Sports Medicine Update: Advances In PRP and Stem Cells with Injury Management
Here, Mr. Adam Whatley MSc, shares his insight into the future of platelet rich plasma (PRP) and stem cell treatments in sports medicine and injury care.
Development for platelet-rich plasma and stem cell therapies in sports injury care
This is a huge industry but there is still a significant lack of understanding as to how these biologic treatment interventions are effective in sports medicine. Up until recently there has been a mixed opinion on good quality and level of evidence supporting higher and treatments. However, what we know and understand is research takes time and money, particularly in an area which is relatively new. This being said there is now an increasing body of evidence to support their clinical use in augmenting and supporting regeneration, and repair, which is extremely exciting for the future of injury and pain management.
Joint health and cartilage repair
With cartilage injury there is little or no potential for self-repair. Therefore, in many joints, particularly weight-bearing joints the predominant cause for arthritic change is repetitive or acute trauma. Up until recently, there was little we could do to alter the relentless and progressive nature of the arthritic process. Now, using biologic treatments including platelet-rich plasma (PRP), bone marrow aspirate, and stem cells we can alter the biological environment and provide an immune-modulated cartilage protective environment.
We understand and know that PRP treatment can up regulate tendon cell repair, and with this evidence-based advantage its use has been advocated in tendon issues from elbow to Achilles. The basic biological science evidence for this augmented repair has been sound for quite some time, but it is only recently that the clinical evidence is vastly building to support its use in tendon injury and repair.
In my opinion, the only greatest concern is that there has been mixed standardisation and preparation of methods leading to some cases of reported mixed outcomes.
There is also an ongoing debate currently as to the value of leucocytes in the PRP preparation and as to whether leucocyte-poor or rich PRP is best in acute or chronic tendon issues. There is currently mixed evidence to suggest for and against.
CBMA is also another common orthopedic biologic treatment. Aspirated from bone marrow, this provides stem cells, growth factors and an anti-inflammatory.
CBMA was shown to be also effective in improving the quality of cartilage repair and tendon repair. Is very important as a patient to understand more about stem cell therapy as a treatment. Harvested stem cells may not actually be involved in the repair or regeneration of the tissue into which they are administered. Instead they may provide an immune modulation and facilitate a repair processes.
Biologic treatments are now becoming increasingly used within the orthopaedic and sports medicine communities, and the results have been very good to say the least. The future for these natural treatments within the treatment and management of sports injuries is very exciting. Already much of the literature has been expressing how effective treatments like PRP or over harmful steroid, Articularly in the long term.
Here at Dynamic Osteopaths & Regenerative Medicine we have been performing these treatments for sports injuries for a good number of years and the success have been fantastic.
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