Platelet Rich Plasma Therapy
~ Cutting Edge Technology
The art and science of orthobiologics, which combines the body’s natural ability to heal itself and the use of stem cells and advanced medical technologies to repair and heal orthopedic injuries. By definition, orthobiologics is the inclusion of biology and biochemistry in the development of bone and soft tissue replacement materials for skeletal and tissue healing.
The use of orthobiologics in the treatment of foot and ankle injuries, both in the clinical and surgical venues, is significantly increasing. The clinician and the surgeon continue to seek better ways to accelerate and mediate healing of bone and soft tissue, while incorporating less invasive techniques. The use of Platelet-Rich Plasma (PRP) therapy by Dr. Soomekh over the last several years has emerged in the forefront of biologic tools in this endeavor. Its use has been investigated in the treatment of bone healing (intra-operative fusions and fractures), tendon repair, and wound healing. PRP has been studied and utilized for the last 4 decades. Its use is based on the idea that increased concentrations of the bodies own platelets that then yield high concentrations of growth factors and other proteins leads to enhanced healing of bone and soft tissue on a cellular level.
The Basic Science of Platelets
Within our blood there are many types of specialized cells each having a particular job to do. Platelets are cells in our blood that produce special proteins called growth factors. These growth factors are responsible for healing damage to tissues and wounds and clotting.
They contain products called cytokines and granules containing more than 30 proteins that play a pivotal role in soft tissue healing and clotting. These proteins secreted by the granules within minutes after the platelets are called to action. Some of these products are:
- Platelet-derived growth factor (PDGF)
- Insulin-like growth factor (IGF)
- Vascular endothelial growth factor (VEGF)
- Epidermal growth factor (EGF)
- Epithelial cell growth factor
These growth factors directly affect other cells to initiate their growth and healing. The cells that these factors act on those that become bone, cartilage, muscle, tendon, and skin.
At the moment of tissue injury, the inflammatory phase, platelets are activated. They begin to produce their healing products. They also produce produtcs that will increase blood flow to the injured site, allowing even more platelets to reach the injury.
The Basics of Platelet Rich Plasma Therapy:
When there is an initial injury to part of the body, platelets will rush to the area of injury to begin the healing process. When they reach the site of injury, they release their special growth factors (ie: This is part of what is called inflammation. This is true for a new or what is called “acute” injury. In cases of long standing injury or “chronic” injury, there is less inflammation and a low concentration of platelets around the site of injury. In effect, the injury is not being aided by healing factors because it is now an “old” injury.
The idea behind injections of platelet-rich-plasma therapy is to purposefully introduce an increased concentration of the patient’s own platelets into the site of injury. Once there are more platelets around the area, there are then more healing factors in the area, creating an environment that can promote healing. Additionally, the simple act of the needle being introduced several times into the site of injury will stimulate and injure the tissue. The body will think this area is now a new injury. Effectively taking and old chronic injury and changing it to a new acute injury, while at the same time introducing even more platelets. It now is the job of the patient’s own body to heal the inured site.
Collecting the Platelet Rich Plasma
The process of acquiring the platelets is simple. It is all done in the office setting. There is no need for an operating room. The process will take about 20 minutes. Whole blood is drawn from the patient’s arm, in the same way one gives blood at the family doctor’s office. The patient’s blood is then spun down in a centrifuge in order to separate the platelets from the rest of the cells in the blood. The high concentration of platelets is now collected in a syringe ready to be injected into the site of injury.
After the injection has been introduced into the tissues, placing the patient into a special walking shoe or boot for a period of time protects the area. The injured site must be protected during this new healing phase, in order to give it the best chance to heal properly.The PRP will be acting on the tissue for several days and weeks, as the tissue heals and regenerates.
Uses of PRP Therapy in the Foot & Ankle
- Chronic Plantar Fasciitis
- Chronic Achilles Tendinosis
- Big Toe Joint Arthritis
- Ankle Joint Arthritis
- Chronic Joint Pain and Arthritis
- Chronic Tendon Tears
- Chronic Ankle Ligament Tears
- Chronic Wounds
Those patients that have failed conservative therapies are good candidates for platelet rich plasma injections.These injections are a midway approach to solving chronic injuries between conservative care and performing surgery.
Why Choose Dr. Soomekh For your PRP Therapy?
Dr. Soomekh has been offering Platelet rich plasma therapy for many years with excellent results. Patient selection and the determination of the correct situation to implement PRP are crucial to its success. Dr. Soomekh has been perfecting the technique and has written many publications on the subject of PRP. He is recognized by his peers as one of the top PRP specialists in the Los Angeles area.