PRP THERAPY

PRP (platelet rich plasma) therapy takes advantage of the knowledge that our blood contains healing agents and growth factors that can initiate and support healing processes in the case of injuries or chronic diseases. Several studies have shown that PRP has a high density of cytokines that reduce inflammation, postoperative blood loss, scarring, and infection, and on the other hand, promote healing of bones, wounds, and muscle and soft tissue injuries. Thus, PRP treatment in joints, tendons, ligaments and muscles is a procedure that we use regularly.

The background to the mode of operation is that platelets (thrombocytes) obtained from the blood degranulate after injection, releasing various growth factors and cytokines (signaling molecules) that have a regenerative capacity. In addition, in osteoarthritis, the toxic inflammatory effect on cartilage cells is inhibited and PRP also increases the synthetic activity of cartilage. PRP thus improves the joint environment and protects it from further degeneration.

Due to the long known positive effects of hyaluronic acid on cartilage, a combination of hyaluronic acid and PRP is the best possible option to heal the joint as international studies show. Depending on the region and damage, it may be necessary to apply 3-6 times, 7-14 days apart.

How is the treatment performed?

The therapy with PRP can take place right in the office and does not require any preparation. However, drinking enough the day before the therapy (at least 3L of water) to get a sufficient amount of PRP is recommended. I prefer a technique which is called “Autologous conditioned serum” or ACS for short, because it is a closed and sterile circuit and therefore a safe system. For this purpose, 12 ml of blood is taken, which is then immediately processed and centrifuged to separate the red blood from the blood plasma with the platelets and growth factors. Especially, the so-called Interleukin 1 receptor antagonist, a very potent anti-inflammatory growth factor is obtained. The PRP thus obtained in a second internal syringe is then injected ultrasound-guided under sterile conditions into the affected joint, tendon, ligament or muscle.

ACS therapy works because the relevant growth factors in the blood, such as IGF-1, EGF or VEGF, are injected directly into the injured area and ensure that the healing process is initiated and accelerated. This procedure makes use of the body’s own regenerative powers with the advantage that no side effects occur.

After the procedure, there may be short-term swelling due to the volume, which may also be accompanied by a brief period of pain, depending on the damage. Loading is possible immediately, light training to increase blood flow is recommended.

ACS treatment is not considered doping and is not on WADA’s list of prohibited measures or substances because it is not an artificial administration or increase in the amount of growth factors. The treatment is therefore safe for professional and amateur athletes.

ACP Spritze 2 (Klein)
ACP-Zentrifuge 2 (Klein)

When is PRP used?

ACS or PRP is used primarily for chronic sports injuries and overuse syndromes.

Besides joint arthrosis are
chronic tendon injuries such as
Achillodynia,
Tennis elbow,
Patellar tendinitis or jumper’s knee,
Runner’s knee or also
Irritations of the long biceps tendon typical treatment fields.
But also small tears in the rotator cuff of the shoulder or even meniscus tears can be healed by PRP injections.

In addition to being used instead of surgery, ACS also improves the healing process postoperatively after tendon or ligament reconstruction, leading to faster resilience. Austria’s exceptional boxer Marcos Nader was thus able to win the IBF middleweight title only 10 weeks after suffering an Achilles tendon rupture.

In acute injury situations such as muscle tears or tendon and ligament tears, PRP also has the advantage of leading to faster tissue healing.
However, a controlled injection under ultrasound is essential to obtain the best possible result.

Angel Centrifuge

STEM CELL CONCENTRATES

A further development of the use of PRP is the extraction and administration of stem cell concentrates mixed with even higher concentrations of growth factors . This is done naturally by obtaining bone marrow instead of blood.

Stem cells are cells that not only self-replicate, but rather can differentiate into other cells. Stem cells repair, regenerate and have a strong anti-inflammatory effect by maturing into different cell types and influencing neighboring cell types by releasing signaling substances. Numerous publications have shown that the use of the body’s own stem cells does not produce any side effects, but even has a positive influence on the immune system. In addition to the local effect of stem cells, they are also attracted to inflamed, weakened or damaged tissue when injected into the bloodstream and then develop their regenerative effect locally.

Stem cell therapy is used to treat weak areas of the body that cannot regenerate on their own or with the help of other treatments.

As already mentioned, stem cells can be obtained either from bone marrow or from the body’s own fatty tissue. In each case, this requires a minimal procedure, whereby under local anesthesia and sedation, the bone marrow is aspirated and then mechanically processed in a centrifuge during the same procedure. The resulting concentrate is then injected into the affected area on the body.

The advantage of stem cell therapy is that no surgery is necessary and thanks to the minimally invasive procedure there is hardly any swelling. Furthermore, the risk of infection is negligible due to the complication-free and rapidly performed therapy and the anti-infective mechanism of action of stem cells and growth factors. The treatment is performed on an outpatient basis and allows a quick return to physical activities. Due to the regeneration of damaged tissue (skin, cartilage, tendons, intervertebral discs …), this type of therapy can also be combined with surgery for faster recovery.

WHEN CAN STEM CELL THERAPY BE USED?

Stem cells are used whenever there is tissue damage or inflammation. They are responsible for the regeneration and repair of body tissues so that body cells such as connective tissue, cartilage, tendons, heart, nerves and the skin are regularly renewed and repaired.

If there is tissue damage that the body can no longer reverse on its own or with the help of other treatments, and if the local stem cells are too weak or are no longer available in sufficient quantities, stem cell therapy supports the healing process through the guided administration of the body’s own healthy stem cells.

Due to the strong anti-inflammatory and regenerative properties of the body’s own healthy  stem cells, stem cell therapy opens up great possibilities for medicine.

Stem cells from bone marrow concentrate have become a key element of regenerative medicine due to their ability to differentiate into a variety of different cell lineages. In addition, their capacities of paracrine secretion of a wide range of cytokines, chemokines, and growth factors make them distinctly attractive for clinical application. Especially the anti-apoptotic (cell death), anti-inflammatory, vascular, immunomodulatory and scar-breaking effects make these cells very interesting for any kind of regenerative medicine.

Because adult mesenchymal cells (stem cells) are the most promising cell types for cell-based therapies and are present in bone marrow and fat unused, they are the starting tissue for a high-yield and relatively easily accessible source for regenerative cell derivation. The additional secretion of trophic factors as well as their immunosuppressive properties and low immunogenicity maximizes the therapeutic and regenerative outcome in a wide range of applications, making them very relevant for clinical applications. Consequently, the therapeutic potential is enormous and side effects can be virtually ruled out.

The field of application in orthopedics is large and comprehensive:

  • Muscle and tendon injury
  • Scar and wound healing
  • Bone regeneration
  • Cartilage Regeneration

Furthermore, stem cell therapy can also be successfully used for vascular diseases and neurological disorders.