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All That is Gold Does Not Glitter

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All Platelet Rich Plasma is not created equal.

Regenerative Medicine has been catching on in the last few years with the increased use of Platelet Rich Plasma, PRP. With PRP we can use messengers (growth factors and cytokines that are present on the platelets of our own blood) that tell our own stem cells and regenerative cells to go to work. These messengers initiate healing and treat pain in arthritis, ligament and tendon injuries, chronic neck and back conditions, to name a few. But there are so many forms of PRP and not all are good and effective.

So how can patients know they are getting the best form of PRP? Ask the physician:

1. Is the PRP system FDA approved?

-FDA systems are closed, which means they are less likely to be contaminated
-FDA systems must do what they claim to do. i.e. produce adequete levels of growth factors and cytokines

2. How much blood will be taken?

-if less than 60 cc or ml are taken the PRP isn’t concentrated enough to optimize efficacy

3. What color will the PRP be?

A: Dark red PRP has cells and cellular debris in it that can temporarily cause a lot of pain and swelling if injected into a joint. Red is OK almost anywhere else. Gold is usually better if is concentrated

4. What is the concentration of the growth factors and cytokines?

A: Greater than at least 4 times baseline should be the minimum regardless of whether the PRP is red or gold

5. Do you use a matrix?

A: Matrix is a biologic scaffold that holds the growth factors and cytokines in place so they have the can be used to their maximal benefit. The longer these messengers stay in the damaged area the more time they can call the other regenerative cells to where they are needed to start the healing process.
– the matrix structure itself is anti-inflamatory which can decrease pain tremendously

6. Do you add any medications to the PRP?

A: Some doctors may add cortisone, human growth hormone, and hyaluronic acid (Euflexxa, Hyalgan, Orthovisc, Supartz, Synvisc, rooster combs)
Patients should also be aware that PRP treatments are also being heralded as “stem cell” treatments. This is misleading, if not downright false. If the physician is not sticking a large needle into your hip or doing a mini-liposuction, you are not getting stem cell treatments. The most important point is that about 90% of the time if a high quality PRP treatment is used, true stem cell treatments aren’t required.

In summary, you want at least 60 cc’s of blood taken, concentrated to at least 4 times baseline, preferably gold, with a matrix, no medication added, and processed in an FDA approved system.

All that is gold does not glitter,
Not all those who wander are lost;
The old that is strong does not wither,
Deep roots are not reached by the frost.

From the ashes a fire shall be woken,
A light from the shadows shall spring;
Renewed shall be blade that was broken,
The crownless again shall be king.

J.R.R. Tolkien, The Lord of the Rings