Wednesday, September 2, 2009

PRP Injection...done

After much anticipation, and 3 months after my problem started, I had my PRP injection. But not without snafus!

My appointment was at 11am. at 11:45 the radiologist came out and asked me if I knew if BKs office arranged for the PRP machine (centrifuge) to be brought over. Umm, I would assume so given all the trouble it had been to arrange this. He said he hadn't seen the rep from the company around but knew she was over at HSS, so she was "in the neighborhood".

At around 12:15 the rep arrived with the machine. We began getting the injection underway close to 12:45.

First, the radiologist, using ultrasound, checked out the hip. He could see the debrided labrum and where bone had been shaved, as well as "reduced echo" on the anterior joint capsule. He then took blood from my arm, 10cc. For some reason, this was more uncomfortable than normal. He handed the blood to the rep who spun it down for 5 minutes and then placed 3 cc of plasma into another syringe. The radiologist then injected this into the area around the capsule and the muscles and tendons. He went through the muscles a few times leaving me pretty sore. It has been 11 hours and my thigh really hurts. I just want to climb into bed and sleep for 12 hours!

I really really hope this works!

What I learned from the rep (who was super sweet) is that there are different kinds of PRP, this specific one is called ACP, autologous conditioned plasma.
http://www.orthoillustrated.com/index.cfm?ResDiaRelID=122

I am still not 100% what the differences are but I am working on learning more. The rep is emailing me some info tomorrow!

15 comments:

louisawb said...

HI please would you explain this procedure for me? What does it do? how does it help? whats the success rate? Is it available in the UK?
Big Thank you for all your info!
Louisa

Susie said...

I don't have the answer to alot of your questions, which is very unlike me! I usually have to know EVERYTHING! I guess this shows just what kind of state of desperation I am in. I have changed the link in the post to allow everyone to see the animation of the procedure without logging in (and I spell checked he post!)
Basically, blood is drawn from your arm, it is then spun down so that it seperates into red blood cells and plasma/platelets. The plasma and platelets are then removed carefully from the mixture and injected into the area that "needs help". It goes on the theory that when you have an injury, blood rushes to the area to help heal it. It is the plasma and platelets in the blood that do the healing so here, they are injecting JUST the plasma and platelets to promote healing. Since it is your own blood, there really are no contraindications or negative results, unlike cortisone.

Nicola said...

Hi - I have been following your struggles for a while now and really hope this injection brings you relief at last. I have just had my third surgery on left hip plus a steriod injection into the right hip so I understand and wish you all the best xox

Dillon said...

I'm seriously thinking about treating my chronic tendonitis/inflammation with PRP injections. How is your healing process going so far?

Susie said...

Dillon-
I have not had great results but this is not a cut and dry case. If I had a condition that was just straight forward tendonitis, I would do it!

Anonymous said...

Ok, it's now October. Did you only have one injection or did you follow up with another 3 weeks later? How are you feeling now?

Anonymous said...

I've had PRP injections 3 diff. times. Twice to my foot and then both my SI joints in my lower back. In both cases, i was very happy. I would be say 80%. Every case is diff. , but I'm happy I got the injections, as with my lower back there was no real cure for it. With my foot, it would have been surgery and months wearing a boot on my driving foot.

Anonymous said...

Hi
It's been one month since my last PRP injections (5) in my SI joints and I'm not seeing any results. This was my 2nd set of shots so it's about 7 weeks after the initial procedure. Has anyone had to have a 3rd or 4th before results were noticed ? I'm desperately hoping there is still some light at the end of the tunnel. Help !

Jeff said...

I have been a PRP procurement service provider since 1997. I learned about it form some of the Medtronic sales representatives. Separating platelets from whole blood (in the operative setting) was originally used as a way to preserve platelet function during cardiac bypass surgery. Platelets sometimes get pretty beat-up when subjected to the heart/lung machine. Preserving platelet function means decreased post-operative bleeding as well as other associated complications. Around the same time (mid 1990s) another consultant showed-up where I worked (Yale/New Haven Hosp). He said there was research that showed, if only in a preliminary fashion, the use of one's own concentrated platelet-rich plasma, could help enhance tissue regeneration. In other words, reduce healing time dramatically. Just look at some of the results achieved in difficult-to-heal diabetic ulcers.

