Is PRP Able To Prevent Knee Replacement?
Platelet-Rich Plasma -PRP in Amarillo - shows impressive results
Let's start by saying that claiming any treatment can prevent a specific surgery is a bold thing to say. Understand, everyone is different and that's why results differ from patient to patient. However, it is absolutely appropriate to look at the research that has been done, the effects that have been noted, and where the treatment trend is going. So let's do exactly that.
The first thing we want to be clear on is what exactly PRP is. PRP stands for platelet-rich plasma. It is a newer treatment in which the provider draws blood from the patient, spins it down in the centrifuge to separate the parts of the blood right there in the office, then extracts the plasma that separated from the rest of the blood, and then finally, the provider injects the platelet-rich plasma back into the patient's complaint or problem spot.
PRP has little to no adverse effects or allergic reactions because 'the cure' came from the patient themselves. So it's perfect in that aspect. Other common joint treatments include cortisone and hyaluronic acid. Cortisone only treats the inflammation and PRP has beat cortisone and hyaluronic acid in several randomized controlled research trials.
Now, why does PRP plasma injected into a problem spot in this way make any difference?
The plasma contains healing platelets in the blood that when concentrated and injected back into your knee, may provide you with pain relief by way of regenerating, repairing, and replacing damaged knee tissue according to Care Medical (https://www.caringmedical.com/prolotherapy-news/platelet-rich-plasma-knee-osteoarthritis/)
What is becoming more and more clear about PRP for knee pain is that it is more effective when part of a cycle. If you've heard that one shot didn't fix it, there's a reason for that. Our medical provider spent time in Dallas with colleagues and PRP professionals to find the very best way to get the very best effects from the treatment. PRP shows the best results when done as part of a cycle of PRP treatment combined with low-level laser and targetted rehabilitation. Pain almost always responds to a multi-modal approach which is exactly what we offer here at Creek Stone Integrated Medical.
One research paper concluded, "Platelet-rich plasma injections delay the need for knee replacement” – “85.7% of the patients did not undergo total knee replacement during the five-year follow-up”
Now, many folks do go on to have knee replacement but PRP can delay it significantly and there are those avoiding it altogether. Some patients have been told that their knee is bone on bone but they are too young to have the replacement surgery. Some would do replacement but they can't be out of work or they are active in sports and just can't do the knee replacement. Some patients have had a knee replacement on one knee and don't want to have the procedure on the other knee.
Let's be clear from the top; PRP does not work for every single patient. Sometimes, joints are just simply too far gone and cannot be salvaged through PRP. Every treatment has its limitations. For example, if a patient's knee can't be bent, the integrity of the joint is probably compromised too significantly. Sometimes, the limitation is due to the doctor or the patient giving up too soon and not staying the course. Remember, it's not just one shot and 'BAM' - you're cured. It's not instant relief. Cortisone, for example, treats inflammation and can have a fairly rapid effect on the pain level. However, they are short-lived and do nothing to rebuild or repair the joint. While cortisone can be fast-acting and effective short-term, the research is piling up about the detrimental effects of cortisone injections. They are actually showing to be bad for the joints.
