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.
