Platelet Rich Plasma (PRP) Injections
Platelet rich plasma (PRP) contains a high concentration of platelets and a variable amount of white blood cells (depending on your specific needs). PRP injections enhance the body’s natural ability to heal, can reduce inflammation in tendons and arthritic joints, and accelerate the repair of injured tendons and ligaments. A PRP injection is generally a quick outpatient procedure. During this treatment, PRP is taken from your own blood and injected directly into the damaged tissue under ultrasound guidance. This releases growth factors that stimulate and increase the number of reparative cells your body produces.
When to Consider PRP Injections
PRP injections may accelerate the healing of both acute and chronic joint and tendon injuries. While not for every condition that may affect joints, the treatment tends to be more effective on patients who are generally in good health. PRP therapy may help professional and amateur athletes get back into the game faster. There's also research suggesting the injections may also make it easier for patients with chronic conditions to participate more in physical therapy. Research on the use of platelet rich plasma therapy suggests it may be more effective for chronic tendon injuries, although patients have also reported positive results when the treatment is used in conjunction with surgery. Used in one form or another to promote cell regeneration since the late 1980s, PRP therapy may produce results lasting anywhere from several months to indefinitely, depending on how well tissues heal. Risks associated with the injections are minimal.
Alpha-2 Macroglobulin (A2M) Knee Joint Injections
Alpha 2 macroglobulin is a major type of protein found in plasma, the colorless part of blood. It's believed that A2M helps minimize pain in the knee by deactivating certain enzymes that can break down cartilage cells. When cells in cartilage break down in the knee, the bones that connect to form the knee joint experience increased friction during movement, which causes tissues to become inflamed and nerves to become irritated.
How Do A2M Injections Work?
A2M is a broad spectrum multi-purpose protease inhibitor that deactivates three specific chemicals linked to cartilage breakdown. When these three chemicals are "trapped" by the A2M protein, the body can naturally eliminate them to prevent tissue damage. The injections are prepared by taking the patient's own blood and preparing an injection with a higher than normal amount of A2M. A local aesthetic is usually included to minimize discomfort. The A2M injection will be placed directly into the affected part of the knee under ultrasound guidance. A fibronectin-aggrecan G3 complex test (FAC) may be done to determine if the knee joint will likely respond well to A2M therapy.
What Are the Possible Benefits?
Clinical studies involving A2M injections suggest the treatment can provide noticeable and sustained relief from arthritis symptoms. According to the American Academy of Orthopaedic Surgeons, A2M injections may be considered when conservative treatments have failed to provide meaningful relief or when knee pain reaches a point where daily life is affected. The reduction in inflammation may slow or stop the progression of OA (osteoarthritis) affecting the knee joint. Treatment with A2M injections may also benefit patients with knee pain due to arthritis by:
• Preventing further cartilage loss
• Promoting the growth of healthy tissue around the knee
• Improving overall joint function
• Providing an alternative to knee surgery
Are Orthobiologic Therapies Right for Me?
If other treatment options like anti-inflammatory medications or certain types of physical therapy have not worked for you in the past, orthobiologics might be a good option to try. Here are some questions to consider when exploring whether orthobiologic therapies could be right for you:
• Has physical therapy not yet provided the relief and restored function you’d expected?
• Has bracing failed to work for you?
• Do you have a tendon injury or arthritis?
• Has anti-inflammatory medication failed to relieve your pain in the past?
• Have cortisone injections failed?