PRP – Platelet Rich Plasma Therapy

What is Platelet Rich Plasma?

Platelet Rich Plasma therapy (PRP) is a groundbreaking non-operative treatment option that relieves pain by naturally promoting long lasting healing of musculoskeletal conditions. The platelets in your blood carry natural healing properties that help your body repair damaged tendons and soft tissue. They decrease inflammation, assist with cell growth/healing, and alert your immune system while also strengthening tissue.

Medical practitioners can use platelet rich plasma (PRP) injections to promote the healing properties of your own blood to help the body repair soft tissue damage. Currently, a growing number of people are turning to PRP injections to treat an expanding list of orthopedic conditions, including osteoarthritis. It is most commonly used for knee osteoarthritis, but may be used on other joints as well.

How is it done?

PRP begins by collecting blood from the patient similar to a clinic laboratory blood draw. The amount of blood needed is determined by the size of the area to be treated and the concentration of platelets desired. The blood is then placed in a centrifuge where it is separated into 3 components, the plasma portion of the blood, the PRP layer, and the cellular layer containing red and white blood cells. The PRP layer is then extracted to be used for injection.

Blood samples separated for PRP Therapy

PRP injections are completed using visualization techniques via ultrasound or fluoroscopy, so that the injection is administered exactly to the injured area of the body. Local anesthetic can be used at the site of the injection to minimize patient discomfort.

The patient is educated about activity restrictions and is often recommended to limit activity and WB for the next few days. The patient is encouraged to rest the area for a few weeks and then will begin the rehabilitation process following the procedure.

The patient is typically seen by the physician in the clinic for routine follow-up about 1 month after the injection.

The injections are completed as an outpatient procedure, and patients return home the same day. Additional injections may be needed depending upon how the tissue reacts to the initial PRP injection, you may need an additional injection. An evaluation will be done to see if the tissue is responding before a second procedure is planned. Your treatment plan will be discussed in detail following your injection.

What to expect after a PRP injection

Following the injection the injection site may become swollen and painful. This will hopefully replace chronic inflammation with a short period of acute inflammation and will also stabilize the tissues in the affected area. The area may be aching and throbbing for at least 24 hours, and this could last for up to 7-10 days. Tylenol or your prescribed pain medication can be used for post injection pain. Most patients begin see benefits approximately 4-6 weeks post injection.

Pre-Care and Post-Care Instructions for PRP treatment

Click on the headings below for additional information concerning pre- and post-care instructions to prepare for blood draw and PRP treatment.

Pre-Care Instructions to prepare for blood draw and PRP treatment

The American Academy of Orthopaedic Surgeons recommends patients adhere to the following pre-injection guidelines:

  • Avoid corticosteroid medications for 2-3 weeks prior to the procedure
  • Do not take anticoagulation medication like Coumadin/Warfarin, Plavix/Clopidogrel for 5 days before the procedure. (discuss with physician before discontinuation)
  • Stop taking non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, Motrin and Aleve, or arthritis medications such as Celebrex, a week prior to the procedure
  • In addition, high doses of some Vitamins and Supplements like Omega 3s can thin your blood so please avoid these
  • Drink plenty of fluids the day before and day of the procedure
  • You should not have PRP therapy if you have: Abnormal platelet function, Active systemic infection, Active cancer, Low-platelet count, Severe anemia, Hypofibrinogenaemia

During the course of your treatments, notify our staff of any changes to your medical history, health status, or personal activities that may be relevant to your treatment.

Post-Care Instructions after a PRP treatment

What to Expect after Treatment:
Immediately following the procedure, the most commonly reported temporary side effects are soreness, redness, swelling, tenderness, numbness and/or a feeling of pressure at the injection sites and/or treated area(s).

Discomfort/ Pain Management:
Cold gel packs/ice may be gently applied immediately after treatment to reduce swelling if needed. Tylenol and or prescriptions pain medication is recommended if needed for discomfort but avoid NSAIDs such as ibuprofen, Motrin and Aleve.

To Maximize Results and Prevent Complications:

  • Keep moving the joint and stretching with gentle active range of motion (AROM) exercises
  • Avoid strenuous exercise, heavy lifting, or impact activity for 1 week
  • Transition with non-impact activities with progressive resistance, duration, and intensity: elliptical trainer, stationary bike, deep water running before resuming full exercise regimen

Follow up Appointment/Treatment:
Most patients see improvement within 4-6 weeks with continued improvement for up to 12-16 weeks depending on the area treated. If the desired level of pain relief has not been reached within 4 weeks we recommend repeating the procedure at 4-6 week intervals until you achieve the result you desire for up to 3 treatments

PRP Common Treatment Areas

Click on the common treatment areas below for additional information on the various conditions PRP can be used for to treat pain.

