The study was particularly interesting because a series of MRI scans were also performed and these showed that no deterioration in the arthritis occurred in the knees injected.

COMMENT:

This is a very interesting and illuminating research paper.  We are using PRP injections as a joint preserving treatment in selected patients with knee arthritis and are monitoring our results carefully.

Platelet-rich plasma (PRP) injections are a biological therapy that can be used to treat a variety of conditions. The material injected is derived from the patients own blood.  The treatment relies on the fact that normal blood contains cells called platelets that are rich in growth factors. These cells can be concentrated as PRP and then injected into the affected area to induce a healing response that helps to relieve pain.

What can PRP treat?

We use PRP injections for two main conditions:

–Tendon problems (tendinopathies) such as Patella tendinopathy, Tennis elbow and achilles tendinopathy, that have failed to respond to other treatments. Before we recommend PRP we conduct a thorough assessment which may include appropriate scans to confirm the diagnosis.  We do not usually recommend it as a first-line treatment, but rather consider it once a course of physiotherapy has proved unsuccessful.

–Arthritis – PRP injections can help relieve pain in arthritic joints.  This is a relatively new use for PRP but one that has been researched in some detail and has shown great promise in many patients that we have treated.

What is the process?

Before starting a course of Platelet-Rich Plasma injections we advise the patient that any anti inflammatory medications should be stopped at least 10 days prior to the first injection.

The PRP injection is performed in our outpatient clinics.  The whole procedure takes about 45 minutes, with most of this time spent preparing the PRP for injection.

First we draw some blood from the patient under strict sterile conditions.  The precise amount varies depending on the area being treated.  The blood sample is then spun down in a centrifuge to separate the blood components.  The Platelet-Rich Plasma (PRP) component is separated and is injected under sterile conditions either with or without the use of ultrasound guidance, depending on the location. The platelets need to be activated to release the healing growth factors, and this usually happens when they come into contact with the damaged tissue.

No specific restrictions on activity are necessary after the injection, but we certainly do not recommend that patients be any more active than they are usually.  We also advise our patients that in some cases a temporary flare-up in symptoms may occur lasting a few days, as the healing process is stimulated.  This is not common.

Patients are reviewed after 4 weeks or so to look at the response.  Further injections can be performed.

For further details about viscosupplementation as a treatment please click here to view an informative brochure.

SWT (shock wave therapy) is a revolutionary non-invasive technology that we use to treat various tendon conditions. It involves mechanical shock waves being passed through the skin to the injured part of the patient’s body. Don’t worry, the shock waves are not usually painful and no anaesthetic is required.

SWT offers  a number of benefits as a treatment:

• No need for an anaesthetic
• Non-invasive procedure
• No need for surgery or medication
• Treatment sessions last for an average of only 20 minutes (not including assessment)
• No hospital admission
• Temporary pain-relieving effect after treatment
• No lengthy rehabilitation, loss of mobility or time away from work
• Fewer complications than surgery or injections
• Strong clinical results

We have been using this treatment for 6 years and have found it to be an excellent and very effective treatment for a wide variety of tendon conditions that have proved resistant to other forms of treatment. Some of the patients that we have successfully treated were facing surgery until we offered them this revolutionary option.

Clinical trials have shown the Swiss DolorClast (the machine that we use) to be successful in treating a variety of painful tendinopathies and orthopaedic indications in the foot, ankle, knee and upper limbs.

What conditions that can be successfully treated with SWT ?

• Achilles tendinopathy
• Plantar fasciitis
• Tennis elbow
• Golfers elbow
• Calcific tendonitis of the shoulder
• Trochanteric bursitis (greater trochanteric pain syndrome)
• Patella tendinopathy
• Shin splints

The shockwaves are delivered by a handpiece.  When the handpiece is placed on the surface of the skin the impulses are delivered through the skin as a small shockwave that spreads inside the injured tissue. The shockwaves prompt the body to respond naturally by increasing blood circulation, the number of blood vessels and therefore metabolism in the injured tissue. This accelerates the body’s natural healing process by increasing new cell generation and dissolving calcium deposits.  Patients often notice an immediate pain relieving effect after the treatment.

A course of three treatments are required spaced apart by approximately a week.  Patients should not take anti-inflammatory medication for at least 10 days before the first treatment and throughout the course of treatment as these can interfere with the healing effects of the treatment.

Although many of the major medical insurance companies in the UK have approved the treatment method and will reimburse for some indications accordingly, patients are urged to check with their insurer before commencing treatment.

For those who are not insured, we offer a comprehensive and competitive self-pay package of treatment.

This is a very interesting study as contributes to the increasing body of knowledge about the usefulness of PRP in the treatment of arthritis.

We are currently using PRP injections in selected patients with knee arthritis as a joint-preservation strategy.