgery would have prevented me from playing altogether.This was a very special win,” stated Pernice.
Now, one year after treatment, Pernice notes, “I have no pain in my right shoulder, movement, range of motion… everything’s as good as it could be, or better than it was.”Dr. Rogers was pleased and surprised when his recent repeat ultrasound exam showed that the tendon was nearly completely healed.“This is a very remarkable outcome, a testimony to Tom’s hard work and this treatment’s ability to heal a very bad injury.”