The Napa Medical Research Foundation team has contributed a book chapter “Platelet Rich Plasma” in the recently published textbook Essentials of Regenerative Medicine” (2019). The chapter is a comprehensive review of platelet rich plasma (PRP), the most popular and well-studied of biologic treatments, currently used by professional sports teams and athletes, but also increasingly used for patients with chronic injuries, pain and disability.
In this latest textbook, Dr. Bodor, Ryan Dregalla, PhD and Yvette Uribe, BA, discuss PRP, its mechanism of action, different preparations, clinical applications and evidence-based medicine. For this chapter, the NMRF team reviewed and analyzed over 300 articles and referenced over 100. Additionally, the authors confirmed through their own research that the previously noted pattern that leukocyte poor-PRP (PRP with few white cells) is effective for osteoarthritis, whereas leukocyte rich-PRP is not. This publication has also allowed Dr. Bodor and his team to share their findings on how the best outcomes for patients with chronic musculoskeletal pain can be obtained if a distinct injury can be identified and injected using precise imaging techniques.
The platelets are the body’s first responders. Dr. Bodor likens them to paramedics or emergency medical technicians. They arrive quickly by way of the bloodstream to a site of injury and within minutes form a clot to stop the bleeding. Then they start to fix injured tissue fibers by using adhesive, pulling together torn fibers and weaving new ones.
Dr. Bodor explains “the fundamental principle of surgery is that you take one end of something that is torn, pass a suture, cross the gap, pass the suture again, pull the ends together and tie a knot. Whether you use human hands, robotic hands or platelets with their filopodia (appendages) to do that work, that is the fundamental principle.” Once the site of the injury is stabilized, the platelets recruit cells called fibroblasts to create collagen, the basic fiber of all musculoskeletal tissues, plus other cells to rebuild a particular tissue, whether it be ligament, tendon, muscle or bone.
PRP, combined with high-resolution imaging to identify and guide delivery to a previously unrecognized site of injury, has been a game-changer for patients with formerly unsolvable problems who come to the Bodor Clinic. Disc tears, which are the most common cause of chronic low back pain as well as knee osteoarthritis, have had significant positive results. “We don’t believe that chronic pain is in the brain as pain specialists like to say, at least not in most cases. We believe that many patients have unrecognized injuries, or injuries for which we have not had good treatments.”
Dr. Bodor explains “we were among the first (in 2013) to apply PRP treatment, which had been found to be effective for sports injuries and spinal discs. Since then we’ve treated over 350 patients with a 60-70% success rate at achieving resolution of symptoms or substantial improvement for many years following a single treatment.”
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Essentials of Regenerative Medicine
In Interventional Pain Management