| By, Dr. Vijay D ShettyFull-time consultant Orthopaedic Surgeon
 Founder member, Biologic Orthopaedic Society.  Los Angeles, USA
  A number of orthopaedic and sports conditions remain  a major therapeutic challenge to Orthopaedic surgeons even this day-and-age of  technological advance. Some of these difficult conditions include plantar  fasciitis (chronic pain in the sole of the foot), tennis elbow (chronic pain in  the elbow), ligament and muscle injuries (around the knee and other joints) and  Tendo-achelles (heel) injuries. Persistent symptoms, due to these conditions,  in young sporty individuals have lead to premature ending of their competitive  careers. Sports medicine experts all over the world, for a very long time, have  been looking at the various options available to treat these conditions  effectively. In this direction, Platelet-rich plasma (PRP) therapy is taking  the sports medicine world by storm, as is seen in recent years. PRP is now being  effectively used to mend ligaments and repair tendon injuries; thanks to the  recent technological surge.  PlateletsPlatelets are  small disk or plate-like structures normally found in blood. They are tiny  cells, yet powerful, that are partially responsible for blood clotting (stops  bleeding), and are critical in healing process. They promote more rapid healing  by secreting healing and growth factors and there by enhance recovery.  Platelet-rich plasmaPlatelet-rich plasma is the name given to plasma (normal component of blood)  with a high concentration of platelets. When blood, taken from the patient is  placed into a tube and spun in a centrifuge (a device that spins), it separates  the blood into several different components, one of which is called as platelet-rich  plasma. Each cubic millimeter of this plasma solution can contain 1.5 to 2  million platelets. These concentrated platelets contain huge doses of very  important bioactive proteins,  such as growth factors, that are necessary for the repair and regeneration of tissues.  These special proteins can also initiate new blood vessel formation, bone  regeneration and healing, connective tissue repair and endorse overall wound  healing.
 
 Platelet-rich plasma therapy (Biologic  therapy)Whole blood (about 30 ml) is drawn from the patient, prior to the injection, in  the blood bank. The blood is then centrifuged to separate the plasma (buffy  coat) from the blood. This concentrate, which contains platelets and growth  factors (multiplied several fold), is then mixed with activating agents and is  injected back into the patient’s own damaged tissue where it begins to initiate  the process of repair. The repair  response in the injured tissue is kick-started by the formation of a  blood clot. This is then followed by the implanted platelets being dissolved,  triggering the release of growth factors which in turn leads to the formation  of a fibrous scar tissue. Eventually the injured tissue is completely replaced  by healthy cells.
 
 Safety of PRPThe chances of an adverse reaction is completely nullified because the  components used for treatment are derived from a person’s own body. This makes  the procedure entirely safe. Thus there is NO RISK of transmission of disease.
 
 A word of CautionPRP therapy is not a quick fix.  Regeneration of injured tendons and liaments will take time. Physical therapy  may be continued a week after the procedure. A patient who has undergone PRP  therapy may initially suffer some soreness or discomfort, especially at the  injection site. Local icepacks and analgesics will help to resolve these  symptoms.BenefitsEarly results with PRP treatment are very encouraging. Research indicates that  the procedure will gain prominence as the first choice of treatment, for many of  the conditions listed above, for reasons both medical and financial. Some of  the highlights of PRP are the following:•   Non-operative treatment•   Based on body’s own healing potential
 •   Can be considered when all doors are  shut
 •   Cheap compared to any other surgical  procedures
 •   The entire procedure (admission,  injection, recovery and discharge) lasts for not more  than four hours
 •   It may reduce or even completely eliminate the  need for complicated treatments like, aggressive medications or surgery
 The futureAlthough  PRP therapy is gaining popularity in sports medicine, it’s use is fast  spreading into other fields including dentistry, heart surgery and wound  healing. It is exciting to learn that researchers are looking into its role in  regenerating bone or helping arthritis. As both research and experience move  forward, doctors see a wide range of clientele and applications on the horizon  for PRP. A new international society, dedicated to research into the use of  biological therapies in orthopaedics, was formed in the USA recently,  of which the author is a founder member. PRP  Blog:  BloodCure.com PRP  website:  ApexPRP.com
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