Biologic Treatment

Platelet Rich Plasma

Platelet rich plasma, or PRP as it is commonly called, is a type of growth factor (GF) therapy. Blood is drawn from the patient’s vein and placed in a sterile tube where it is spun in a centrifuge. The blood is separated into its components, and platelets are concentrated from the blood creating platelet-rich plasma (PRP). PRP then can attract mesenchymal stem cells that can turn into cells that form cartilage, tendon, and bone, while also attracting macrophages that are important modulators of the inflammatory response. Lastly, fibroblasts are recruited and form collagen and extra-cellular matrix proteins and are activated by cytokines produced from the macrophages. Together this results in cell proliferation and can stimulate and improve healing.

Amniotic Stem Cells

Amniotic stem cells are derived from the amniotic fluid and amniotic membrane tissue, the cells are unspecified and are able to differentiate into the pathways that forms new muscle, tendon, ligament, bone, cartilage, and other connective tissue, then will continue to proliferate and repair the associated structures.

Stem cells have an immunosuppressive effect by adjusting the activation of natural killer cells, dendritic cells, macrophages, and T and B lymphocytes. This in turn has advantageous anti-inflammatory and antifibrotic actions to maximize their therapeutic effects in the concerned and injured site. Studies published to date have reported favorable outcomes, with most focusing on clinical improvement versus quality of regeneration.

Studies have shown:

• PRP injections have become an attractive option for circumventing the potential risks of corticosteroid injections
• PRP injections have been found to increase the local concentrations of platelets and growth factors, including PDGR, VEGF, TGF-β, and epidermal growth factor, which have been implicated as important factors in the early healing process.
• Stem Cells released significantly higher levels of growth factors IGF, TGF-β1, and VEGF than PRP. The nucleated cells in Stem Cells are three times higher than that in PRP.
• Stem Cells combined with platelet-rich plasma (PRP) improved pain and joint function in patients with partial tears of tendons. In addition, tear size decreased after Mix of Stem Cell-PRP injection.