Both
stem cell and PRP therapy have been in use for quite some time now. In the
past, the products were very difficult and expensive to extract and utilize,
limiting benefits and availability to only professional
athletes. Now, with newer technologies, harvesting techniques, and
manufacturers producing more affordable and advanced equipment, these products
can more easily be obtained and put to use for your benefit.
Biological
Benefits
·
Growth factors to signal cell recruitment and stimulate tissue repair
pathways
·
Stem cells to give added cell signaling power to supercharge tissue
repair pathways (note: includes bone marrow concentrate and amniotic
membrane-derived injections
Treatment Options
Platelet-rich
plasma (PRP) therapy
PRP uses a patient's own
blood components to stimulate a healing response in damaged tissues. In
response to an injury or tissue damage, your body naturally recruits platelets
from the blood to initiate a healing response. Under normal conditions, platelets
store numerous growth factors that are released in response to signals from the
injured tissue. Modern technology allows us to concentrate platelets from your
blood, and induce this growth factor release as we inject the solution directly
into your shoulder joint, simulating this same healing response in a more
powerful form to relieve shoulder arthritis pain. By enhancing the body's
natural healing capacity, the treatment may lead to a more rapid, more
efficient, and more thorough restoration of the joint's biologic
environment's to a more healthy state.
Bone
Marrow–Derived Stem Cell Therapy
It is well established
that a significant population of our body’s stem cells are contained within our
bone marrow. By harvesting blood and tissue from the bone marrow of the hip, an
injectable product can be produced by concentrating platelets and cells
withdrawn through a needle aspiration procedure done with local anesthetic in
the office procedure room. Bone marrow-derived stem cell therapy contains all
of the growth and healing factors in PRP, along with concentrated mesenchymal
stem cells, which further contribute to the regenerative process.
Amniotic–Derived
Stem Cell Therapy
Processed
tissue derived from human amniotic membrane includes adult epithelial
stem cells and growth factors. The product is derived from the
placenta's amniotic membrane obtained from volunteers after childbirth, from
tissues that would otherwise be thrown away. Amniotic membrane
provides an enhanced environment for tissue growth, repair, and healing along
with anti-inflammatory and anti-scarring properties. This
combination of properties is excellent to aid in relieving shoulder pain due to
arthritis.
Treatment plan
Depending on the severity
and duration of your injury, one to three injections are suggested. Following
the initial treatment, a follow-up visit occurs 3-4 weeks later. At this visit
an evaluation of your response to the initial therapy is performed and a
decision will be made regarding the potential need for additional treatments.
Frequently Asked
Questions
Are these treatments
safe?
Research and clinical
data show that these therapies are extremely safe, with minimal risk for any adverse
reaction or complication. There is a small risk of infection from any injection
into the body, but this is rare.
Are these stem cells
the same as embryonic stem cells?
No. The stem cells
obtained from your bone marrow or from amniotic tissue are adult stem
cells. There is no ethical or FDA concern about the use of these
stem cells as opposed to either embryonic stem cells or so-called “more than
minimally manipulated” adult stem cells, both of which we do not offer as
treatments.
What should I expect
after my stem cell or PRP treatment?
Often, following the
initial injection, an "achy" soreness is felt at the site of injury.
This "soreness" is seen as a positive sign that the healing response
has been set in motion. This effect can last for several days and gradually
decreases as healing and tissue repair occurs. It is important that
anti-inflammatory medications such as Ibuprofen, Naproxen and Aspirin be
avoided following treatments. These medicines may block the effects of the
intended healing response facilitated by the injection itself. It is acceptable
to use over-the-counter pain medication, such as Tylenol and in some cases a
prescribed analgesic, which does not have anti-inflammatory properties, to
control discomfort as needed. Your physician will discuss pain
management options with you. You may be permitted to resume normal day to day
activities and light exercise soon after the injection. More strenuous exercise
typically should be avoided for 4-6 weeks.
If the in-office stem
cell or PRP therapy procedure does not work as well as I hoped can I still have
surgery?
Yes. For those patients
wanting to do everything they can to avoid surgery, stem cell or PRP therapy
should definitely be considered before surgery if your diagnosis is an appropriate
indication for treatment. There is nothing about these procedures
that would preclude you from having surgery in the future if pain persists or
worsens over time.
How long does it take
to notice improvement after treatment?
Stem cell and PRP therapy
work by decreasing inflammation and improving the biological environment of
your joint. As such, results do not usually occur
overnight. Some individuals start to feel better in less than a
week, but this is variable per patient. The tissue reparative
process takes 2-3 months. Various factors such as age, physical
activity level, nutrition, and the disease state of the joint being treated,
may all effect an individual’s response and rate of symptom improvement.
What should I expect
after treatment?
You may experience some
pain and soreness for 2-7 days. The initial inflammatory phase may last up to 7
days, and the secondary phase may last up to 14 days.
You may utilize Tylenol
for pain, and/or ice as needed for pain and swelling (30 minutes on, 30 minutes
off), repeat as needed.
Some patients soon after
injection will feel great one day, and for no apparent reason the area treated
may begin to experience pain again. This is a normal part of the healing
process. However, if you experience any excessive pain or swelling, or have any
concerns, do not hesitate to contact your physician.
My goal is to achieve an
80% improvement in arthritis pain, if possible, and this may take only 1
injection or up to 3 over the course of 3-6 months. Results can vary
greatly based on many patient factors such as severity of the arthritis,
activity level, nutrition, overall health status, and lifestyle.
Michael A.
Cohn, M.D.
Orthopedic
Surgeon
Shoulder,
Elbow, Wrist and Hand Surgery
Orthopedic
Center of Palm Beach County
(561)
967-6500