PRP can sometimes feel a little worse in the beginning or no pain relief for a bit. PRP is NOT like cortisone. While with cortisone, nothing is being healed, PRP brings healing through inflammation. When tissue is repaired, the inflammation goes away. Cortisone is short-term. PRP is long-term. For more comparisons between the different types of knee injections, visit https://www.caringmedical.com/prolotherapy-news/different-types-knee-injections-2/
For you science-y people, the exact mechanism for PRP treatment goes like this;
February 2021 (10) study from the Department of General Surgery and Medical-Surgical Specialties, Section of Orthopaedics and Traumatology at the University of Catania, Italy. Here is what the researchers documented:
“PRP supplies and releases cytokines (cells that send signals to other cells that a repair process needs to begin), growth factors, and α-granules (the proteins of the platelets), which can offer a recovering stimulus and promote healing and tissue repair. The PRP injection can promote the release of fibrinogen (a substance that helps in wound healing or a ligament tear for example), interleukin-1 receptor antagonist (acting as an inti-inflammatory), tissue growth factors (TGFs), platelet-derived growth factors (PDGFs), and vascular endothelial growth factors (VEGFs). These growth factors have local and systemic involvement, encouraging the inhibition of catabolic enzymes (stops an overactive inflammatory response from breaking down tissue healing tissue – this is the problems of chronic swelling) and cytokines, modulating inflammation and local angiogenesis (development of new blood vessels, you need circulation to heal), and recruiting local stem cells and fibroblasts to sites of damage, and inducing healthy nearby cells to manufacture greater numbers of growth factors.” https://pubmed.ncbi.nlm.nih.gov/33546408/
MRI evidence that PRP regrows cartilage
A January 2020 study published in the Journal of Pain Research (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6959502/) investigated the effect of PRP on cartilage characteristics by special MRI sequencing in knee osteoarthritis patients. All the patients were women and about 58 years old. Here is what the researchers wrote:
In this double-blind randomized clinical trial, patients with bilateral knee osteoarthritis were included in the study. Each patient’s knees were randomly placed into the control or the treatment groups. PRP was injected in two sessions with 4-week intervals in the PRP group.
Pain questionnaires were utilized and MRI was performed for all patients, before, and 8 months after treatment.
- In the PRP group, all of the radiologic variables (patellofemoral cartilage volume, synovitis, and medial and lateral meniscal disintegrity), with the exception of subarticular bone marrow abnormality, had significant improvement. In a comparison between the two groups, patellofemoral cartilage volume and synovitis had significantly changed in the PRP group.
- “In this study, in addition to the effect of PRP on pain, there was a significant effect on radiologic characteristics (patellofemoral cartilage volume and synovitis).
WOW. That's impressive.
What we are coming to understand as well is that if an office practices a single-shot injection technique, sometimes it is going to help but long-term and overall, it likely will not. Single PRP shots, rather than a cycle of them, may only be a temporary 'fix' because the single shot didn't address the cause of the damage, the knee instability. Knee instability is noticed when it feels loose or 'wobbles' a bit. Maybe it feels like it could 'give out' at times. Common sense tells us and patients that one shot of PRP can patch problems with the cartilage but cannot stabilize the entire knee.
PRP will not work if it is considered a one-shot treatment and offered in a similar manner to cortisone. One-shot and done. Once again, PRP therapy should be considered to be a process and performed in a cycle. For some patients, we may see them in our office periodically for 3-6 total visits per area treated.
Here at Creek Stone, our Family Nurse Practitioner is our medical professional, is trained in PRP therapy, and performs PRP treatment right here in our Amarillo clinic.
Make sure you call us at 806-355-3000 to set up your PRP therapy today
One of the most exciting things about PRP treatment is that it's not just for the knee. Here at Creek Stone, we can use PRP to help treat shoulders, knees, hips, ankles, plantar fasciitis, carpal tunnel, hair loss, elbows, and much much more. The possibilities for PRP, at this time, appear to be almost endless. And exciting.
Dr. Jeff Williams, DC, FIANM is a Fellowship-trained Neuromusculoskeletal specialist, Orthopedic specialist, and chiropractor in Amarillo, TX. As an Amarillo chiropractor, Dr. Williams treats chronic pain, disc pain, low back pain, neck pain, whiplash injuries, and more. Dr. Williams is also the host of The Chiropractic Forward Podcast (https://www.chiropracticforward.com). Through the podcast, Dr. Williams teaches fellow chiropractors and advocates weekly for evidence-based, patient-centered practice through current and relevant research. If you have any questions for Dr. Williams, feel free to email at [email protected] Learn more about Dr. Williams and his practice at https://www.amarillochiropractor.com.
Dr. Williams was voted Best Chiropractor In Amarillo in the Best of Amarillo 2020. Dr. Williams's full-time Amarillo chiropractic practice is Creek Stone Integrated Care at 3501 SW 45th St., Ste. T, Amarillo, TX 79109. If you are searching for a chiropractor near me, Dr. Williams is your Amarillo Chiropractor.
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