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You may have been recently given a diagnosis that has you facing the possibility of having surgery. For example, you may have been playing basketball with your son, stepped out and twisted your knee, and now you are facing possible arthroscopy for a torn meniscus. But wait! Good news! Rarely do we refer our patients with meniscus or labral tears or even severe joint instability for surgery.  Prolotherapy works very well for labrum (hip and shoulder) and meniscus degeneration and meniscus tears. When PRP is added to the Prolotherapy solution, it can work even better! So what is PRP Prolotherapy and how does it work?

What is PRP Prolotherapy? Platelets play a central role in blood clotting and wound healing. Tissue repair begins with clot formation and platelet degranulation, releasing the growth factors that stimulate repair in the body. Platelet-derived growth factors are biologically active substances that enhance tissue repair mechanisms. After platelets are activated at a wound site, proteins are released that directly and indirectly influence virtually all aspects of the wound healing cascade. Studies have shown a direct correlation between the platelet concentration and the level of secretory proteins, as well as the amount of proliferation involved in the wound healing. 

In basic terms, PRP Prolotherapy involves the injection of concentrated platelets obtained from the patient’s own blood into the injured area, which release a great quantity of growth factors that stimulate recovery in non-healing injuries. PRP Prolotherapy causes a mass influx of growth factors, such as platelet-derived growth factor, transforming growth factor and others, which exert their effects of fibroblasts causing proliferation and thereby accelerating the regeneration of injured tissues. Specifically PRP enhances the fibroblastic events involved in tissue healing, including chemotaxis, proliferation of cells, proteosynthesis, reparation, extracellular matrix deposition, and the remodeling of tissues.  Adding PRP to Prolotherapy can accelerate the healing needed in more severe injuries and degeneration.

How is PRP obtained to be used with Prolotherapy?  We obtain therapeutic doses of growth factors from an autologous blood collection (blood from the patient), plasma separation (blood is centrifuged), and application of the plasma rich in growth factors (injecting the plasma into the injured area.)  We use the PRP that is plasma enriched with growth factors from the patient’s blood as one of the proliferant solutions for the Prolotherapy treatment. Dr. Hauser does not just inject the PRP during the Prolotherapy treatment. He also treats the surrounding support structures with Hackett-Hemwall dextrose Prolotherapy in order to strengthen the joint instability that is nearly always a factor in the development of the condition in the first place. Thus the patients will receive a comprehensive treatment that not only addresses the tear or degenerated area, but also the surrounding structures. We feel that “one-shot PRP treatments” are not nearly as effective as our more comprehensive approach. In fact, we frequently see those patients in our office stating that they have not fully recovered.

We typically see patients every 4-6 weeks. Typically 2-6 visits are necessary to completely resolve the issue.  (See Figures 1-4.)

1. The appropriate amount of blood is drawn from the patient.		2. The blood is processed by first dispensing it into a centrifuge collection container.		3. The blood plus mixing agents are spun in acentrifuge to concentrate plasma growth factors.		4. After drawing PRP into a syringe, it is used as Prolotherapy solution for injection.

What conditions benefit from using PRP Prolotherapy? Scientific literature reports using PRP to successfully treat soft tissue injuries such as tendinopathy, tendinosis, acute and chronic muscle strain, muscle fibrosis, ligamentous sprains and joint capsular laxity. PRP has also been utilized to treat intra-articular injuries. Examples include arthritis, arthrofibrosis, articular cartilage defects, meniscal injury, and chronic synovitis or joint inflammation.

PRP solutions have been used successfully to enhance surgical outcomes in maxillofacial, cosmetic, spine, orthopedic, and podiatric surgery.  In regard to its use today, you will see that the majority of doctors using it apply it onto their current knowledge -base of Prolotherapy. In other words, the doctors doing PRP are using it as a proliferant, much like they use other solutions in Prolotherapy.  In simple terms, PRP is a type of Prolotherapy!

Dr. Hauser has been using PRP Prolotherapy for many years and has a lot of experience with it. He is one of the leaders in the field of using PRP in Prolotherapy solutions. At Caring Medical, we have treated many conditions with it, but Dr. Hauser does not use it on every patient. Because we use an individualized approach with our patients, we do not feel that it is necessary on the more simple cases who do extremely well with aggressive Hackett-Hemwall dextrose Prolotherapy! Cases such as we described above including meniscus tears, ACL tears, MCL tears, hip labral tears, shoulder labral tears, severe osteoarthritis, and the like have been successfully treated with PRP Prolotherapy in our clinic.

Dr. Hauser and our team have published a remarkable study on the use of PRP Prolotherapy as a first line treatment for meniscus tears. You’ll definitely want to read it! If you are interested in using PRP Prolotherapy for your injury, we’d love to help you! Give us a call at 708-848-7789!