The science of Platelet Rich Plasma (PRP) therapy is still relatively new to the world of orthopedics. As such, there are many studies being performed that test the application of the plasma platelets in various clinical settings. In the rush to show how beneficial PRP applications can be in surgery, only sometimes is there research to show that PRP can be just as effective outside of surgery. Unfortunately, PRP is being studied more as an adjunct to surgery instead of as an alternative to surgery.
Platelet-Rich Plasma (PRP) in Surgery
Recently we posted an article about “ultra-octogenarian” and stem cell injection therapy – showing research that says you are never too old for Comprehensive Prolotherapy. In this new PRP research, doctors sought to determine if patients deemed too old for a specific surgery could get that surgery if blood platelets were introduced into the equation. New research is applying PRP to microfracture surgery.
Microfracture surgery for articular cartilage repair
Surgeons seem to be sold on microfracture surgery for articular cartilage repair (where the bones under the cartilage are microfractured to stimulate healing). This is not a surgery we recommend as we feel that Comprehensive Prolotherapy is more effective without fracturing bones. But surgeons want it to work, so the use of stem cells, as reported in our recent article on surgery and stem cells, and now PRP, is the focus of current research striving to prove the addition of these applications make surgery more successful.
This PRP research has one message: patients under 40 benefit the most from microfracture. With the addition of PRP, patients under 50 benefit the most.
New research: PRP and microfracture surgery
Knowing that people under 40 benefit most from microfracture, researchers set out to find how they could extend the age of patients who benefit from this surgery. Here is the gist of the study:
“The aim of this study was the first to report the results regarding the PRP as an adjunct for arthroscopic microfracture in the early osteoarthritic (OA) knee with cartilage lesion over 40 years of age. 49 patients who underwent arthroscopic microfracture for cartilage lesion sized less than 4 cm(2) with early OA, aged 40-50 years, were enrolled and randomly divided into 2 groups: a control group with only arthroscopic microfracture (25 patients) and a study group with arthroscopic microfracture and PRP (24 patients). . . In the postoperative 2 years, clinical results showed significantly better in the study group than in the control group. In post-arthroscopic finding, hardness and elasticity degree was better in the study group. The PRP injection with arthroscopic microfracture would be improved the results in early osteoarthritic knee with cartilage lesion in 40-50 years old, and the indication of this technique could be extended to 50 years.”1
Therefore, if Platelet Rich Plasma Therapy is included in the surgery, it makes the surgery work better for older patients. So are you too old for PRP? Evidently PRP can extend the effectiveness in the older patient in cartilage repair as documented by this study’s discussion of stronger, harder, more elastic soft tissue (cartilage.)
PRP as an alternative to surgery
Again we always have to ask, if the PRP did all these amazing things within the surgical context- make surgery work for patients too old, wouldn’t it be just as effective as an injection for articular cartilage repair?
The answer is yes if included in a comprehensive program offered by a Prolotherapy doctor. This is discussed in our article Science Shows Platelet Rich Plasma is Not a Single Injection Treatment. PRP Prolotherapy is a successful, non-invasive and cost-effective treatment for patients of all ages. For more on Prolotherapy information.
1. Lee GW, Son JH, Kim JD, Jung GH. Is platelet-rich plasma able to enhance the results of arthroscopic microfracture in early osteoarthritis and cartilage lesion over 40 years of age? Eur J Orthop Surg Traumatol. 2012 Jul 5. [Epub ahead of print]