PRP

The Regenerative Medicine Clinic

Orthopaedic Surgeons & Molecular Immunobiologists located in Wilmington, NC

Your body is filled with specialized cells that help heal and regenerate injured or diseased tissues. Unfortunately, these healing properties may not always get to the areas of your body that need them the most. Dedicated to providing the simplest and most natural treatment, regenerative orthopedist Austin Yeargan III MD, at The Regenerative Medicine Clinic in Wilmington, North Carolina, uses platelet-rich plasma (PRP) to provide your diseased or damaged tissue with the cells needed for healing. To learn more about PRP and how it may benefit your health, call the office or click the online booking button to schedule an in-office or telemedicine consultation.

PRP

What is PRP?

PRP is a form of regenerative medicine that contains a high concentration of platelets, which contain growth factors and specialized proteins, and it’s made from a sample of your own blood. Your blood is filled with many essential elements your body needs to maintain good health, including red blood cells, white blood cells, and platelets.

You may know that the platelets in your blood are needed to form blood clots to stop cuts from bleeding. But your platelets are also a source of growth factors and specialized proteins that help repair damaged tissues. 

By concentrating your body’s own healing properties and injecting them directly into the tissues that need them, PRP therapy supports and accelerates the healing process. 

Many famous athletes credit PRP therapy for helping heal their injuries and allowing them to get back to their sport a lot faster. 

Am I a good candidate for PRP?

Platelet rich plasma, or PRP, is an anabolic treatment that does not cause further harm to your joints, but can give symptomatic relief in the setting of arthritis and inflammatory joint disease.  The treatments are simple and quickly performed with little patient discomfort. 

Patients need to know that while there was much excitement about the growth factors that are found in platelets (which are dense-granule containing pieces of megakaryocyte cells like exosomes), PRP still struggles for any clinical indication. 

PRP likely has its best role for replacing catabolic treatments that cause further joint destruction and similar periods of short-term pain relief like corticosteroids (often called cortisone).  PRP costs more than corticosteroids but in terms of your joint’s health, it’s probably worth it.


What can I expect during PRP treatment?

Dr. Yeargan performs your PRP treatment at the office. To begin, he draws a sample of blood from your arm, which he then spins in a centrifuge to separate the healing properties from the other components in your blood.

Then he prepares your injection and administers it using ultrasound-guided imagery to ensure your PRP gets to the tissue that needs it. You may experience some redness after your injection, but this is to be expected.

Prior to your injection, Dr. Yeargan reviews how to prepare for your PRP, what to expect during your injection, and how to care for yourself following the procedure. Because PRP initiates an inflammatory response, he may suggest you refrain from using anti-inflammatory medication before and after your injection for a set period of time. 

Arthritis Treatments are either catabolic or anabolic.
Catabolic treatments kill the inflammatory response, which is also known as the healing response. These treatments are instantly detrimental to tissues like cartilage and cause more rapid progression of arthritis. Corticosteroid injections like ‘cortisone’ are catabolic treatments that have destructive consequences for the joint. Cartilage sparing treatments should not include corticosteroid treatments.

Anabolic treatments enhance the healing response through anti-inflammatory and immunomodulatory signaling pathways. These pathways stimulate cell proliferation, differentiation, growth and specialization. The pathways are mediated through biological processes that your body carries out when it heals naturally. Anabolic treaments activate second and third phase healing proteins that repair and regenerate, then remodel degenerative tissues.

Platelet Rich Plasma-Platelet rich plasma, also known as PRP is an anabolic treatment that has utility in the treatment of arthritis symptoms but does not address the cause the way that signaling cell treatments like the Nanoplastytm do. PRP has a role in the treatment of arthritis symptoms and short term results can be excellent in that setting.

Platelet rich plasma treatments do not contain the signaling cells necessary for complete repair and regeneration or remodeling. What they do contain is anabolic anti-inflammatory and immunomodulatory signaling molecules that fool the joint lining into thinking that it needs to focus on repair rather than letting the joint breakdown (the catabolic joint). PRP works really well for a short time and that makes sense from a scientific standpoint. If PRP is priced appropriately it is a really good value and can provide six months to a year of relief from the symptoms of arthritis. Most patients experience about six months of relief before they require another injection of PRP or another treatment to address their symptoms.

Results with PRP can be enhanced depending on the formulation used and the experience of the provider with patient selection in particular. The use of multiple other modalities in the setting of non-operative treatment for knee arthritis can amplify treatment results.

In summary, PRP is a relatively inexpensive, anabolic treatment for the symptoms of joint arthritis that won’t cause harm to your joint, may slow the progression of arthritis and avoids the sinister catabolic consequences of corticosteroid injections.


Amnionic Fluid Injections

Amnionic fluid contains hyaluronic acid, growth factors, cytokines and healing proteins that favor cell and tissue regeneration and convert the joint fluid from a catabolic breakdown destructive state to an anabolic state favoring repair rather than fusion. Amnionic fluid is a sourced allograft tissue which means it doesn’t come from you. It does have anti-inflammatory and immunomodulatory properites and it doesn’t carry the risk of transmission of genetic information from someone else’s potentially cancerous cells because there are no cells in it, live or dead. Amnionic fluid injections typically last around 3-6 months and are a relatively inexpensive option that may be indicated in some specific cases.


Umbilical Cord Products

Most clinics are using umbilical cord products with little to no proven efficacy. In our clinic, the only allograft products we use are acellular products to ensure there is no risk of transmission of malignancy to our patients.

