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.”
Great bakers know that when it comes to delivering the best treats and sweets, you have to carefully measure your ingredients.
The same applies to Platelet Rich Plasma (PRP) therapy. The measured amount, the dosage, of concentrated platelets and other cells in the plasma, must be customized to each patient’s specific condition to achieve the best outcomes.
Platelet rich plasma uses highly concentrated platelets to speed up the healing process, decrease inflammation and stimulate tissue regeneration.See our blog on PRP. As we go in-depth in the study of PRP, we now know that determining the best PRPtreatment is not just about how much platelets are in the injection.
Not All PRP are the same
There are other factors that need to be considered to obtain the best PRP treatment. There are other other cells in the PRP, specifically the red blood cells and white blood cells that need to be adjusted depending on the patient’s condition. Platelets release growth factors that facilitate the healing process. The timing and pattern of growth factor release and the individual’s cellular response to growth factors may vary. This can affect outcome and should be thought out in determining PRP treatment. There is a wide variety of methods used to harvest, process and deliver PRP therapy.The resulting platelet count, cell composition and PRP quality are highly variable and can affect clinical outcome.
Only physicians truly experienced in using PRP know how to adjust the dosing appropriately. Joints, tendons, ligament and nerves require their own specific PRP formulation. Imagine if a doctor writes the incorrect kind and amount of antibiotic to treat your specific infection.Patients should make sure that they do their homework in seeking skilled and experienced physicians providing their PRP treatment. These physicians should not only know how to provide the best customized PRP for your need, they should also be adept in the delivery of PRP therapy. These physicians should have advanced training in diagnostic ultrasound or fluoroscopic (xray) guided procedures to make the procedure safe, comfortable and effective.
Not all PRP dosing is the same. Patients should choose physicians who have the knowledge and expertise to ensure they get the right kind of PRP for their orthopedic condition.
Dr. Christopher J. Rogers and Dr Mary A. Ambach are experts and key leaders in the field of regenerative medicine.They are board certified doctors with over 20 years of combined research and clinical experience in platelet rich plasma and other cell based therapies.
In recent years, doctors have learned more about the body’s remarkable ability to heal itself.Platelet-rich plasma therapy is a form of regenerative medicine that harnesses those abilities to heal many joint, tendon and spine injuries.
What is plasma and what are platelets?
Plasma is the liquid portion of your blood. It is primarily composed of water and proteins and provides a means for red blood cells, white blood cells and platelets to circulate throughout the body.Platelets are a special type of blood cell that stimulate healing.They contain hundreds of growth factors that initiate the healing process and encourage tissue regeneration.
Platelet-rich plasma (PRP) contains a concentration of platelets that is greater than that found in the blood. This significantly increased concentration of growth factors creates an increased stimulus to injured tissues, encouraging them to complete the healing process.
How does Platelet-Rich Plasma Therapy Work?
Scientific studies show that by increasing the concentration of growth factors, the body can speed up the healing process. By injecting inflamed or damaged tissue, injuries are encouraged to heal quickly even if they have persisted for years.
How is the PRP treatment performed?
About 4 tablespoons of blood are drawn from the patient using techniques similar to a typical blood exam.The sample is placed into a centrifuge which spins the blood and separates the platelets from the other blood components.After numbing the injured area, the concentrated platelet solution is injected under the visual guidance of an ultrasound or digital xray by your physician.
Areas where PRP therapy has been shown to be effective include:
Chronic tendon injuries: Platelet-rich plasma therapy can treat sports injuries, such as tennis elbow, gluteal tendinopathy, plantar fasciitis, patellar tendinitis and Achilles tendonitis.
Joint arthritis: PRP is used to reduce the inflammation, pain and stiffness caused by arthritis of knees, hips and other joints. PRP also improves the cushion in the joint and kills the cartilage destroying cells.
Spine pain:PRP therapy can reduce the pain of chronic disc tears, irritated nerves (sciatica) or joint arthritis.
The effectiveness of PRP therapy varies among different patients as a result of:
Overall health of the patient
The severity of the injured tissues
The length of time the tissue has been injured
Preparing for PRP therapy
The patient should eat and be well hydrated before the procedure to avoid lightheadedness. Patients should tell their doctor about any medications or prescriptions they use on a regular basis. It’s also important to follow the doctor’s instructions when it comes to anti-inflammatory medications or blood thinners.
The PRP Treatment
The procedure is typically performed in a doctor’s clinic. The doctor begins by drawing blood from the patient, and uses a centrifuge to separate the platelets and plasma from the rest of the blood cells. The doctor will then numb the area to be treated and carefully inject the PRP into the injured tissues or joint. The platelets release growth factors which will initiate tissue healing. This treatment takes approximately 30-60 minutes.
After Receiving PRP Therapy
The injection site may be sore for a few days following the procedure.Patients may take mild analgesics like Tylenol or use ice to minimize soreness.Patients usually resume gentle activities within the first week after treatment.The results of PRP are not immediate and patients can observe slow gradual improvement over a couple of months. A review of our clinic data shows that most patients continue to have relief even years after PRP treatment.
Talk with your doctor today if you are interested in learning more about PRP therapy.