Platelets work as a healing acceleration agent because within them are contained growth factors - signaling proteins that tell certain cells what to do and when. Some encourage bone or tendon cells to divide and become many. Others signal endothelial cells (blood vessel cells) to grow into the wound site to support new tissue growth - all normal biological functions unless you are a little older or suffering from some disease/disorder that impedes your ability to heal. Athletes, like the those of us that are older, want to heal or stay healthy and productive. Their livelihood health depends on their ability stay in top condition or return to top condition in the shortest time possible. PRP represents the safest alternative to return to function in the shortest time.

The catch? Beware the snake oil! Just like anything that becomes popular, the "me too" products will follow. Platelet-RICH plasma doesn't mean kinda'-rich in platelets or sometimes-rich in platelets. Platelet-rich plasma is a platelet concentrate of 6 times baseline or better, and the PRP procurement system has to reproducible and consistent. The companies that taut their PRP separation devices as the best because they're the same as the higher-priced systems are the ones that are causing the discussion about efficacy. For instance, removing 10 mls of blood and returning 3 mls of PRP equals about 2 times baseline PRP product. You might as well save your money and just meditate. However, with Medtronic's Magellan system, removing 50 mls of whole blood will yield 7 times baseline in a 6 ml volume. 3 mls equals 14 times baseline!

If you need more info, contact me at 203-878-3783 or ejsoule@gmail.com
Jeff Soule

Finally

Anonymous said...

As an aside to the comment left by Jeff, the Medtronic system also uses tubing sets that attract platelets, meaning when you throw the tubing away, you are throwing away significant numbers of Growth factors (proteins) necessary for angiogenesis. It is simply a function of the plastic used to make the tubing. The Harvest Technologies system, which started the use of PRP in 1999 and has done over a million patient procedures, seems to win in every head to head comparison with other PRP companies. My doctor uses Harvest Technologies for my arthritis and I have experienced great relief.

greg sarin said...

I see these posts are kind of old but will add. Jeff makes some great comments about PRP and are quite accurate. I am an Orthopaedic Surgeon and perform PRP injections regularly. There are many different companies and different concentrations. Sorry to say but ACP might actually be the WORST PRP system out there. Jeff is right...with that system you are better off meditating and there are actually studies that show just the blood taken from you has higher concentrations than ACP. ACP is a BAD product. DO NOT USE. I currently think there are a couple companies worth talking about. I am paid by none of them and will only mention one. Biomet is the ONLY company that has level one studies to show the efficacy of this procedure. I do believe Harvest is a good company and they have done tons of injetions but they have failed to produce level one studies to my knowledge. Hope this helps!

Anonymous said...

I am interventional pain doc and have done a myriad of treatments for SI joint instability and to consistently treat SI joints, a physician has to put the PRP intra-articularly under fluoro. SI joints can't consistently be injected under ultrasound. It may look like the PRP is in your joint but most of the time it is not. How do I know? I have used both and did injections of contrast undr U/S and then took images under the C-arm and no the solution was not IA! This was a consistent finding. Many docs use a U/S machine now because the payments are so much better. The trick is to #1) use the C-arm, #2) get cocentrated PRP from a Harvest or Biomet machine, #3) do prolo with dextrose along with the PRP, #4) and make sure the doc has done thousands of injections. If these are not followed, results are suboptimal.

Paul S said...

How painful are PRP injections in the lower spine and SI joint?

Anonymous said...

Hi, I am having a prp injection in my shoulder and have heard that after the shot it is very painful. Is this true and will I be able to endure this pain. Very apprehensive!
Could you please answer this for me.
Thank you.

Anonymous said...

Hi, I am having a prp injection in my shoulder and have heard that after the shot it is very painful. Is this true and will I be able to endure this pain. Very apprehensive!
Could you please answer this for me.
Thank you.