Platelet Rich Plasma – PRP
Platelet Rich Plasma / PRP is platelet-enriched blood plasma used in tissue regeneration therapies. Blood from the patient’s own body (autologous) is used to harvest the cytokine-rich platelets that are the building blocks of growth and regeneration. Using a special centrifuge technique to harvest the platelets and form the concentrate, they then undergo a process of activation and are injected into the site of the injury, thereby stimulating the healing of bone and soft tissue.
With a proprietary technique used at SIR, activated PRP comes from the stimulation of harvested platelets, which immediately releases the 20+ cytokines from the cell membranes that then attract all of the body’s cells to the treatment site to expedite healing. Activation results in immediate degranulation of the cells to release the growth and healing factors, thus improving treatment efficiency.
At SIR, this new minimally invasive biotechnological procedure to use PRP is performed with imaging guidance for the treatment of tendonitis and osteoarthritis of major joints. It turbocharges the body’s natural healing processes and enlists the body’s own biochemistry for rapid repair of the damage, usually taking only weeks instead of months or even up to a year.
In some cases, PRP may be combined with adult stem cells, from either bone marrow (BMACs) or fat tissue (ADSCs), to create additional healing properties. The effects of stem cells taken from adipose and bone marrow are comparable, but method of harvesting the cells may be a determining factor in deciding which source to pursue.
PRP With Bone Marrow Aspirate Concentrate (BMAC)
PRP with bone marrow aspirate concentrate / BMAC contains abundant cells that may be used as the source of stem cells to aid the body in recovery, but the process of extracting stem cells from bone marrow requires general anesthesia due to pain associated with this procedure. Also, because the quantity of stem cells is drastically reduced as a person ages, the yield of stem cells in older patients may be low.
PRP With Adipose Derived Stem Cells (ADSC's)
PRP with adipose derived stem cells / ADSC refers to fat tissue in the body, which is extracted from the patient with a mini-liposuction method, broken down to remove the stem cells and separate them from the fat cells, then activated and injected back into the body or applied topically. At SIR, we have found that it is better to use ADSC because they are more accessible, and it is a safer procedure that requires only liposuction with local anesthesia. Our top-of-the-line technology carefully handles the fat that is extracted to protect the patient and avoid infection. We use “closed system” technology, which means that the extracted tissue does not come in contact with the outside environment.
Also, this system allows us to gain access to high numbers of stem cells that are viable to use, thus increasing the potential success of the treatment.
Steroid Injections – Anti-inflammatory
Inflammation is one of the body’s first reactions to injury and serves several important purposes, the first of which is to set off a series of bodily reactions to trap and remove bacteria, foreign particles, and tissue debris from the injured area. The pain and tenderness that accompany inflammation are strong reminders to the patient to protect the injured area, but the inflammation must be stopped to avoid counterproductive body effects, such as retarding blood flow to the injured area and delaying healing.
Steroid Injections of anesthetics and corticosteroids are used for fast-acting, short-term relief for inflamed joints, ligaments, and tendons. Corticosteroids (cortisone) are strong anti-inflammatory substances that offer significant relief with minimal discomfort to the patient. They are commonly administered into tissue around a ligament (especially the elbow, knee and ankle), tissue around a tendon (especially elbow, shoulder, and wrist) and directly into joints of the ankle, elbow, hip, knee, shoulder, spine, wrist, and even the small joints of the hands and feet.
SIR’s patient will receive consultation regarding the estimated term of relief with these injections, the role of these injections in a comprehensive treatment plan, and possible side effects and potential risks.
Alpha 2 Macroglobulin - A2M – PRP
A revolutionary new biologic treatment for OA is a protein that is present in the liver and is carried to other organs in the body thru the bloodstream. This protein, ALPHA-2-MACROGLOBULIN (A2M), is one of the largest and heaviest proteins made in the human body and has the capability to break down the body’s unneeded chemicals and molecules. Scientists at Cytonics Corporation discovered that A2M can capture and neutralize the chemicals created in an arthritic joint that cause destruction of the joint cartilage, thus halting the progressive damage that occurs in the osteoarthritic joint.
The process of harvesting A2M developed by Cytonics is the only system currently available that concentrates A2M to a level nine to ten times the concentration normally found in the blood stream and minimizes the collection of other proteins, platelets, and white blood cells. Other systems currently on the market leave in a high concentration of platelets and white blood cells in their preparations, with the white cells being very inflammatory in nature and destructive to the joint cartilage. The concentrated A2M is delivered directly to the knee or other affected joint via injection to slow or halt the progression of joint deterioration.
The Cytonics system marks the beginning of the era of targeted osteoarthritis therapy. In the first rollout to the public, Cytonics is allowing access to its proprietary process to selected physicians, and Dr. Grubbs at SIR is one of these selected physicians. At SIR, we have named this procedure the PLATELET + PLASMA + “PLUS” or the “3P” injection for osteoarthritis of the knee to signify that it is in the FDA-designated category of PRP but is truly more of a specialized protein “PLUS” injection. Again, this is truly unique among the others in this classification.
Synvisc For Knee Osteoarthritis
Knee osteoarthritis is a common joint disorder that occurs when the cartilage in the knee deteriorates and the joint (synovial) fluid breaks down. When the natural cushioning wears away, the bones in the knee begin to rub against each other and result in pain, inflammation, and stiffness. Knee osteoarthritis may be hereditary, or it may be caused as a result of an injury, infection, or even obesity.
At SIR, a minimally invasive technique called the Synvisc injection is used to treat knee osteoarthritis. (Synvisc has not been tested to show pain relief in joints other than the knee.) During Synvisc, a gel-like fluid is injected into the knee. This gel is made of a natural substance in the body called hyaluronan and acts as a lubricant in the joint. Synvisc is an outpatient procedure performed under CT guidance and takes about 30 minutes.