Neck

  • Whiplash injuries
  • Headaches related to the neck arthritis

Back

  • Lower back pain
  • Facet joint arthritis
  • Pain associated with scoliosis

Shoulder

  • Arthritis
  • Rotator cuff tendinitis or tear
  • Rotator cuff impingement syndrome or Bursitis
  • Bicipital tendinitis
  • Labrum tears
  • Arthritis
  • Instability

Elbow

  • Arthritis
  • Bursitis
  • Lateral epicondylitis (Tennis Elbow)
  • Medial epicondylitis (Golfer’s Elbow)
  • Common extensor tendon injuries
  • Bicep tendon injuries
  • Triceps tendon injuries

Wrist/Hand

  • De Quervain’s tenosynovitis
  • Arthritis
  • Other wrist or finger tendinitis
  • Ligament tears or dysfunction of the fingers and tendon
  • Ligament or cartilage damage

Hip

  • Arthritis
  • Iliotibial band tendinitis (ITB Syndrome)
  • Psoas tendinitis and bursitis
  • Greater trochanteric bursitis
  • Hip labrum tears
  • Piriformis syndrome
  • Sacroiliac joint dysfunction

Knee

  • Arthritis
  • Patellar tendinitis (Jumper’s Knee)
  • Patella femoral syndrome
  • Chondromalacia of the patella
  • Partially torn or strained major ligaments of knee (ACL/LCL/MCL)
  • Meniscus tears
  • Patellar instability

Ankle/Foot

  • Plantar fasciitis
  • Achilles tendinitis
  • Peroneal tendinitis
  • Arthritis
  • Recurrent ankle sprains
  • Other foot or ankle tendinitis conditions

A2M (Alpha-2-Macroglobulin) Therapy

What is A2M Therapy?

Alpha-2-Macroglobuilin (A2M) is found in the blood and is the major non-immunoglobulin protein found in plasma protein. This substance can be used to treat osteoarthritis symptoms and may impact the progression of the disease. Alpha-2-Macroglobuilin (A2M) binds to the chemicals produced in the joints that degrade cartilage over time and neutralizes their degenerative effect.

Alpha-2-Macroglobuilin (A2M) can:

  • Stop the breakdown of cartilage and prevent cartilage loss
  • Halt the progression of osteoarthritis
  • Reduce the pain caused by osteoarthritis
  • Improve joint function
  • Promote tissue growth
  • Support the restoration of the affected joint(s)
Alpha-2-Macroglobuilin (A2M)

How does the A2M injection work?

A2M injection an office procedure that can be completed in addition to PRP injection. Blood is drawn from the patient and then processed in a centrifuge. The spinning of the blood will separate out two different types of plasma. Once the plasma is separated it goes through and additional filtration process to be able to isolate the A2M. A concentrated dose of A2M will then be injected back into the problem joint or joints.

Patients generally feel no inflammation or pain after the injection. More importantly they often note improved pain and mobility in the injected joint. The time frame of relief can vary based on age, severity of osteoarthritis, and several other factors. The goal is limit pain and improve function for a significant period of time and possibly delay the need for any surgical procedures.

Centrifuge spinning blood for A2M Therapy.

Bone Marrow Aspirate Concentrate (BMAC) Therapy

Bone Marrow Aspirate Concentrate (BMAC) Therapy

Dr. Brown is pleased to announce a new, cutting edge procedure we are offering to our patients – Bone Marrow Aspirate Concentrate (BMAC) therapy. This is a revolutionary regenerative therapy which accelerates the body’s healing abilities. It is a drug-free alternative to surgical intervention.

Is BMAC right for you?

BMAC therapy/stem cell therapy is a medication free and non-surgical treatment for people suffering from:

  • Lumbar disc degeneration
  • Osteoarthritis
  • Rotator cuff tears
  • Ligament injuries
  • Tendinitis
  • Muscle sprains and strains
  • Non-healing fractures
  • Plantar fasciitis
  • Sports injuries

Benefits of BMAC

Benefits of this regenerative medicine synthetic treatment and therapy include:

  • Decreased pain
  • Quicker recovery time
  • Alternative procedure to surgical intervention
  • Increased healing potential
  • May eliminate the need for long-term medication

Frequently Asked Questions

Below are some of the most frequently asked questions from patients interested in Bone Marrow Aspirate Concentrate Therapy. Click on a question to learn more.
  • Q: What is Bone Marrow Aspiration Therapy (BMAC)?

    BMAC therapy is a noninvasive procedure that Dr. Brown performs in an outpatient setting. Bone Marrow aspirate is directly obtained from a bone called the iliac crest (hip). Bone marrow houses stem cells which can form new cells, such as bone, cartilage, and muscle tissue. There are numerous growth factors and chemicals that promote healing in bone marrow aspirate.

    A special needle is used to gather the bone marrow which can collect a high concentration of stem cells and growth factors from your bone marrow. The newly concentrated stem cells and growth factors are then injected into the problematic area to stimulate cell regeneration.

  • Q: I have heard of cortisone injections. Is that the same thing?

    Studies have shown that cortisone injections may weaken tissue. Cortisone shots may provide temporary pain relief but do not promote long-term healing. Bone marrow stem cell and growth factor therapy is used to promote healing of the target tissues such as ligaments, tendons, cartilage, or discs.
  • Q: Does insurance pay for BMAC injections?

