Your knee hurts. No, actually wait, it really freaking hurts. In fact it hurts so much you can’t even remember the last time it didn’t hurt! “How did I get here?” you may be thinking, and “why isn’t it getting better?” Both very valid questions to which I’m going to go out on a limb and try and answer…
You injured your knee a while ago, or you don’t even remember injuring it, it’s just slowly not been your “good knee” for months (or years) now. Maybe it was a sports injury, a prior surgery, or wear and tear over time (osteoarthritis). You pushed through it. You did the icing, you took the Ibuprofen, you even tried that ointment your friend said worked for her. You were diligent with your physical therapy and you even bit the bullet (or quite literally your tongue) and got the dreaded steroid shot. Great! It worked – all better! Until it didn’t…
And here we are. First off, let me say hat’s off to you for not giving up on your quality of life, your mobility and your health! Secondly, way to take an active role in your own healthcare by taking the time to do some research. (Already my favorite type of patient.) You are here because you know there HAS to be another way and you are right.
PRP – platelet rich plasma. This is your own blood, drawn in the office, which is then specifically prepared to increase its concentration of platelets, and injected back into your knee. We all have platelets in our blood. When you cut your finger these platelets rush to the cut in record time and because they are so full of good stuff (that’s a medical term by the way), these platelets help heal your cut. PRP therefore contains a boat load of growth factors, cytokines, like TGF-b1, PDGF, bFGF, VEGF, EGF, IGF1 and anti-inflammatory mediators like IL-4 and IL-10. (Read…”good stuff”.) At concentrated, supraphysiologic levels, these growth factors and cytokines augment your body’s natural healing process and basically kick start the stages of healing inflammation, cellular proliferation and later tissue remodeling.
You may be thinking that sounds too good to be true Doc. I could nerd out on how amazing the body is when given a chance… but I’ll stick to the facts. There are different levels of evidence in scientific research. And the use of PRP for knee osteoarthritis has LEVEL 1 evidence – meaning it’s safe for use in humans and has a randomized control trial! Right about now you might be thinking if there is Level 1 evidence, which is out there for the world to see, why has my doctor not given me a PRP shot yet? Well to answer that my friends, I’d need a can of worms, a can opener, a soapbox… you get the picture and I don’t want to digress (let’s just say one of the reasons I left “big box” medicine – withholding of treatments that actually work!).
Okay so there is hope! No, actually there is more than hope, there is evidence! So start planning your next bike ride, golf game, hike, or workout. Get yourself back to living and get back in the game.
In good health,
Komal Dhingsa, MD
Reference: Le ADK, Enweze L, DeBaun MR, Dragoo JL. Current Clinical Recommendations for Use of Platelet-Rich Plasma. Curr Rev Musculoskelet Med. 2018;11(4):624-634. doi:10.1007/s12178-018-9527-7