Monday, February 15, 2010

Public Perception of Platelet-Rich Plasma

Does the use of platelet-rich plasma by professional athletes, change public perception about effectiveness and application? While hundreds of sources (including this blog) have differentiated platelet-rich plasma therapy from steroid use and blood-doping, many remain unaware of the differences. Other posts on this blog explain the different aims and means of PRP compared to illegal substances used in sport. Thus, this post contends that in the current age of professional athletics, where fans' heroes may have cheated their games, the use of PRP by athletes may create public skepticism. While this may be considered a negative result, it also serves to build awareness about PRP and encourage further public investigation. Because the true beneficiaries of platelet-rich plasma will be the working and active public, it the duty of doctors and writers to properly fill the informational gaps that exist as a result of mass-appeal reporting on this therapy.

The public knows pro athletes rely heavily on their bodies ability to perform at intensely high levels. This has conflicting implications: fans know athletes need to be healthy to perform and they know some are willing to test ethical boundaries to gain a physical advantage. For the kind of money pro athletes compete for, few are surprised that these boundaries are crossed and many people are quick to jump to uneducated conclusions about PRP.

An example of these overly quick judgments occurred in December when Tiger Woods was implicated by many bloggers and writers, to having used steroids when he received PRP injections in his surgically repaired knee. CNN's Anderson Cooper accurately distinguished between the two soon after.

It could also be argued that the public perceives treatment effectiveness favorably when athletes credit PRP for their hastened return following injury. This also has negative implications because in such cases, PRP is used simultaneously with other accepted and experimental therapies. To what degree PRP was used in relation to other therapies and recovery procedures, is not reported. There is no way of discerning to what extent PRP actually influenced the recovery in these instances.

In the last four months alone, it has been revealed John Daly, Joakim Noah, Brandon Roy, Blake Griffin and Chris Canty all received PRP for various soft-tissue injuries. In this same time period, at least five legitimate, clinical studies have been published on platelet-rich plasma, with four indicating PRP is or may be effective.

The majority of media attention surrounding PRP however, does not focus on the clinical studies. The construction worker with chronic tennis elbow is then unaware that he may be back to work sooner because he does not require surgery. The mother of four living each day in pain due to Plantars Fasciitis, is unaware she may be able to soon get on the field and play with her children. Therefore, the medical community along with writers, must continue to publish PRP clinical studies and expose them to the public, regardless of supporting or negative outcomes.

PRP has far more potential to one day save jobs and improve people's lives than it does in professional athletics. While platelet-rich plasma therapy remains in development and should currently be offered as a last resort to invasive surgery, improving the flow of accurate information will bring future accessibility and sound judgment to the use of PRP.

Wednesday, February 3, 2010

Platelet-Rich Plasma Injection More Effective than Cortisone Injection

A recently published study by Dr. Taco Gosens from the Netherlands, revealed platelet-rich plasma (PRP) injections were more effective than cortisone injections for chronic tennis elbow. The controlled trial studied 100 patients with chronic lateral epicondylitis (tennis elbow). The results are reported in this month's (Feb.) Academy Journal of Sports Medicine.

Patients were randomly selected into either the PRP group or corticosteroid group. Successful treatment was defined as "more than 25% reduction in visual analog score or DASH score without a re-intervention after 1 year."

At one-year follow-up, 73% of patients in the platelet-rich plasma group were treated successfully compared with just 51% of the cortisone group. What was further significant: the corticosteroid group was initially better and then declined, whereas the PRP group improved steadily.

In conclusion, the study reported treatment of chronic lateral epicondylitis with PRP reduces pain and significantly increases function. PRP significantly exceeds the effect of corticosteroid injection for the same injury.

Currently, PRP remains a therapy for patients who have failed other non-surgical treatments. As cortisone injections are temporary pain relievers and can cause tissue damage, they have also been a final resort when other non-surgical therapies fail.

Based on this study, PRP could eventually be used as a substitute for cortisone injections. PRP is shown to be more effective and has the advantage of using patients' own natural components to heal soft-tissue tears. Cortisone as an outside agent introduced to the body, is designed to temporarily relieve pain, but can be further damaging to an injury. As evidence supporting PRP effectiveness continues to be published and insurance companies come to understand PRP's value, the substitution is likely.

View Abstract.