Heal injuries with PRP

Everyone knows pro athletes get the best treatments available, regardless of the cost. They are not concerned with the associated fee’s, or what their insurance will cover. Yet, for the average citizen, this is what dictates medical care. It’s no longer the particulars of the condition they are seeking relief from; it’s all about their insurance coverage, and the specifics of their policy.

To any doctor practicing more than a few years, the changes have been dramatic. No longer is it simply a matter of determining a correct diagnosis, followed by an evaluation of the best therapy or treatment, and then obtaining the patient’s consent. Multiple considerations must be accounted for, such as the patient’s insurance, what policy restrictions they have, and how large the patient’s deductible is. Thus, many treatments are not available for the average individual because of financial reasons.

Finances rule the day when it comes to medical care. The insurers apparently analyze the data, crunch the numbers, and woe unto any physician who is an outlier, and provides more treatment than other area doctors. I’ve been told, in politically correct terms, not to spend too much of the insurance company’s money, regardless of my patient outcomes. It is important to know, I’ve been in practice long enough to remember medicine before this age of insurance-mandated care.

A perfect example of the disparity in available treatment options would be the previously-mentioned professional athlete, as opposed to the general public, who are depending on their insurance plans to pay for the techniques that will resolve their problem. The professional athlete opts for specific methods only on the basis of potential benefits versus possible risks and complications.

This patient population is looking for therapies that entail minimal “down-time”, with a good likelihood of excellent function, as well as relief of pain. As a generalization, surgery does not provide these goals, since all surgeries require time for healing, and all carry the potential for complications. Depending on how invasive the procedure is, there can be extensive healing time. For the athlete looking to return to competition, surgery is not preferable.

A treatment option chosen by more athletes than ever before is that of injection therapy with platelet-rich plasma, more commonly known as PRP. This comes under the heading of regenerative medicine, techniques which deal with the process of replacing, engineering or regenerating human cells, tissues or organs to restore or establish normal function. A tremendous amount of attention has been directed to this concept, and various ways it can be utilized, because, in effect, it is a means by which we can help the body to heal itself. The results are therefore long-lasting, another benefit to regenerative medicine.

All blood contains small solid components: white blood cells, red blood cells, and platelets. The platelets in your blood contain hundreds of proteins called growth factors. These growth factors have the ability to stimulate new cell growth and healing inside the body. The term ‘PRP’ refers to blood plasma with a higher concentration of platelets than a typical blood sample — about 5 to 10 times higher. To create platelet-rich plasma, a small sample of blood is drawn from the patient. Using a centrifuge, the blood is separated into layers.

The platelet-rich layer is carefully removed from the sample, then injected back into the patient directly into the damaged tissue, where the concentration of growth factors can get to work repairing and healing the injury from the inside out. It can increase the body’s regeneration process up to eight times more than normal because of the high concentration of platelets and growth factors.

Since the treatment uses the patient’s own blood, PRP has very few risk factors or complications. It is no more invasive than any other injection, a procedure performed on a daily basis. Of particular importance is the absence of any kind of drug reaction. This is because we are using the patient’s own blood to treat their injury. It is a natural process — using the body to heal the body — and so doesn’t have many potential negative side effects. This makes it an option doctors are more willing to utilize, and even experiment with, in hopes of finding different uses for the healing potential of the human body, when assisted by platelet-rich plasma injection.

PRP has been used successfully to treat the heel pain of plantar fasciitis, ankle sprains, and muscle strains. The platelets are administered into the injured or damaged tissue via an injection, so, in that respect, it is invasive, but far less so than any kind of surgery.

Some other orthopedic problems successfully treated with platelet-rich plasma injections include chronic tendon problems like Achilles tendonitis, as well as ligament tears. PRP has been used in surgeries to promote cell regeneration, thus helping to provide more lasting repair. It has also recently been utilized in the treatment of osteoarthritis, providing notable reduction of joint pain. This opens up a whole new world of uses.

Many famous, high profile athletes have gotten PRP injections. Some examples include Stephen Curry, Stephen Strasburg, and, perhaps most famously, Kobe Bryant. Athletes of every major sport, including the Olympics, have used PRP. But over the past several years, even “regular” people have been able to obtain this advanced treatment for their orthopedic sports medicine injuries. People are using PRP because of its speed and effectiveness, but, since there is rarely insurance coverage for it, PRP is generally an out-of-pocket expense. Perhaps the insurers are just fiscally conservative and are waiting for all the facts to be in, all the needed studies to be performed. Or, alternatively, they simply don’t want to pay for another service, subtracting from their profit margins.

Each game missed by a pro athlete can mean missing out on huge sums of money. There is an understandable desire by both players and their teams to find the most efficient healing method possible for a quick recovery. PRP has clearly found a place amongst this patient population. But this new technique appears to be effective for a variety of common conditions, problems experienced by many Americans. Although insurance coverage is infrequent, the benefits, and lack of complications, would seem to make PRP worthy of consideration as a treatment option, despite the financial difficulties.

Research continues, but we know enough about PRP to see obvious benefits for various sports injuries as well as chronic joint problem. To learn more, talk to a knowledgeable physician about PRP for your orthopedic problem.

Editor’s note: Dr. Conway McLean is a podiatric physician now practicing foot and ankle medicine in the Upper Peninsula, having assumed the practice of Dr. Ken Tabor. McLean has lectured internationally on surgery and wound care, and is board certified in both, with a sub-specialty in foot orthotic therapy. Dr. McLean welcomes questions, comments and suggestions at drcmclean@penmed.com.