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I had a new treatment for my plantar fasciitis called platelet-rich plasma or PRP that seemed to work beautifully. But I heard a report on TV that said they are taking a second look at this product because it's not working as well as they had hoped. What's going on?
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Platelet-rich plasma (PRP, also known as blood injection therapy) refers to the use of a sample of serum (blood) plasma to enhance healing of soft tissues and bone. The product has as much as four times more than the normal amount of platelets, along with growth factors and inflammatory cells.
This treatment enhances the body’s natural ability to heal itself and is used to improve healing and shorten recovery time from acute and chronic soft tissue injuries. It has been used for chronic osteoarthritis, tennis elbow, plantar fasciitis, rotator cuff tears, and the early stages of wound healing.
As with any new treatment, over time it is possible to see more clearly the pros and cons of treatment. Data can be collected on long-term results and more information published to guide surgeons in using this treatment tool.
Taking a look back over the past few years, we now see there are some inconsistencies in results with this treatment. Some studies have shown no benefit from the use of platelet-rich plasma (PRP) for tissue healing. Why is that?
First, not all PRP is the same. The product may vary based on how much whole blood was taken and how quickly platelets recover during the injection. The presence of other blood parts such as red or white blood cells can make a difference. And any other substances that might have been added (e.g., thrombin, calcium chloride) can affect how the PRP functions.
Second, the potency (strength) of each PRP preparation varies -- again, this depends on what's in the product. Too little or too much of any component part can change how quickly and how effectively the body responds to the product. Then there is what's called biologic variation -- everyone responds a little differently to the same PRP. Individual body chemistry, metabolism, and reactivity can vary significantly.
Along these same lines, getting the right mix of product for each person is a challenge. Clearly, one formulation does not fit all. The amount of PRP to achieve the best result for each person is called the dose-response. This goes back to how the body responds to each substance within the PRP (e.g., growth factors, cytokines, proteins, clotting factors).
And finally, even with the right mix of elements within the PRP, using it at the exact right time for best results may make a difference. The best timing for the use of PRP has not yet been determined. Likewise, the way in which the PRP is delivered (e.g., injected, brushed on) might make a difference in results.
Future research done using PRP will have to pay attention to which PRP product was used and how it was used. The early enthusiasm about PRP may be still warranted but since not all results have been positive, scientists will be taking a closer look at this new treatment before continuing as if this product is fail-proof.
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*Disclaimer:*The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic. |
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