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PRP Biologics 2

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Bennett Orthopedics and Sportsmedicine
Bennett Orthopedics and Sportsmedicine

PRP Biologics 2

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How is PRP Used? Office Setting- 50 minute procedure Phlebotomist Centrifuge Injection Sonosite MSK Ultrasound Surgical Adjunct- adds some time PRFM-platelet rich fibrin matrix Activated PRP-gel form Unactivated PRP-Liquid Form Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
How is PRP Processed? -Draw 20-60-120 cc’s venous blood -Blood is placed into a centrifuge -Separates RBC’s from plasma and WBC’s and platelets -Platelets and some WBC’s suspended in plasma -Forms a concentrate of platelets in a small amount of plasma for injection -PRP is then injected into affected site. -Usually 2-3 injections may be required. -Patients begin to respond within the first week. Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
PRP Blood Draw Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
Steps-Blood Prep 1 2 3 4 Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
Steps-Centrifuge 5 6 7 8 8 Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
Preparing PRP Video Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
Arthrex ACP Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
What can be Treated with PRP? Tendon Injuries Tennis Elbow Golfer’s Elbow Jumper’s Knee Plantar Fasciitis Rotator Cuff Tears Ligament Injuries Medial Collateral Ligament Anterior Cruciate Ligament Tears Cartilage Injuries Chondromalacia Meniscal Injuries Osteoarthritis Bone Non-Unions Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
PRP Studies-as of 2011 International Cartilage Repair Society, 10th World Congress, Montreal 2012 copyright 2012
Office Examples Injection Ultrasound Guided Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
PRP-Tennis Elbow Injection Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
PRP-Knee-Injection Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
SONOSITE MSK Ultrasound Military Development Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
Ultrasound Posterior Labrum Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
Ultrasound Elbow Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
PRP-Tennis Elbow Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
Ultrasound Proximal Biceps Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
Ultrasound Distal Biceps Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
Ultrasound/PRP Distal Biceps Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
Ultrasound-PRP-Gluteus Medius Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
Injections/Response Time From 1-3, depending on Condition Local Anesthetic, for tendon injuries Time to response varies, 2 days to 3 months Can worsen symptoms up to 2 weeks May not need to cease activity Duration-data is evolving Bennett Orthopedics and Sportsmedicine copyright 2012
PRE-POST Knee X-rays 64 year Old Female Tennis player 6 months post-PRP injection x 3 Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
Close-Up-Right 8/2010-Pre-Right 2/2011-Post-Right Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
Close-Up Left 8/2010-pre-left 2/2011-post-Left Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
My Experience > 6 years 90 percent+ responders- all conditions 7 percent overall failure rate-all conditions 70 percent improvement with one injection in Osteoarthritis or Chondromalcia 90 percent plus with 2nd and 3rd injection in Osteoarthritis and Chondromalcia 5 percent repeat injections, only Osteoarthritis or Chondromalcia Degradation of response in Osteoarthritis and Chondromalcia does not go to zero Duration-Osteoarthritis and Chondromalcia-85 percent 18 months or more Tendon/Labrum/Meniscus- 70-80 percent responders-takes longer~ 3 -4 months Bennett Orthopedics and Sportsmedicine copyright 2012
OsteoArthritis Studies- PRP International Cartilage Repair Society, 10th World Congress, Montreal 2012 copyright 2012
PRP and Osteoarthritis International Cartilage Repair Society, 10th World Congress, Montreal 2012 copyright 2012
Osteoarthritis Positive PRP Fortier, 2011 International Cartilage Repair Society, 10th World Congress, Montreal 2012 copyright 2012
PRP Duration Kohn, Italy, 2011 International Cartilage Repair Society, 10th World Congress, Montreal 2012 copyright 2012
PRP-Duration-Cartilage Damage/Early and Advanced Osteoarthritis Kohn , Italy 2011 International Cartilage Repair Society, 10th World Congress, Montreal 2012 copyright 2012
PRP and Hyaluronic Acid Lubricating Injections Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! Copyright 2012 A Randomized Clinical Trial Evaluating Plasma Rich in growth Factors(PRGF-Endoret) Versus Hyaluronic Acid in the Short-Term treatment of Symptomatic Knee Osteoarthritis Sanchez M, Arthroscopy, August Vol.28, No. 8 2012 Hyaluronic Acid Reduction in pain. PRGF- High percent reduction in pain PRGF lasting out to 24 weeks
Hype?Orthokine-Germany-ACS Kobe/ARod/Couples International Cartilage Repair Society, 10th World Congress, Montreal 2012 copyright 2012
Kobe/A-Rod/Couples ACS-ORTHOKINE International Cartilage Repair Society, 10th World Congress, Montreal 2012 copyright 2012
PRP-Summary Fairy Tale or Fairly Useful? Anti-Inflammatory-although early can be increased Catabolic to Anabolic Synovial Cells Secrete Hyaluronic Acid Target Cells All Respond Recruit Stem Cells Bennett Orthopedics and Sportsmedicine Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
Fairly Useful? No. Very useful!!!! Can help to avoid surgery Requires the proper use of PRP Which requires variations in concentrations or substances for various injuries May require various compositions in a temporal fashion as well copyright 2012 Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You!

