Platelet-rich Plasma Therapy

Wednesday, February 18, 2009

The New York Times for February 16th discusses an innovative new treatment called platelet-rich plasma therapy, or PRP, a process which one professor at Stanford University Medical Center claims “has the potential to revolutionize not just sports medicine but all of orthopedics.”

The idea behind the treatment is fairly simple: Once doctors procure blood samples from the individual being treated and separate them into platelets via a filtration system or centrifuge, the patient is then injected with the platelets in the area affected by injury as a means of encouraging the body’s natural instinct to repair muscle, bone, and other tissue.

Initial research suggests that using platelet-rich plasma therapy also appears to help regenerate torn fibers in ligaments and tendons, which, if true, could shorten the rehabilitation process and potentially eliminate the need for surgery in certain situations.

To be considered as well is the fact that the chance for rejection or allergic reactions from the treatment is greatly minimized due to the fact that the substance injected in platelet-rich plasma treatment is “autologus,” or comes from the patient’s own body. Meanwhile, the chance of infection in the patient too is substantially reduced given that no incision need be made in the absence of surgery and a much shorter recovery is required for the patient considering that the procedure takes only about 20 minutes from beginning to end.

Researchers are quick to point out that early studies show platelet-rich plasma therapy is far from a cure-all; in fact, in anywhere between 20 and 40 percent of cases evaluated, it was determined that the treatment was entirely ineffective. Yet, for the most common-injuries – those described by Samir Mehta at the Hospital of the University of Pennsylvania as suffered by “the guy who plays softball on weekends” and “the woman who runs a 5k race every now and then” – the potential for PRP to enhance the entire field of sports medicine continues to hold real promise. A 2006 study by The American Journal of Sports Medicine, for example, found that patients using platelet-rich plasma treatment in cases of chronic elbow tendinitis – or “tennis elbow” – saw a 60 percent improvement in pain measurements within the first two months of receiving their first treatment. Similar research done on patients suffering from ruptured Achilles’ tendons also found recovery time greatly reduced as a result of the use of PRP.

As news of the success achieved in patients receiving plasma-rich platelet therapy continues to grow, professional athletes and the teams for which they play have also jumped aboard the PRP bandwagon. Players like Troy Polamalu and Hines Ward of the Pittsburgh Steelers, for instance, both acknowledged they’d received a form of the treatment in the period leading up to February’s Super Bowl match-up against the Arizona Cardinals; Polamulu, states The New York Times, received the procedure for a strained calf just before the conference championship game with the Baltimore Ravens, while Ward, who suffered a medial collateral ligament sprain in his right knee in the first quarter of the Ravens’ contest, received similar therapy the day after getting hurt. Still, the extent to which PRP has begun to infiltrate professional sports does not stop at football, with the article suggesting that at least “one major league pitcher, about 20 professional soccer players and perhaps hundreds of recreational athletes” have been recipients of this particular type of therapy in the recent past.

The New York Times notes there is a major financial incentive for professional sports teams to champion the benefits which plasma-rich platelet treatment thus far appears to offer. Using Major League Baseball as an illustration, 2008 saw 519 players from the 30 teams comprising the MLB lose some 28,602 days of playing time due to injuries and associated recovery time – a collective figure which ending up costing professional baseball $455 million in total salaries spent while players remained idle. By being able to reduce the amount of time a player is forced to spend being rehabilitated, even by week or merely a few day, the article suggest, costless dollars could be saved and players utilized for the purpose for which they were originally signed to play professional sports in the first place.

It seems that when it comes to the field of medicine, there is rarely a time when a singular drug or procedure can be viewed as being a “sure thing” for the patient being treated. Platelet-rich plasma therapy, however, certainly appears promising and, by all accounts, looks well on its way to proving itself a noteworthy exception. Should it do so, both the short and long-term effects it has upon the future of sports could be groundbreaking, and a radical departure from the conventional programs of treatment currently available to amateur and professional athletes alike as a result of past advances made in the field of sports medicine.