The future of regenerative medicine is here. By capturing the body's own natural powers to regenerate and heal, the pioneers of regenerative medicine are finding ways to focus those powers and speed up the process. One such therapy utilizes platelets. These tiny particles - that aren't really blood cells - float around in the blood ready to help clot blood and heal a wound. When you cut yourself, those platelets rush to the scene to keep you from bleeding to death and stimulate the tissues to start healing. Platelet-derived growth factors have long been known to have the power to promote healing. Now, scientists have developed a method of concentrating these powers into an injectable solution that contains platelet rich plasma (PRP).
Although the exact science has not really been worked out, some clinics around the world are offering PRP therapy. The goal of this therapy is to promote tissue regeneration. Different types of machines are used to concentrate the plasma. Different protocols are used to concoct the solution. And these differences result in tremendous variability from one treatment method to the next. So like most areas of regenerative medicine, the details are still being worked out.
Despite the unknowns, the option of PRP therapy is still on the menu for the millions who have debilitating conditions like tendon injuries, muscle injuries, ligament injuries, cartilage damage and arthritis.
The preliminary tests have shown a possibility that this treatment allows for more rapid healing and recovery from an injury. However, many of these tests have been in rats, rabbits and a few desperate athletes. In one recent study, a group of people with bad knees was divided into three groups. One group received three PRP injections. Another group received high molecular weight viscosupplementation and the final group got three injections of low molecular weight viscosupplementation. Interestingly, the PRP did better than the other two groups. And not surprisingly, the youngest people with the least amount of arthritis did the best.1 As with stem cell treatment, the promising results from PRP therapy hinge on patient selection. With the right people selected for a treatment, the results are usually favorable.
Because there was no control group, this study failed to address whether or not it is naturally possible for young people with minimal joint damage to get better despite the PRP therapy. That is the biggest question as yet to be answered by a large randomized, double-blinded, placebo controlled study of PRP therapy. Unfortunately, behind every promise stands a person about to make some money and PRP therapy is no exception. Until, this research is done, and it will be done in time, some doctors are holding a needle full of promises with no solid proof to back it up.
But maybe you are not the type of person who needs proof. Maybe you are so tired of living with pain that you are willing to try anything. There does not seem to be much risk involved with PRP therapy, so why not? Well that's your decision. But don't count on your insurance to join you on the PRP bandwagon. Just open up your wallet and say "Ouch," as the needle full of platelets, growth factors and promises inserts into your affected joint. The promises of regenerative medicine are here but the science has yet to catch up. Welcome to the future of regenerative medicine.
- Arthroscopy. 2011 Nov;27(11):1490-501