    No. Despite several recent publications in peer-reviewed journal showing the effectiveness of BMAC, it is not covered by insurance at this time. Compared to many prescribed medications and treatments, these procedures are not FDA approved for these diagnoses. Nevertheless, regenerative medicine has shown great promise in effectively treating these difficult-to-treat, painful and disabling conditions.
  • Q: How long does it take to “work”?

    Many patients will notice some level of improvement within 2-6 weeks. However, the full benefits of decrease pain and associated improvement in function may take 3-6 months.
  • Q: How many injections will I need? Are there other regenerative medicine options?

    We expect only to perform one BMAC stem cell and growth factor injection. Other options include PRP (platelet-rich plasma) injections, amniotic-derived tissue injections, or Prolotherapy.

Placental Tissue and Amniotic Products

Placental Tissue and Amniotic Products

The placenta (supporting the growth and development of the fetus) and the amniotic membrane (the inner layer of the placenta and amniotic fluid that surround the fetus) are rich in amino acids, peptides, vitamins, trace elements, growth factors, nutrients and biologically active components.

Recently placental and amniotic derived products have been promoted as providing live stem cell therapy. It has been shown by the Interventional Orthopedics Foundation and many other research laboratories that no live stem cells are derived from cryopreserved amniotic and placental products.

How does it work?

Regenerative medicine promotes the “process of replacing, engineering or regenerating human cells, tissues or organs to restore her establish normal function.”  This field holds a promise of engineering damaged tissues and organs via stimulating the body’s own repair mechanisms to functionally heal previously unrepairable tissues or organs.

One of these methods is placental tissue and amniotic products. If chronic soft tissue, joint, neck or back pain is preventing you from enjoying your life or threatening to result in surgery or joint replacement, placental tissue or amniotic products may be the answer for you.

Your body contains a variety of highly specialized cells that work together with other cells in your body to heal damaged tissues, and these products can facilitate this process.

Our joints, cartilage, ligaments, muscles and bones are constantly breaking down/deteriorating due to wear and tear and injury. Our body naturally helps rebuild and heal these joints with the help of a variety of cells and growth factors.

Unfortunately, as we age both the number and potency of our healing cells decrease in this regenerative process loses effectiveness. This helps explain why when we cut our finger at age 8, the wound heals quickly and without a scar, whereas the same cut finger at age 50 takes much longer to heal and may result in a scar.

In the simplest terms, placental and amniotic tissues takes advantage of your body’s ability to repair itself. With placental and amniotic tissues, a small amount of this tissue product is injected into your damaged joint, spine or wound.

Not only does placental or amniotic tissue therapy provide anti-inflammatory benefit seen with “cortisone injections” (“steroid shots”), it also has numerous other regenerative benefits that makes cellular therapy with placental or amniotic products a superior nonsurgical treatment for chronic joint pain, tendon tears, and cartilage damage .

Benefits of natural cells and biologic components

The natural cells and the other natural biologic components contained in placental tissue and amniotic products are:

  • Safe
  • Effective
  • Free of tissue rejection concerns because of amniotic cells immune privilege status
  • Easy to administer
  • Anti-inflammatory (reduces pain and stiffness)
  • Contain hyaluronic acid (improves joint mobility)
  • Contains growth factors that stimulate stem cells to work at maximum capacity
  • Do not require an invasive procedure to obtain
  • Less expensive and much less difficult to obtain than cells obtained by other methods such as bone marrow or liposuction
  • Commercially available and simple to use

Is it safe?

The fact that 1) placental tissue products come from the maternal placenta, 2) amniotic products are produced from the amniotic membrane and umbilical cord, and 3) amniotic fluid is disposed by hospital personnel after newborn delivery, eliminates ethical, political and moral concerns once associated with stem cell therapy.

Not only do the mothers who donate their placentas and amniotic fluid and membranes undergo rigorous health screening and have their pregnancy closely monitored, their baby must be born healthy and numerous other criteria must be satisfied in order for the placental and amniotic products to be accepted and processed by an FDA-cleared lab.

The possibilities with this cellular therapy are limitless. Treatment with placental and amniotic product therapy has the potential to dramatically improve, or even cure, hundreds of musculoskeletal, wounds and other conditions.

The role of cellular components and regenerative medicine “stems” from their ability to transform damaged tissue into healthy, revitalized (new) tissue. The placental and amniotic products are introduced in the body by injection to replace diseased or injured cells and body tissues or organs, where they then regenerate the damaged/unhealthy tissues (damage resulting from aging trauma, disease, etc.) into healthy cells and healed tissues.

Appointments

To make an appointment, call the office directly at (303) 945-4790 or request one through our online Patient Portal.

Patient Portal

Main Office

12596 West Bayaud Ave
Suite 205
Lakewood, CO 80228

Phone: (303) 945-4790
Fax: (877) 861-0393 or
(720) 645-1959

Office Hours

Monday - Thursday
8:00am - 5:00pm