Do PRP Injections For Arthritis Actually Work. What Does The Science Say

[Music] wow [Music] hi welcome to another episode of talking with docs i'm dr brad weaning and i'm dr paul zalzow today paul in our five years actually this is our first uh follow-up it's like a 2.0 version yeah so it's talking about prp or platelet-rich plasma should i do it okay well like we always do before we figure out if we should do it we should figure out what it is okay so you've probably seen this or might have had this offered to you before it's called prp a prp injection for a variety of musculoskeletal conditions so what is it so what it is is you have a venous blood sample taken typically in your doctor's office then that blood is taken and put in a test tube and it's put in a centrifuge which is a really fancy merry-go-round that goes really fast yeah so fast that the heavy stuff goes to the bottom and the light stuff goes to the top and the platelet-rich plasma is the stuff that you're going to take and re-inject into the area of concern right so your blood is composed composed of plasma which is the carrier for a bunch of different things red cells white cells platelets multiple growth factors yeah tons of stuff in your bloodstream uh so they're separating out the platelet-rich part with the idea that that is going to help heal or cure certain medical conditions yeah like what kind of conditions we see it well because of our field we see it mostly for things like knee arthritis yep um ligamentous injuries yeah or inflammation yeah tendinitis yeah maybe a torn meniscus acutely sometimes they're using it i think even in some acl reconstructions they've been talking about using it as an augment yeah so different sort of musculoskeletal disorders yes actually i did come across a paper uh for alopecia oh yeah no that's a big one on the injury yeah yeah baldness so it's just like george costanza like that cream that he got and put on his head that really sting he had to wear the hat yeah so so they're using it for anything yeah it's like frank's hot sauce put that stuff on everything right but the question ultimately when we talk about any type of treatment is what does the evidence say is there any evidence to show that it works and and first and foremost we want to make sure that it's safe so let's talk about the safety side of things is it safe paul i i think it's safe because it's basically you know not a foreign material to your body right it's left your body for a little while and been processed minimally processed and then injected back into your body so there is always the risk of infection yeah whenever you have an injection there's always a risk of infection in this case stuff has been taken out and processed and there's a chance that it becomes contaminated with bacteria gets injected back and you get an infection rare very rare very rare and in the studies that i was reading when they talk about adverse events or aes if you're like a research looker um they did talk about the incidents being uh comparable to hyaluronic acid which is another gel injection we inject in these um but that some people do have a little bit of a flare reaction afterwards for whatever reason even though it's your own stuff well that flare reaction is basically inflammation which is one of the first you know signs of healing and that's that's the other thing when you think about blood you think about injecting prp back why kind of makes sense is because whenever you injure yourself break a bone or a tear of muscle tear a tendon or a ligament you bleed that's the first phase of your body trying to heal things right you bleed and that's that's not a bad thing right yeah sometimes it becomes pathologic but the first phase of healing is bleeding and there must be a reason for that right and so that's what people are trying to capitalize on sure and sort of focus that and concentrate it when we reinject it back in okay so our first video on this was about three years ago at that point we certainly said that we were kids we didn't know what we were talking about newbies and we said there's not a lot of of supportive clinical evidence to justify recommendation okay so here we are three years later yeah we've had a pandemic changed change the world changed my car changed my car um yeah i haven't really changed much else no i would agree our kids are older yeah um what would you say the evidence says now i think um i don't i still don't think the evidence is definitive okay like there's certain definitive studies out there like high blood pressure is bad for you we need to lower your blood pressure there's definitive studies that like sunlight causes cancer sure those are things i consider like real definitive studies yes i can't find a definitive study on the use of prp yep that says yeah this is now the new gold standard for treatment agreed uh but i think there is enough evidence out there to warrant more research being done to see if it works really well and to warrant its clinical use at this point i think it's reasonable to to use it clinically right so so i would agree so in all the studies that i read there's a bunch of things that seem to be common themes so there are very few randomized controlled trials which is level one type evidence where you take the new treatment compare it to the standard treatment and see if there's a difference or an improvement or a placebo placebo and what they found is that it is often comparable to hyaluronic acid and every now and then there's a study that might show that it shows some benefit at one year but certainly it's not definitive and the trouble is that so many of these studies are so different so the amount of prp um the way that it's processed the number of injections the volume of injection there's so many variables that it's really hard to pool them and compare and say well if we take all these studies together it shows that there's there's a benefit certainly they all did show that they have similar risk profiles which means that it's safe but i would say there's growing evidence for its use like you're talking about but it's probably not uh it's not a slam dunk recommendation at this point yeah yeah that's a good way to put it there's growing evidence that there that that it's useful but right now not definitive here's the million dollar question okay would you use it on yourself i mean not do it to yourself sure have it done for say knee arthritis so that's a good question and what i would ask you back i'd say a how much money do i have because cost is a very real issue for this for for most people and b how much arthritis do i have so i think for me if i didn't have any enough money i didn't have the means and i had advanced arthritis i think the evidence says that person is probably not worth doing it too and that's a great point because most of the studies were like mild to moderate arthritis not really severe arthritis which is a lot of the population we see yes so mild to moderate arthritis so that's a good question and cost it's not free right and it's not usually covered uh i don't i'm not sure about the coverage but most i would say that most insurance doesn't cover it at this point i'd agree so it's that you're out of pocket for it and it's probably three to four times the cost of hyaluronic acid so some people could argue well if it's so much more expensive what if i had hyaluronic acid say every six months for a year compared to one prp and then at the end of 12 months and it's hard to answer the question if you do it on yourself because we're not in that boat no we're maybe a neighboring boat a cruise ship not far off but certainly not in that boat right now with with that big daily pain that's interfering with work so and i think the other thing to recognize is that prp does not change your arthritis you don't end up with less arthritis this is all about symptom control so if you're someone that needs a knee replacement getting prp is not going to prevent you from needing a knee replacement it's going to make you more comfortable while you wait which is often what we do anyway but i think it's critical to recognize that this is not a solution it is a symptom manager yeah you're right it's not a cure and it might be um misleading in some of the advertisers you might see where this is like a cure it's not a cure so what is the cure for arthritis well totally replacement if it's in the knee we don't have a cure yeah we don't have a cure can't bring your cartilage back no i can't reverse that it's like aging almost no there's no cure for aging yeah we cannot cure your arthritis but we do replace them that's why we're replacing these because there's no cure right so keep that in mind if you're thinking of if you're approaching this it's like taking an aspirin or taking acetaminophen or icing your knee these are all symptom control things you do prp is a much more invasive symptom control but it is a symptom control maneuver and i think the takeaway is i think if you have the means and the motivation i think it's not unreasonable to try at this point i you you may see us next video with no hats and a full head of hair because that's right with the prp that's right i'm gonna be like a chia pet i like it so if you like this video please like it subscribe to our channel and share your experiences with prp in the comments if you've had one and remember you are in charge of your own health we'll see you next time

Channel: Talking With Docs

Views: 171,204

Keywords: PRP, Stem cells, Knee injection, Platelet rich plasma, Knee arthritis, Arthritis, Joint pain

Id: KBekonxJ1tU

Length: 8min 56sec (536 seconds)

Published: Mon Nov 15 2021