This page will provide a brief explanation to the most commonly asked questions we receive. Links to more detailed information is also provided. You can also use the contact form on this page to ask more detailed questions.
What is Platelet Rich Plasma Therapy?
Platelet Rich Plasma or more commonly known as PRP therapy is a type of Regenerative Injection Therapy that doctors use to treat many injured or degenerative joint and spinal injuries issues.
Much like taking a blood test, PRP preparation begins with a blood draw from a vein in your arm. Once the tube is filled with the blood, it is placed in a centrifuge to spin out and separate the blood platelets from the rest of the blood cells and components.
Platelet Rich Plasma or more commonly known as PRP therapy is a type of Regenerative Injection Therapy that doctors use to treat many injured or degenerative joint and spinal injuries issues.
Much like taking a blood test, PRP preparation begins with a blood draw from a vein in your arm. Once the tube is filled with the blood, it is placed in a centrifuge to spin out and separate the blood platelets from the rest of the blood cells and components.
A solution of platelet rich plasma is then prepared to inject into the areas that are causing you pain and loss of function.The goal is to jump start the body to start healing damaged tissue. We have published research on the possible effectiveness of this treatment in peer review journals. We invite you to review this research at these links.
- Treatment of unresolved lower back pain with platelet rich plasma injections
- Treatment of unresolved shoulder pain with platelet-rich plasma therapy
- The effect of platelet-rich plasma therapy on unresolved wrist pain
What are Mesenchymal stem cells (MSCs)? What is Bone Marrow Aspirate or Bone Marrow Aspirate Concentrate?
In our practice, Bone Marrow Concentrate is used as a treatment for musculoskeletal disorders. We treat degenerative joint disease, degenerative disc disease of the spine, and tendon and ligament injury. The bone marrow concentrate, also known as “Autologous stem cells” which means they come from you, are taken in a simple extraction procedure from the iliac crest of the pelvic bone.
The bone marrow derived stem cells are “de-differentiated pluripotent” cells, which means that they continue to divide to create more stem cells; these eventually “morph” into the tissue needing repair — for our purposes, collagen, bone, and cartilage.
We have published research on the possible effectiveness of this treatment in peer review journals. We invite you to review this research at these links.
- Short-term outcomes in treatment of knee osteoarthritis with 4 bone marrow concentrate injections.
- Short-term outcomes of treatment of hip osteoarthritis with 4 bone marrow concentrate injections: a case series.
- Treatment of lower back pain with bone marrow concentrate.
The use of bone marrow-derived stem cells was first tested in the 1960s. Even then, doctors knew that stem cells had unique regenerative powers due to their ability to morph into bone and cartilage and migrate to the site of damage once introduced into the body. Using stem cells from a patient’s own bone marrow was particularly interesting, because these types of autologous stem cells are readily available without ethical (embryonic) problems in their use. In musculoskeletal medicine, stem cells provide an answer to the conundrum of cartilage and other soft tissue rejuvenation.
Some research suggests that the introduction of stem cells into the joint also reawakens and revitalizes the stem cells already present in the synovial fluid of the knee, as well as in the cartilage and bone. This “supercharges” the healing process of all structures in and around the joint (cartilage, menisci, ligaments, and tendons). Stem Cell Therapy is considered a solution with limited side effects.
Where Do We Get the Stem Cells for Therapy?
For each treatment, stem cells are taken from the patient’s iliac crest at the back of the pelvis. These cells are valuable because they are undifferentiated cells, meaning that they do not have a tissue type but can grow to become other, more specialized types of cells. If a joint, cartilage, tendon, ligament, or muscle needs regeneration, stem cells can supply the building material.
How is the procedure performed?
The bone marrow aspirate or stem cell therapy injection procedure is a very simple, in-office procedure with no general anesthesia, as it involves very little to almost no pain. Moreover, it takes only about 30 minutes from start to finish. During bone marrow Stem Cell Therapy, a practitioner will inject lidocaine at the top of the buttocks, at or near the posterior superior iliac spine, to numb the area. A tiny incision (which heals quickly after the procedure) is made to allow insertion of a needle to aspirate bone marrow.
No stitches are necessary. The solution obtained is spun in a centrifuge. The stem cells are then harvested and injected into the target area or joint under ultrasound guidance when required.
Although bone marrow aspiration is typically painful during other procedures such as bone marrow transplantation, it is nearly pain free in this case. A relatively small amount is collected.
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What are the healing properties of stem cells?
The use of bone marrow-derived stem cells was first tested in the 1960s. Even then, doctors knew that stem cells had unique regenerative powers due to their ability to morph into bone and cartilage and migrate to the site of damage once introduced into the body. Using stem cells from a patient’s own bone marrow or adipose (fat) tissue was particularly interesting, because these types of autologous stem cells are readily available without ethical (embryonic) problems in their use. In musculoskeletal medicine, stem cells provide an answer to the conundrum of cartilage and other soft tissue rejuvenation.
Some research suggests that the introduction of stem cells into the joint also reawakens and revitalizes the stem cells already present in the synovial fluid of the knee, as well as in the cartilage and bone. This “supercharges” the healing process of all structures in and around the joint (cartilage, menisci, ligaments, and tendons). Stem Cell Therapy is considered a solution with limited side effects.
Am I Too Old for Stem Cell Therapy?
Let’s do a comparison of treatments for the older patient. A recent study from the journal American Health and Drug Benefits suggests that to save on national health care costs, patients over the age of 70 should just have a knee replacement and not even explore steroid or hyaluronic acid (viscosupplementation injections). In recent research, doctors have noted that health care interventions for knee osteoarthritis are poorly perceived, and that patients expect the “inevitable” joint replacement. The expected failure of conservative treatment to manage pain and symptoms is common partly because clinicians frequently trivialize osteoarthritis.
This is almost paradoxical. The patients are too old for other treatments, yet some doctors suggest that they should simply proceed to
the most invasive and dangerous treatment that requires the most healing and recovery time. What is too old for a knee replacement?
And, what is too old for extended recovery and rehabilitation? Evidently, there is no limit.
In another recent study in the medical journal Transplantation, researchers reported results of Stem Cell Therapy in patients who showed rapid and progressive improvement (in function), with enhanced knee cartilage quality. “[Stem Cell Therapy] . . . may be a valid alternative treatment for chronic knee osteoarthritis. The intervention is simple, does not require hospitalization or surgery, provides pain relief, and significantly improves cartilage quality.”
Pasquale MK, Louder AM, Cheung RY, Reiners AT, Mardekian J, Sanchez RJ, Goli V. Healthcare utilization and costs of knee or hip replacements versus pain-relief injections. Am Health Drug Benefits 2015 Oct;8(7):384-94.
Smith TO, Purdy R, Lister S, Salter C, Fleetcroft R, Conaghan PG. Attitudes of people with osteoarthritis towards their conservative management: a systematic review and meta-ethnography. Rheumatol Int. 2013 Dec 5.
Orozco L, Munar A, Soler R, Alberca M, Soler F, Huguet M, Sentís J, Sánchez A, García-Sancho J. Treatment of knee osteoarthritis with autologous mesenchymal stem cells: a pilot study. Transplantation. 2013 May 15.
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