Over the years a number of alternative therapies have been developed to treat various “sports related” injures such as Torn tendons, muscles and ligaments. Among one of the most popular options, is Platelet Rich Plasma therapy. This has become a popular treatment options for many athletes and there are many practices that specialize only in these types of therapy’s. If you haven’t hear of this therapy, it is relatively simple and involves using one’s own blood which is taken and then after some manipulation of the blood is injected into the wounded area. It is supposed to help spur the body’s natural healing process.
The question remains like many alternative therapies, does it work? In this article from Scientific American, they answer this question and provide a detailed analysis of this therapy so you can decide if it is something you may want to try should you be suffering from an injury that has not responded to other treatments:
“Is Platelet-Rich Plasma an Effective Healing Therapy?
Athletes such as Tiger Woods and the Pittsburgh Steelers’s Hines Ward have undergone platelet-rich plasma therapy, but is there evidence that the treatment really speeds the healing of injuries?
Torn tendons, muscles and ligaments plague athletes in many types of sports. In attempts to help heal the wounded tissue, some athletes, both amateur and professional, have turned to platelet-rich plasma (PRP) therapy. For the treatment, doctors take a small vial of a patient’s blood, about 30 milliliters, and spin it in a centrifuge to separate the platelet-rich plasma from the other components. Then they inject the concentrated platelets at the site of the patient’s injury. In theory, the growth factors that platelets secrete (not including human growth hormone) spur tissue recovery.
Before playing in all four professional golf majors this year, Tiger Woods received four injections of PRP in his left knee following surgery. PRP injections in his elbow may have been the reason that Los Angeles Dodgers’s pitcher Takashi Saito was able to return to the mound for the 2008 Major League Baseball playoffs.
Whereas doctors have used PRP therapy since the mid-1990s to aid bone healing after spinal injury and soft tissue recovery following plastic surgery, it has only been in the past year that the treatment has caught on for treatment of sports-related injuries. “PRP treatment really gained speed last January. It got press that two of the Pittsburgh Steelers [Hines Ward and Troy Polamalu] used it before [winning] the Super Bowl. More and more patients started to ask about it,” says Dennis A. Cardone, a doctor of osteopathic medicine at the New York University (N.Y.U.) Hospital for Joint Diseases. Cardone has treated 30 amateur athletes with PRP therapy over the past year.
Despite its use among athletes, the effectiveness of PRP therapy in sports medicine remains in question. Canadian doctor Anthony Galea, one of the pioneers in using PRP for athletes, was arrested in Canada for allegedly smuggling human growth hormone (HGH) and Actovegin into the U.S., The New York Times reported on Tuesday, where these potentially performance enhancing drugs are illegal. Galea had treated Woods and several other athletes, including Olympic gold medalist and sprinter Donovan Bailey, with PRP. Galea’s arrest raised suspicion that he might have combined HGH with his PRP therapy.
ScientificAmerican.com spoke with N.Y.U.’s Cardone about what we know and don’t know about PRP therapy.[An edited transcript of the interview follows.]
What kinds of athletes have you treated over the last year with platelet-rich plasma (PRP) therapy?
They’ve been runners to basketball players to football players to collegiate competitive cheerleaders, a lacrosse player and a soccer player.How could concentrating the platelets that are at the site of injury help healing?
Theoretically, many of the athletes may have a type of tendonitis, [such as] Achilles tendonitis or, say, patellar tendonitis in the knee or tennis elbow. Many of these tendon injuries become chronic, and involve microscopic tearing of the tendon and formation of scar tissue. A reason why it’s difficult to heal these tendon injuries is related to poor blood supply to the region. The perfect example would be the Achilles. It’s a tendon with, in general, a poor blood supply, so when there are these microscopic tears or chronic scarring, the body has a difficult time healing it. The theory is that the body can’t on its own get enough of these healing or growth factors to the area, but now this concentrated platelet injected there just enhances the nutrients and growth factors to allow the body to heal it.You use the word “theory”. What kind of evidence is there that PRP helps heal tendonitis?
We all would like to see more evidence for this therapy. While there is some evidence, we still do not have the type of randomized, blinded, placebo-controlled studies that we would like to see. Most of the early literature has been poorly designed studies so we need better evidence about this treatment going forward. Ultimately we’d all like to see a study where we had 100 people with an Achilles tendonitis, 50 of them were injected with placebo and 50 of them were injected with PRP to really see if there was a difference.The studies that have been performed have been, “Okay, let’s take 30 people with tennis elbow and let’s inject these 30 people with PRP therapy, and let’s follow them for a month and let’s see how they do.” So you’re just looking at this one population, you’re not comparing it to a control population [that receives an injection with placebo]. The thing about doing PRP therapy is that there are potentially other healers going on. Number one is there’s always potential for some type of placebo effect any time you put a needle in anyway. Number two is when you put a needle into a tendon, like you do for PRP therapy, you are likely to cause some bleeding and this is known to help healing [by bringing in more platelets]. So even by sticking a needle in a tendon and aggravating the tendon, you actually are helping the healing response.
Everyone looks at this one study that came out more than a year ago on tennis elbow but the problem is, it was a cohort study. Some people come in, they already know they want it, or there are patients that have failed other treatments. Any time we talk to anyone about PRP treatment, one of the first things that needs to be said is that, right now, there’s not good evidence to support the treatment.
Are any clinical trials currently going on?
Absolutely. In the next six months to a year, we should really start seeing results from many clinical trials, and hopefully good ones, ranging in everything from rotator cuff problems [in the shoulder] to tennis elbow to Achilles and patellar tendonitis.”What have studies have told about how well PRP therapy works? How have patients done on PRP therapy? Are multiple injections usually needed? These questions and more are answered in the remaining article you can continue to read on the Scientific American website by clicking the link below:
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