Growth Factors and Proliferation for Knee Injuries
You have heard us talk about the Prolotherapy and its ability to heal most joint injuries, sports injuries and chronic pain. As a review, Prolotherapy is an injection treatment that causes a mild inflammation that initiates an immune response. This inflammation mimics what the body does naturally in response to soft tissue injuries. What most people don’t know is that the body possesses a remarkable healing ability and many injuries are healed on their own. The body heals through an inflammatory process that is initiated by the immune system. When there is injury to a tendon or ligament, the immune system increases circulation to the area resulting in redness, warmth and swelling. As inflammation runs it course type 1 collagen is laid down by fibroblasts to increase ligament and tendon strength. The goal of this natural healing process is the regenerate collagen and extracellular matrix that gives connective tissues its strength and durability against strong forces.
A recent study on the medial cruciate ligament (MCL) and anterior cruciate ligament (ACL) of rabbits shows exactly which growth factors have the best effect on the fibroblasts that regenerate soft tissue.1 As mentioned above, fibroblasts lay down type 1 collagen. These fibroblasts are stimulated by growth factors, proteins that play a regulatory role during the early phases of ligament healing. In this study, the ACL and MCL of six rabbits were removed and exposed to various growth factors. The purpose was to examine which growth factors created the greatest proliferation of the fibroblasts in the MCL and ACL. The results showed that three specific growth factors (epidermal growth factor, basic fibroblast growth factor and platelet-derived growth factor-BB) significantly increased the proliferative response of the MCL and ACL fibroblasts.
What was interesting to us is that these three growth factors are the same growth factors that are stimulated by Hackett-Hemwall dextrose Prolotherapy and Platelet-Rich Plasma (PRP) Prolotherapy. Prolotherapy achieves healing by proliferation of new, healthy collagen. The term “Prolotherapy” was coined because of the proliferation it causes. If an injury is not healed through the natural healing process or if the healing process is taking too long, Prolotherapy can be administered as the stimulus needed to bring begin the inflammatory cascade and reach 100% healing. Oftentimes traditional treatments such as pain medications, cortisone shots and even surgery can be avoided with Prolotherapy.
1. Scherping, SC, CC Schmidt, HI Georgescu, CK Kwoh, CH Evans, and SL Woo. “Effect of Growth Factors on the Proliferation of Ligament Fibroblasts from Skeletally Mature Rabbits.” Connective Tissue Research 36.1 (1997): 1-8.