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PRP Biologics 2

  • 1. How is PRP Used? Office Setting- 50 minute procedure Phlebotomist Centrifuge Injection Sonosite MSK Ultrasound Surgical Adjunct- adds some time PRFM-platelet rich fibrin matrix Activated PRP-gel form Unactivated PRP-Liquid Form Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 2. How is PRP Processed? -Draw 20-60-120 cc’s venous blood -Blood is placed into a centrifuge -Separates RBC’s from plasma and WBC’s and platelets -Platelets and some WBC’s suspended in plasma -Forms a concentrate of platelets in a small amount of plasma for injection -PRP is then injected into affected site. -Usually 2-3 injections may be required. -Patients begin to respond within the first week. Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 3. PRP Blood Draw Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 4. Steps-Blood Prep 1 2 3 4 Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 5. Steps-Centrifuge 5 6 7 8 8 Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 6. Preparing PRP Video Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 7. Arthrex ACP Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 8. What can be Treated with PRP? Tendon Injuries Tennis Elbow Golfer’s Elbow Jumper’s Knee Plantar Fasciitis Rotator Cuff Tears Ligament Injuries Medial Collateral Ligament Anterior Cruciate Ligament Tears Cartilage Injuries Chondromalacia Meniscal Injuries Osteoarthritis Bone Non-Unions Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 9. PRP Studies-as of 2011 International Cartilage Repair Society, 10th World Congress, Montreal 2012 copyright 2012
  • 10. Office Examples Injection Ultrasound Guided Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 11. PRP-Tennis Elbow Injection Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 12. PRP-Knee-Injection Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 13. SONOSITE MSK Ultrasound Military Development Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 14. Ultrasound Posterior Labrum Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 15. Ultrasound Elbow Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 16. PRP-Tennis Elbow Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 17. Ultrasound Proximal Biceps Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 18. Ultrasound Distal Biceps Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 19. Ultrasound/PRP Distal Biceps Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 20. Ultrasound-PRP-Gluteus Medius Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 21. Injections/Response Time From 1-3, depending on Condition Local Anesthetic, for tendon injuries Time to response varies, 2 days to 3 months Can worsen symptoms up to 2 weeks May not need to cease activity Duration-data is evolving Bennett Orthopedics and Sportsmedicine copyright 2012
  • 22. PRE-POST Knee X-rays 64 year Old Female Tennis player 6 months post-PRP injection x 3 Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 23. Close-Up-Right 8/2010-Pre-Right 2/2011-Post-Right Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 24. Close-Up Left 8/2010-pre-left 2/2011-post-Left Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 25. My Experience > 6 years 90 percent+ responders- all conditions 7 percent overall failure rate-all conditions 70 percent improvement with one injection in Osteoarthritis or Chondromalcia 90 percent plus with 2nd and 3rd injection in Osteoarthritis and Chondromalcia 5 percent repeat injections, only Osteoarthritis or Chondromalcia Degradation of response in Osteoarthritis and Chondromalcia does not go to zero Duration-Osteoarthritis and Chondromalcia-85 percent 18 months or more Tendon/Labrum/Meniscus- 70-80 percent responders-takes longer~ 3 -4 months Bennett Orthopedics and Sportsmedicine copyright 2012
  • 26. OsteoArthritis Studies- PRP International Cartilage Repair Society, 10th World Congress, Montreal 2012 copyright 2012
  • 27. PRP and Osteoarthritis International Cartilage Repair Society, 10th World Congress, Montreal 2012 copyright 2012
  • 28. Osteoarthritis Positive PRP Fortier, 2011 International Cartilage Repair Society, 10th World Congress, Montreal 2012 copyright 2012
  • 29. PRP Duration Kohn, Italy, 2011 International Cartilage Repair Society, 10th World Congress, Montreal 2012 copyright 2012
  • 30. PRP-Duration-Cartilage Damage/Early and Advanced Osteoarthritis Kohn , Italy 2011 International Cartilage Repair Society, 10th World Congress, Montreal 2012 copyright 2012
  • 31. PRP and Hyaluronic Acid Lubricating Injections Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! Copyright 2012 A Randomized Clinical Trial Evaluating Plasma Rich in growth Factors(PRGF-Endoret) Versus Hyaluronic Acid in the Short-Term treatment of Symptomatic Knee Osteoarthritis Sanchez M, Arthroscopy, August Vol.28, No. 8 2012 Hyaluronic Acid Reduction in pain. PRGF- High percent reduction in pain PRGF lasting out to 24 weeks
  • 32. Hype?Orthokine-Germany-ACS Kobe/ARod/Couples International Cartilage Repair Society, 10th World Congress, Montreal 2012 copyright 2012
  • 33. Kobe/A-Rod/Couples ACS-ORTHOKINE International Cartilage Repair Society, 10th World Congress, Montreal 2012 copyright 2012
  • 34. PRP-Summary Fairy Tale or Fairly Useful? Anti-Inflammatory-although early can be increased Catabolic to Anabolic Synovial Cells Secrete Hyaluronic Acid Target Cells All Respond Recruit Stem Cells Bennett Orthopedics and Sportsmedicine Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You! copyright 2012
  • 35. Fairly Useful? No. Very useful!!!! Can help to avoid surgery Requires the proper use of PRP Which requires variations in concentrations or substances for various injuries May require various compositions in a temporal fashion as well copyright 2012 Bennett Orthopedics and Sportsmedicine Regenerating the Youth in You!