Whenever other human cells are transplanted from one human to another, there is a risk of malignant transformation and antigen infection. While some companies proclaim that there are ‘more stem cells’ or ‘younger stem cells’ in umbilical cord products, these claims are false (Muschler, JBJS, 2018). We believe, as does the FDA, that there remains hidden danger when using these allograft cell products. The FDA has come out against these regenerative treatments in the name of patient safety and we will not offer them until they can be proven safe for our patients.

Wharton’s jelly contains the sought-after growth factors and healing proteins without the cell fraction and is an inexpensive option that lasts approximately 3 months where symptom relief for osteoarthritis is concerned in some limited clinical analyses. There may be benefit in these treatments for some patients.

Arthritis Treatments are either catabolic or anabolic. Umbilical cord cells are an anabolic treatment that is now offered in regenerative medicine clinics across the nation amid some deserved controversy. because it contains someone else’s genetic information that might result in the transmission of cancer cells. What’s more is that even though these treatments are cheap for clinics to buy, they are sold at ten times their cost and have no proven efficacy at all. To say that these treatments are ‘grasping at straws’ would be an understatement.

Corticosteroids are catabolic treatments. When most pain clinics say ‘stem cell treatments’ they are talking about an off-the-shelf product called “Wharton’s jelly” or “Umbilical Cord Stem Cells”. These products have not been proven safe or effective but their widespread use continues. There may be some clinical utility in the management of arthritis symptoms that has yet to be revealed and experimentation is ongoing. Any clinical utility comes from the immunomodulatory signaling cytokines, growth factors and healing proteins that are present in the suspension, not from the cells as advertised. They’re all dead.
Wharton’s jelly is extracted from the umbilical cord and processed to concentrate valuable healing proteins called cytokines and growth factors. In addition, the concentration of hyaluronic acid is high in wharton’s jelly. Hyaluronic acid activates a serine protease inhibitor that prevents destruction of the cartilage matrix.

Catabolic treatments kill the inflammatory response, which is also known as the healing response. These treatments are instantly detrimental to tissues like cartilage and cause more rapid progression of arthritis. Corticosteroid injections like ‘cortisone’ are catabolic treatments that have destructive consequences for the joint. Cartilage sparing treatments should not include corticosteroid treatments.

Anabolic treatments enhance the healing response through anti-inflammatory and immunomodulatory signaling pathways. These pathways stimulate cell proliferation, differentiation, growth and specialization. The pathways are mediated through biological processes that your body carries out when it heals naturally. Anabolic treatments activate second and third phase healing proteins that repair and regenerate, then remodel degenerative tissues.

Wharton’s jelly treatments, also known as Umbilical cord treatments or umbilical stem cells are allograft tissues, meaning they come from someone else. That doesn’t mean they are necessariliy bad, it’s just not your own body’s proteins and potentially someone else’s genetic material. No one really knows what the potential of these treatments is and more importantly, what the negative consequences could be.

Logically, these treatments should be relatively inexpensive as they are experimental and based more on hype than scientific evidence or even clinical accolades. Costs to clinics are roughly 1000-2000 with mark ups as high as 20k in some pain medicine clinics in North Carolina.

Wharton’s jelly or Umbilical cord treatments are often sold to patients as ‘regenerative medicine stem cell treatments’ which they are not. What they are is an anabolic allograft treatment that may have some utility in the treatment of arthritis symptoms but does not address the cause the way that signaling cell treatments like the Nanoplastytm do. The cells that may be present in the Wharton’s Jelly treatments are not alive but dead cells do carry the genetic material of other patients and that may be problematic and consquences potentially fatal in the case of neoplastic transformation (cancer).

Platelet rich plasma, or PRP is another anabolic treatment that has a role in the treatment of arthritis symptoms and has demonstrated short term results from three to six months can be excellent in that setting. The advantage of PRP over umbilical cord treatments like Whartons’s Jelly is that PRP is an autologous treatment, meaning that the proteins that drive the treatment results are taken from you, they don’t come from an unknown, but tested source.

Platelet rich plasma treatments do not contain the signaling cells necessary for complete repair and regeneration or remodeling and neither do umbilical cord products like Wharton’s Jelly. What they do contain is anabolic anti-inflammatory and immunomodulatory signaling molecules that fool the joint lining into thinking that it needs to focus on repair rather than letting the joint breakdown (the catabolic joint). PRP works really well for a short time and that makes sense from a scientific standpoint. If PRP is priced appropriately it is a really good value and can provide up to a year of relief from the symptoms of arthritis. Most patients experience about six months of relief before they require another injection of PRP or another treatment to address their symptoms. Wharton’s jelly is more expensive, unproven and potentially detrimental to patient health. Application of umbilical cord products should be carefully considered in each case.

Results with PRP can be enhanced depending on the formulation used and the experience of the provider with patient selection in particular. The use of multiple other modalities in the setting of non-operative treatment for knee arthritis can amplify treatment results. Wharton’s jelly and other umbilical cord treatments are not FDA regulated and the responsibility for product safety often relies on corporate ethics. Use is off-label and the treatment is experimental.

In summary, PRP is a relatively inexpensive, anabolic treatment for the symptoms of joint arthritis that won’t cause harm to your joint, may slow the progression of arthritis and avoids the sinister catabolic consequences of corticosteroid injections. Wharton’s jelly and other umbilical stem cell products do not contain live stem cells but may contain protein cytokines and other healing and growth factors that provide short term relief from the clinical symptoms associated with arthritis. Both are relatively low-cost, anabolic treatment options for arthritis.

What happens after PRP treatment?

Dr. Yeargan closely monitors your progress and healing following your PRP injection as you come in to see him for regular follow-up visits. Although not always needed, additional PRP injections may be recommended to get the most benefit out of your treatment.

To learn more about PRP from one of the leading specialists in the field, call The Regenerative Medicine Clinic.