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CNOS Sports Medicine Specialist: Education is Key to Effective PRP

Aug 21, 2019 07:00AM ● By MED Magazine

As more patients stay active into their later years, an increasing number are looking for alternative treatments for orthopedic pain and limitations. The search leads many of them to biologic treatments like PRP and stem cell injections. 

These autologous treatments contain concentrated plasma and growth factors that reduce inflammation and augment healing for conditions like mild to moderate tendonitis or arthritis. Side effects are few and downtime is usually minimal. 

But with “pop up” organizations trying to cash-in on the popularity of these orthobiologics (which are usually not covered by insurance), Joseph Carreau, MD, a sports medicine specialist with CNOS in Dakota Dunes, says it’s incumbent upon physicians to choose patients carefully, manage their expectations, and monitor their progress. 

“For patients with advanced arthritis of the knee (Grade 3 or 4), clinical improvement is minimal,” says Carreau. “These patients probably should not undergo platelet injections because of the minimal response they are likely to get. It’s not a medical issue, it’s more an ethical issue.” 

In the right patients, Dr. Carreau says PRP injections can provide three to six months of relief from arthritis pain. Some of his patients are still doing well after a year. On the other hand, patients who get only minimal improvement from PRP, are not likely to benefit from repeated injections. At an orthopedic clinic like CNOS, these patients can be offered other options. 

While stem cell treatment may be more powerful than PRP due to the higher levels of growth factors, Carreau says this, too, has its limits, which patients should be told. 

“It may be able to control the local environment better, but what it is not going to do is regrow cartilage in an arthritic knee. That could not be any further from the truth.” 

Carreau says the key to countering the hype around biologics is to frame this approach as one of several good options that an orthopedic specialist can offer. 

“Biologic treatments have amazing potential to maximize the effectiveness of other modalities,” he says. “When we understand their role, we can better counsel patients.”