03 Sep Is all Platelet-Rich Plasma created equal?
By Farhan Malik, MD
Atlanta Innovative Medicine
Platelet-rich plasma (PRP) has been around for decades as a healing therapy but has seen explosive growth in the medical field in recent years. That’s due in part to people’s desire for treatments that address the root cause of a health problem rather than mask it with potentially harmful drugs or undergo the possible pitfalls of surgery.
But is all PRP created equal by different medical providers? Not by a long shot. Before we delve into the factors that make certain forms and deliveries of PRP better than others, let’s recap some basics about this form of regenerative medicine.
What is PRP?
Our blood contains platelets that are essentially little packets of powerful growth factors floating in the bloodstream. These growth factors (GF) come in many forms and with very medical sounding names. It is those growth factors that run to the aid of damaged tissue in order to repair it. Whenever you cut yourself, these growth factors not only clot the bleeding, but also repair the damaged areas. This is why PRP can be so incredibly effective. However, you must understand that not all PRP is created equal.
PRP is harvested by collecting a small sample of the patient’s blood and processing it in order to extract and concentrate the platelets. This concentrate is then injected into the injured area of the body, promoting cellular regrowth to help heal degenerated and damaged tendons, ligaments, discs, cartilage and even nerves in some cases.
How are some forms better?
Among practices that offer PRP treatments for musculoskeletal conditions, the vast majority are limited to concentrations of two to five times, which is called regular PRP. However, it is possible to concentrate PRP to 20 times normal levels—and even higher concentration can be achieved with the right equipment and training. This is called super concentrated PRP or SC-PRP, and it is not available everywhere.
To imagine the benefits, think of yourself as a finely tuned machine. The more horsepower you give a sports car, the faster and more powerful it will be. The same applies with PRP. The more concentrated the platelets are, the more growth factor packets work in your favor, and thus the more powerful the healing potential.
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So, why doesn’t everyone do this?
Many of the PRP studies conducted to determine the optimal PRP concentration for healing appeared to show that anything over four times concentration seemed to bring less healing. These flawed studies were the impetus for everyone to jump on that bandwagon, citing these flawed studies—including most of the PRP equipment manufacturers. Subsequently, most of the PRP systems sold to doctor’s offices are designed only for regular PRP. Most of these studies were performed in-vivo (basically in a test tube) and not in the human body.
Here’s why that’s key: platelets, growth factors, tissue remodeling and healing do not operate by themselves. They require oxygen, cell food and nutrition, namely carbs, glucose, vitamins and minerals. Think of it as a healthy nutritious soup to feed the biochemistry needed for PRP to do its job. During these flawed studies, the PRP concentrations were increased but cell food and oxygen were not. To use the machine analogy: car engines need more fuel to go faster but if oxygen intake is not increased proportionately, the engine may sputter and die. The good news is that in several well-designed studies, including one presented at the Interventional Orthopedic Foundation (IOF), it was demonstrated that concentrating PRP up to 40 times with the needed cell food netted increasing healing properties.
SC-PRP with added oxygen and nutrients is created at Atlanta Innovative Medicine by using special equipment and training that the average PRP doctor does not have. When you consider that growth factor levels in normal blood negatively correlate with increasing age (as we age, growth factors decrease), it is important to use SC-PRP to achieve the best possible outcome, especially if the patient is older than age 40.
To find out more or to see if you are a candidate for SC-PRP, even if you have tried PRP before with lackluster results, please contact us.
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Regenerative medicine can be an effective therapy and treatment option for lasting pain relief for a variety of conditions like osteoarthritis of the knee, hip or shoulder; ACL or meniscus tears; tennis or golfer’s elbow; chronic neck and back pain; and more.
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