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PRP/Stem Cell Procedures

Platelet-rich plasma (PRP)

Platelet-rich plasma (PRP) is a newer modality of treatment for the management of many orthopaedic conditions including sport injuries. RBC (red blood cells), WBC (white blood cells), plasma, and platelets are the major components of blood. Platelets are small discoid blood cells with granules containing clotting and growth factors which are released during the healing process. On activation, the platelets accelerate the inflammatory cascade as well as healing by the release of the granules containing growth factors. Platelets have an average lifespan of 7–10 days.

A normal blood specimen contains only 6% platelets whereas platelet rich plasma (PRP) contains a much higher concentration of platelets. A PRP injection is generally recommended in the treatment of tendon or muscle injuries with a success rate of about 70% to 80%. Four to six weeks may be required for complete healing.

Procedure

Your doctor will first draw 10 ml of blood from the large vein in your elbow. The blood will be centrifuged or spun to separate the platelets from other blood components. The entire process takes about 10 minutes. The platelet rich portion of the blood is then extracted.

The injured part of the body is anesthetized with a local anaesthetic and PRP is injected into the affected area under ultrasound guidance.

After the procedure

Following the procedure, you can resume your daily routine activities but avoid strenuous activities such as heavy exercise or lifting. You may experience some pain during the injection which may last for a couple of days. Cold compresses and pain medication may be prescribed for pain relief. Anti-inflammatory medications are to be avoided for up to 48 hours after the injection, as they can affect the platelet function.

Risks and complications are rare but can include infection, nerve or blood vessel injury, scar tissue formation, and calcification at the injection site following a PRP injection.

Call your doctor immediately in case of persistent pain or the development of any adverse reaction after the injection.

Stem Cell Procedures

At our state of the art clinic we are using cutting edge advanced techniques and the latest innovative technology to improve the health and wellbeing of our patients. We provide care for people suffering from diseases that may have limited or suboptimal treatment options and may respond to stem cell based regenerative treatment.

Our Stem Cell Treatment Center emphasizes quality and our well trained physicians are highly committed to clinical research and the advancement of regenerative medicine.

We work with autologous (your own) adipose derived stem cells as well as blood derived stem cells to provide therapy to patients with various inflammatory and/or degenerative conditions.

For adipose derived stem cells, our center utilizes a fat transfer technology to isolate and implant or inject the patient’s own stem cells derived from a small quantity of fat harvested by liposuction on the same day. Using technology developed in South Korea, our group has developed an in office procedure to isolate this cellular medium called the “Stromal Vascular Fraction” or SVF which is very rich in stem cells. Our founders have also worked in conjunction with a number of international organizations and physicians of great expertise to help develop our protocols for various procedures. We have formed a multidisciplinary team to evaluate patients with a variety of conditions often responsive to Stem Cell therapy. Patients who seek care at our center will be evaluated by one of our physicians and given our honest opinion as to the potential benefits and risks of stem cell therapy for their presenting condition.

Stem Cells in Orthopaedic Surgery

In recent times much has been said about the promise of stem cells to heal and improve the quality of life of patients. As individuals grow older and lead more active lifestyles, orthopaedic surgeons are increasingly being called on to use their surgical techniques to improve patients’ quality of life. Earlier solutions to orthopaedic disorders required the use of metals and plastics to improve the mechanical environment for orthopaedic tissues. Newer research has aimed to improve the biologic environment for healing. One area that has shown a promising future is the use of stem cells to regenerate or repair tissues.

Stem cells or Pluripotent Stem Cells (PSCs) in broad terms, are cells that can self- replicate and differentiate into any cell line in the body. In this country, stem cells are usually taken from the patient (Adult Stem Cells) or from the umbilical cord(cord blood cells).

Mesenchymal stem cells (MSCs) are a subset of PSCs which are already committed to differentiating into muscle, bone, ligaments or tendons. Most orthopaedic research has been conducted using adult MSCs.

Fracture healing

Fracture healing occurs through an organized process by which bone cells lay down bone. In certain traumatic situations, the defects are extensive and cannot be healed via the normal biologic process. Several researchers have been able to isolate and purify MSCs from bone marrow and use them to heal these defects.

Intervertebral disc

Disorders of the back and back pain result in significant morbidity and loss of productivity to our society. Most therapeutic solutions rely on conservative or nonsurgical treatment. In certain situations, removal of the degenerated intervertebral disc (IVD) and fusion can lead to a successful result.

Understanding the causes of degeneration and developing treatments to regenerate the IVD may help prevent these problems. When autologous MSCs were transplanted into a rabbit model of degenerative disc disease, the treated rabbits improved and achieved 91 percent of the height of their discs 24 weeks after transplantation. However, research in using this technology in humans has been limited.

Sports medicine

Injuries related to disruption or inflammation of ligaments or tendons are common and can result in significant morbidity to the active individual. When these tissues heal, the resulting scar tissue is of inferior quality. Cell-based therapy is actively being investigated as a new method of treating these injuries. MSCs have also been studied in the repair of meniscal injuries. Tears in the inner third region of the meniscus have a limited capability to heal due to the lack of blood supply. A recent study found that MSCs transplanted into this region of the meniscus in an animal model can result in tissue with better bonding capabilities. New studies are beginning to examine whether these same techniques can be used to improve the results of human meniscal repair.

Arthritis

The treatment of early stage arthritis or damaged cartilage and bone with MSCs has received a lot of interest in recent times. In fact a paper from Stanford University (2011) showed that stem cells reside in multiple tissues in the body and participate in the repair of damaged tissue. These cells are replenished from the bone marrow and are transported to the injury site when needed. Therefore a promising strategy that we use is to reinforce the inherent healing capacity of the body by delivering MSCs harvested from the patient’s own body to the site of injury. These extra cells provide an added “boost” to the healing process and support our concept of instant stem cell therapy.

As we orthopaedic surgeons attempt to improve patients’ quality of life, we will need to expand the techniques we use. In the past, surgeons used a combination of instrumentation and surgical technique to maximize results. As we improve our understanding of the biology of degenerative processes, we may turn to newer agents and more sophisticated techniques to improve quality of life.

If you wish to be advised on the most appropriate treatment, please call +601 9273 2888 or +605 549 5012 to schedule an appointment or click to request an appointment online.

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