Kentucky Derby rasising awareness of platelet rich plasma and stem cell treatments in horses

With the timing of the Kentucky Derby today, there has been recent press about PRP therapy & stem cell usage in athletic horses.

A company called VetCell's from the UK just announced a Stem Cell Technique to Undergo Human Trials. They have treated over 1500 horses successfully & are now applying this stem cell technology to humans. I expect many studies in the next few years which will enlighten us exactly how we can maximize natural healing utilizing stem cells.

http://www.thehorse.com/ViewArticle.aspx?ID=13991&src=RA

Another study from Cornell University was just published on PRP use with horses showing effectiveness of healing tendon injuries. Tendon injuries are an important cause of catastrophic injury in athletic horses, and even minor injuries are often slow to heal and prone to future injury. Researchers performed ultrasound examinations of the tendons at 0, 2, 4, 6, and 8 weeks and mechanical, biochemical, and microscopic evaluation of the tendons 8 weeks after treatment.
Ultrasound while commonly used to look at babies, is seeing increased use in orthopedics and sports medicine to diagnose tendon injuries and to guide needle injections to ensure precise accuracy.

http://www.ncbi.nlm.nih.gov/pubmed/19350658?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum

January 08' Platelet Rich Plasma Enhances Tendon Healing

A new article from the Journal of Cellular Physiology presented some new insights into the role of PRP in tendon healing. After injecting PRP into mice patellar tendons, accelerated healing was demonstrated. The PRP had an 8.8 times platelet concentration above baseline versus whole blood.

Circulation derived cells play a key role in tendon healing. Blood flow is very important in connective tissue regeneration. Tendons typically have a poor blood supply (only 1/3 of the amount found in muscles). This study showed increased quantity of these healing cells in the early phase of tendon repair. Unfortunately, these helpful cells normally disappear with time. Therefore prolonging their presence is advantageous. Also increased type I & III collagen and macrophages were increased; supporting that PRP promotes tendon healing

http://www3.interscience.wiley.com/cgi-bin/abstract/117880365/ABSTRACT?CRETRY=1&SRETRY=0

Ultrasound Guided Platelet Rich Plasma Injections

A growing number of physicians are using musculoskeletal ultrasound to guide various injections. As a leading imaging technique in Europe, ultrasound is safe, economic, convenient, & effective in diagnosing many injuries. The technology has dramatically improved and allows us to visualize nerve & tendon fibers. While the quality is not quite MRI caliber, ultrasound allows for dynamic (motion studies). In other words, ultrasound allows functional evaluation of an injury with movement, whereas MRI takes a still image. Also, ultrasound has color doppler that shows areas of blood flow changes (called neo vascularization). This allows us to deliver the PRP within a millimeter of the target site, or even discover other regions that are affected.

Ultrasound technology continues to grow. I just upgraded to this Sonosite portable machine with color doppler.

Heading to PRP Ultrasound Conference Nov-2nd-3rd, 2007

On Nov 2nd & 3rd, I will be at a PRP course in Ohio. To my knowledge it is the first of it's kind in the US. Several field leaders and those Physicians interested in learning about PRP will gather there to exchange ideas and further our understanding of PRP. Also, there will be needle guided ultrasound tutorials. Musculoskeletal ultrasound is being used increasingly by docs performing PRP injections. I have performed some injections under ultrasound with enhanced ability to guide the needle to precise areas of injury. I will post info following the course.

Platelet Rich Plasma Patient Education Brochure

www.smog-ortho.com/prpguide.pdf

Platelet Rich Plasma Introduction

This blog site was created to establish a non-competitive forum for physicians performing PRP treatments & for patients interested in learning more about this emerging treatment. I was introduced to this treatment by my colleagues, Dr Bert Mandelbaum & Dr Michael Gerhardt; who are premiere orthopaedists responsible for treating numerous soccer athletes from all over the world. PRP is being used by many European professional soccer clubs, and is now making it's way to the U.S.

Initially we injected a few professional soccer athletes for MCL tears/sprains and noted accelerated recovery & earlier than expected return to play. Click link to see article:
http://www.mlsnet.com/news/team_news.jsp?ymd=20070417&content_id=89302&vkey=news_cdc&fext=.jsp&team=t120

Shortly afterwards we began treating weekend warriors with chronic non-healing tendon injuries including tennis/golfers elbow, achilles tendonosis, patellar tendonosis (jumpers knee). After a favorable response from patients and following discussions with other leaders in the community on PRP, we are now injecting PRP for other non-healing injuries including knee arthritis & hip bursitis.

PRP provides a safe and natural alternative to surgery using the body's natural ability to heal itself.