The 5 Keys to Regenerative Medicine

1. WHAT is Regenerative Medicine?

It’s the field of Medicine which deals with treatments that when applied to damaged body tissues, such as tendons or joints, help them to heal by stimulating natural repair.

The regeneration of healthy tissue occurs through natural processes stimulated by these treatments.

Regenerative Medicine embraces various treatments such as Platelet Rich Plasma (PRP), Mesenchymal Stem Cells (MSC), Prolotherapy and the use of semi-synthetic drugs such as Pentosan.

Arthritic hands

2. How NEW are these treatments?

Some of these treatments have been used since the early 1930’s . This is the case of Prolotherapy.

PRP  first saw the light in the late 80’s in Dentistry. Since then it has evolved exponentially expanding to other fields of Medicine. There are 3 major types of PRP therapies:

  • Pure PRP

  • Leukocyte Rich PRP (LR-PRP)

  • Leukocyte Rich Plasma (LRP)

MSC therapy involves tissue engineering where pluripotential cells harvested from the bone marrow, fat tissue or blood are manipulated and then injected into damaged tissues such the heart muscle, where healing will take place and repair may happen.

Through Tissue Engineering Gene therapies have emerged as a promising but experimental treatment to help damaged tissues to repair more quickly.

 

3. Which CONDITIONS can be treated?

In damaged joints (osteoarthritis) and tendons (tendinopathies) PRP and Prolotherapy have shown to help patients with pain and stiffness. Also certain degree of repair has been proof through imaging (MRI and Ultrasonography). In other conditions such as fibromyalgia, plantar fascitis, knee sprains, back and neck pain and muscle injury PRP have proven promising results.

Mesenchymal Stem Cell therapy is currently being used to repair damaged organs such as the heart (Congestive Heart Failure), spinal discs (chronic lower back pain), diabetic nephropathy and Rheumatoid Arthritis, etc.

Severe Arthritis of the right knee

4. WHERE can I find these treatments?

Some of these treatments are widely available such as Prolotherapy or PRP. Many Sports Medicine clinics and GPs worldwide are offering them. The price for a Prolotherapy treatment varies from AUD $100 to $250. PRP therapy is slightly dearer ranging from $350 to $1000 depending on the area and condition to treat.

However MSC therapy is currently used only in clinical trials in humans mainly in America, Europe and Japan.

Runner tying up shoes before run

5. WHERE to from here?

Regenerative Medicine is 21st century medicine. Even though it first appeared in 20th century its full potential to heal and even cure certain health conditions will reveal through the next decades as it is blooming worldwide.

Still traditional therapy where a drug is given to reduce symptoms such as a painkiller to treat pain will continue. However as Regenerative Medicine therapies become more available and new treatments appear, it will eventually become mainstream medicine.

A dream in Regenerative Medicine

PRP – Platelet Rich Plasma

What is PRP?

PRP or Platelet rich plasma is a concentrate of platelets which when injected in human tissue can help to heal damage cells by stopping inflammation and promoting tissue regeneration.

PRP provides a promising alternative to surgery (or at least delays it) by promoting safe and natural healing without surgery.

For 30 years, the application of autologous PRP has been safely used and documented in many fields including; Orthopaedics, Sports Medicine and wound care.

What are platelets?

Blood contains plasma, red cells, white cells and platelets. Platelets are small discoid cells with a life span of about 7-10 days. Platelets contain inside clotting and growth factors.

During the healing process, the platelets are activated and stick together. Then these growth factors are released by the platelets activating the inflammatory cascade thus stimulating the healing process.


When to use PRP?

Although PRP therapy is still considered an experimental therapy, its use has shown an exponential growth in the last 5 years.

Frequent uses of PRP therapy include:

  • Treatment of musculoskeletal conditions such as osteoarthritis of knees and hips, tendon injuries (Achilles, hamstrings, tennis elbow), shoulder and hip bursitismuscular tears (hamstring, quads),  joints and ligament sprains  (ankle, knee).
  • In Aesthetic Medicine where it may help skin to regenerate and to maintain its radiance and elasticity.
  • Diabetic and vascular ulcers treated with perilesional PRP therapy have shown a greater healing and regeneration cell rate.
  • Hair loss caused by androgenic alopecia.  PRP therapy may help  hair growth in patients who had failed to previous treatments with Minoxidil and Finasteride.

PRP injections. The procedure

  • Assessment of the problem/injury. At the first appointment, the doctor will take from you  a detailed clinical history of your injury or specific problem that may require PRP therapy, as well as any other medical conditions and current treatments that may be important.
  • This will be followed by a thorough physical examination.
  • Depending on the situation, you may be requested additional tests such as a blood test or an x-ray/MRI to confirm the diagnosis and pinpoint the injury site for injection.
  • Usually it is during this first consultation when a treatment plan with PRP is outlined to you  and the procedure itself is agreed.
  • Blood collection. On the day of the PRP injection the doctor or nurse will take a blood sample from your arm (5 to 20 ml in a special sterile container). The amount of the sample depends on where the PRP will be injected.
  • PRP injection. Your own blood (autologous) will be then spun down at a specific force and time in order to separate the different blood components into 2 different layers, the PRP layer and the red cell layer.
  • Then the PRP layer will be drawn into a syringe and injected into the region of interest, for example into a your knee.

Is PRP safe?

Because PRP therapy is an autologous therapy (the patient’s own blood components are injected in his own body) the probability of an allergic reaction is very unlikely which can occur when other substances such as steroids or hyaluronic acid are used.

Multiple studies have shown PRP therapy to be a safe and a well tolerated new therapy.

Even though there are potential side effects and complications inherent as to any medical procedure, only mild and self-limiting adverse effects in a small number of patients have been reported.

You may experience mild pain and/or slight swelling which usually resolves spontaneously in 24 to 48 hours.

Less common side effects such as stiffness, syncope, dizziness, headache, nausea, sweating, and palpitations may appear but they are all self-limited.

Sporadic adverse effects of temporary mild rash, local numbness, and itching sensation have also been reported. Pain can be prevented by the use of a local anaesthetic prior to the PRP injections.

After the infiltration you may apply ice to ease the pain. The use of painkillers is also recommended to minimise discomfort, except the use of anti-inflammatories as these drug may alter the effect the regenerative effect of the PRP.

What is the downtime with PRP therapy?

Usually we will recommend you  a couple of days of rest from activities such as yoga, running or the gym . Also the use of anti-inflammatories or ice is not recommended as they could potentially affect the effectiveness of the PRP treatment. Paracetamol instead will be a good painkiller option.

How much does PRP therapy cost?

As PRP therapy is still an experimental treatment there is currently no Medicare rebate in Australia, hence it is a private fee only. For a detail outline of the costs please contact us