PRP Joint Injections
PRP Joint Injections for Orthopaedic Injury
Platelets are essential for tissue repair and renewal through vascular remodelling and collagenesis. The first phase of the body’s wound healing process following injury or trauma (controlled or uncontrolled) is inflammation. During the inflammation cascade, platelets are attracted to the site of trauma and release Growth Factors. Such Growth Factors include:
- TGF – β (Transforming Growth Factor) which stimulates the formation of the extracellular matrix within soft tissue and also regulates bone cell (osteocyte) metabolism;
- PDGF (Platelet-Derived Growth Factor) which stimulates cells to replicate; stimulates new blood vessel formation (angiogenesis); stimulates skin cell turnover (epithelialisation) and granulation tissue formation;
- bFGF (Basic Fibroblast Growth Factor) which triggers endothelial cell and fibroblast proliferation, as well as blood vessel formation;
- EGF (Epidermal Growth Factor) that promotes cellular differentiation and stimulates re-epithelialisation, blood vessel formation and collagenesis;
- VEGF (Vascular Endothelial Growth Factor) that promotes blood vessel formation (angiogenesis);
- CTGF (Connective Tissue Growth Factor) encouraging angiogenesis; increased blood vessel permeability; the induction of mitosis via a mitogen (also known as mitogenesis)
Photo-activated PRP Joint Injections
Photo-activated PRP (Platelet Rich Plasma) injections into the intra-articular joint space provide activated platelets and activated growth factors to help with reducing inflammation and pain, to enhance joint function and possibly stimulate new cartilage growth in the area of injury or degeneration (as in mild osteoarthritis).
A recent double-blind, randomized trial by Patel et al published in the American Journal of Sports Medicine in February 2013 investigated whether treatments with platelet-rich plasma are more effective than placebo for knee osteoarthritis in 78 patients. The authors concluded that a single dose of WBC-filtered PRP in concentrations of 10 times the normal amount is as effective as 2 injections to alleviate symptoms in early knee OA. The results, however, deteriorate after 6 months. Both groups treated with PRP had better results than did the group injected with saline only.
White Blood Cells or No White Blood Cells?
The jury is still out in this controversial topic as to whether WBC’s (White Blood Cells or Leukocytes) should remain in the final PRP product or be removed…
The pro’s for retaining WBC’s:
- It is believed that WBC’s have an anti-microbial activity and assist in reducing infection;
- They could add benefit by releasing other essential growth factors to further enhance the wound healing process
- Some clinicians believe that WBC’s may release cytokines that can have the opposite effect on tissue cells and counter the enhancement of the wound healing process
- Sports Medicine: Graduate Diploma of Sports Medicine, Dr Bosnich has treated many sports injuries over the years with intrarticular injections and assisted some of Australia’s best Orthopaedic Surgeons
- Cosmetic Medicine: A Fellow of the Australasian College of Cosmetic Surgery, Dr Bosnich’s excellent liposuction technique is a very important for retaining viability of stem cells so they are not damaged during harvesting and processing.
He regularly returns to Adelaide to assist well known Orthopaedic Surgeons from Wakefield Orthopaedic Clinic with their operations.
For more information about PRP and/or Adipose-Derived Stem Cell injections for joint pain relief and musculoskeletal injuries, book your consultation with Dr Bosnich today via our online enquiry form or calling us on 1300 360 764.