Platelet-rich plasma therapy has become something of a miracle drug in the sports world.
Tiger Woods, Kobe Bryant, Maria Sharapova, Cliff Lee and Peyton Manning are just a few of the all-star athletes who have used it to return to health while avoiding surgery.
“I will perform a PRP procedure on anyone if I feel that they would benefit from it,” Dr. Axtman said, using the therapy’s popular acronym. “Tennis elbow, golfer’s elbow, patellar tendinitis, muscle tears, plantar fasciitis, rotator cuffs, arthritis of the joints.
“For people who don’t really want to undergo something surgical, this is something you can do with a simple injection,” he said. “And the recovery time is much, much quicker than with surgery.”
Sounds great. But what is platelet-rich plasma therapy?
Basic blood is made up of red blood cells, white blood cells, plasma and platelets. Platelets are best known for helping people with clotting when they cut themselves—they prevent people from bleeding out.
But in addition to that important property, they also contain “an immense amount” of growth factors, Dr. Axtman said.
Growth factors are a naturally occurring substance that stimulate cell growth and healing. Platelet-rich plasma contains up to 10 times as many growth factors as what’s typically found in whole blood.
No horsing around
With platelet-rich plasma therapy, doctors draw some of the patient’s blood and use a centrifuge to separate the platelet-rich plasma from the other substances. They then inject the platelet-rich plasma into the problem area, which accelerates the healing process, Dr. Axtman said.
“They act almost like stem cells. They can heal tissue,” he said of the platelets. “They can activate the natural response of the body to heal itself.”
This therapy has been around since the 1970s, Dr. Axtman said.
Veterinarians originally used it on race horses to accelerate their healing. It has since been used in cardiology, dentistry, plastic surgery and orthopedics, among other fields.
But the recent spate of high-profile athletes using it has pushed the therapy into the mainstream consciousness. Pittsburgh Steelers star players Hines Ward and Troy Polamalu used it before the 2009 Super Bowl and helped their team win the championship.
A study published in the American Journal of Sports Medicine followed 34 athletes with partial ulnar-collateral ligament tears who had each undergone two months of non-operative treatment and failed to return to play.
Each of the athletes then used platelet-rich plasma therapy. Of those 34 players, 88 percent returned to their previous level of play without needing surgery.
“It is a regenerative process,” Dr. Axtman said. “We’re basically using a patient’s tissue to repair itself. We’re using a patient’s own blood products, which is a nice thing about it.”
Still, there are studies that doubt the therapy.
While one recent randomized, double-blind study found the therapy helps with arthritis, and others showed it helps with soft-tissue injuries, others found it didn’t help with tennis elbow or hamstring strains.
Studies that find fault with platelet-rich plasma therapy are generally “bad studies,” Dr. Axtman said. Because there is no uniform protocol, many don’t require a post-procedure regimen and restrictions, and post-procedure therapy is not standardized.
Dr. Axtman requires a strict post-procedure regimen of rest, strength and conditioning, and slowly working a patient back toward their normal activity.
This process can take several months, but the recovery time is still significantly shorter than with surgery. And when studies require a strict post-procedure regimen, the results have almost always been positive, he said.
Dr. Axtman only uses platelet-rich plasma therapy after traditional rehabilitation processes like rest and physical therapy have failed to produce satisfactory results.
But when he does use this therapy, it almost always works. He has seen a success rate better than 95 percent with patients who have used it.
“I will do this on anybody,” said Dr. Axtman, who has worked with groups as diverse as the Grand Rapids Ballet and the National Football League’s Atlanta Falcons. “The youngest person I’ve done it on is 13. The oldest is 86. There’s no major age restriction.
“If it’s something I feel is going to benefit them, then I’ll do it,” he said.