REGENERATIVE INJECTION THERAPY
Platelet Rich Plasma, Prolotherapy, and A2M
Little to no downtime
Speeds & promotes tissue healing
Naturally organic, from patient's own body
Fewer side-effects compared to surgery
Protects and preserves joints
Proven results in Knee OA Pain studies
Regenerative injection therapy (RIT), is a relatively safe way of helping injured soft tissues heal without surgery. It’s been used successfully by doctors for decades and has become more popular in the past several years.
Ligaments link bones together and tendons hold muscles to bones and other structures within the fascial system. When these structures get hurt, they don’t heal very well on their own.
Unlike other tissues, ligaments and tendons don’t have much of a blood supply. The reason skin can patch itself up when it's been cut or scraped is because a huge network of blood vessels are housed in the skin, bringing healing to the injured area to put it back together. Since ligaments and tendons don't have this rich blood supply, we have to bring healing, aka “regeneration,” in other ways. We do this by inserting a needle into and around the area of pain and bathing ligaments and tendons in a nourishing solution, with a sugar solution as well as a numbing agent, similar to what the dentist uses to numb for dental procedures.
There are three main types of RIT that are commonly used: Prolotherapy, PRP, and Autologous Stem Cell therapy (aka Mesenchymal Signaling Cell therapy or MSC, from fat and/or bone marrow). PRP and MSC are called autologous orthobiologics because they are derived from the patient's own body, rather than an outside source. This makes the these preparations very low risk, especially compared to exogenous (outside the body) treatment preparations and drugs.
Prolotherapy (proliferate + therapy) is really a blanket term to describe what happens when we inject, but basically, prolo tones and tightens up weakened tissues to help with range of motion and pain relief and has been shown to be highly effective in osteoarthritis relief.
PRP (platelet rich plasma) comes from the patient's own blood. Growth factors from platelets help regrow and replenish stretched and mildly to moderately injured tissues.
MSC ("stem cells" or mesenchymal signaling cells) come from extracting and purifying some of the patient's own fat and/or bone marrow which is harvested in a sterile procedure and processed for use in the same day, sterile injection procedure.
Depending on the extent of pain, dysfunction, or injuries, one or more of these types of RIT may be used. Relief is often seen in only one treatment, but usually more treatments are required due to the natural aging process, wear and tear, or re-injury. Of note, RIT seems to have a varied success rate based on unknown, possibly genetic, immune, and endocrine factors; time and research will tell. The majority of people respond well but some people don’t respond at all, aside from initial pain relief. Most patients find that it is worth a try, however, to avoid surgery if possible and when indicated.
Middleton, K. K., Barro, V., Muller, B., Terada, S., & Fu, F. H. (2012). Evaluation of the Effects of Platelet-Rich Plasma (PRP) Therapy Involved in the Healing of Sports-Related Soft Tissue Injuries. The Iowa Orthopaedic Journal, 32, 150–163.
Seenauth, C., Inouye, V., & Langland, J. O. (2018). Dextrose Prolotherapy for Chronic Shoulder Pain: A Case Report. Alternative Therapies In Health And Medicine, 24(1), 56-60.
S, P., & S Antony John, C. (2016). Analgesic efficacy of ultrasound identified trigger point injection in myofascial pain syndrome: A pilot study in Indian patients. Indian Journal Of Pain, Vol 30, Iss 3, Pp 162-165 (2016), (3), 162. doi:10.4103/0970-5333.198011
Pas, H. I., Winters, M., Haisma, H. J., Koenis, M. J., Tol, J. L., & Moen, M. H. (2017). Stem cell injections in knee osteoarthritis: a systematic review of the literature. British Journal Of Sports Medicine, 51(15), 1125-1133. doi:10.1136/bjsports-2016-096793
Taniguchi, Y., Yoshioka, T., Kanamori, A., Aoto, K., Sugaya, H., & Yamazaki, M. (2018). Intra-articular platelet-rich plasma (PRP) injections for treating knee pain associated with osteoarthritis of the knee in the Japanese population: a phase I and IIa clinical trial. Nagoya Journal Of Medical Science, 80(1), 39-51. doi:10.18999/nagjms.80.1.39
Reeves, K. D., & Hassanein, K. M. (2003). Long-term effects of dextrose prolotherapy for anterior cruciate ligament laxity. Alternative Therapies In Health And Medicine, 9(3), 58-62.