The musculoskeletal system (MSA) is the basis of the human body. It is a single complex consisting of muscles, bones, ligaments, joints, and nerve endings. ODA provides support for the body and gives the body shape. It provides the ability to move and take poses, protects internal organs, and is also responsible for the motor activity of every part of the body.
What is this?
PRP is platelet-rich plasma. The patient's own plasma is used during the treatment process. It is prepared from autologous blood immediately before injection into the knee.
Platelets are the formed elements of blood that perform the function of forming a blood clot. By gluing, they initially form a “plug” in damaged vessels. This happens immediately after the injury. Then platelets provide their surface for the formation of the main reactions of plasma blood coagulation.
Not long ago, another important function of platelets was established. It turned out that they secrete a large number of growth factors and take part in regenerative processes.
Normally, the concentration of platelets in the blood ranges from 180 to 360 thousand cells per μl. Even this amount is enough to somewhat speed up the regenerative processes. But they occur faster and more intensely if a lot of platelets are injected into the joint. Therefore, the plasma is pre-prepared. Other formed elements of blood are removed from it. The platelet concentration increases 5 or more times.
It has been established that the maximum regenerative potential of tissues is achieved when they are exposed to plasma containing at least 1 million platelets per 1 μl. Further increases do not provide significant benefits. If the platelet count exceeds 1.8 million, inflammatory reactions may be enhanced. Therefore, too high a concentration of these cells is not recommended for use for intra-articular administration.
Features of the sessions
The treatment is based on autoplasma therapy methods: using specialized equipment, platelets are extracted from human blood. Blood cells are mixed with plasma and injected into the damaged area of the body. Sometimes, for better accuracy, injections are controlled by ultrasound. The entire treatment process takes about 20 minutes.
The PRP technique is also effective in the presence of degenerative processes and acute pain syndromes. This treatment activates the regeneration of affected tissues and quickly stops inflammatory processes. High therapeutic rates are ensured due to the action of platelets - the main sources of growth factors. Once in the lesion, blood cells begin to rapidly attract stem cells there, accelerating the regeneration process.
If necessary, platelets can be converted into bone, cartilage or muscle fibers. When exposed to them, the internal structures of the body actively produce elastin and collagen. The innovative technique effectively stimulates such a unique ability of the human body as self-healing.
When a patient develops arthrosis of any kind, the cartilage of the joint loses its ability to recover and absorb nutrition. Enriched bioplasma helps accelerate the natural reanimation of the damaged area. Thanks to the innovative technique, patients can do without painful and dangerous surgery.
Principle of the method
The PRP method in the treatment of knee joints is based on enhancing the regeneration of intra-articular tissues. Thanks to platelet-rich plasma, cartilage, menisci, ligaments and other tissues are restored faster.
Even in ancient times, doctors drew attention to the fact that traumatic injuries accompanied by the formation of a hematoma heal much faster. The reasons for this have been established only in recent decades. It turned out that platelets secrete a number of substances that accelerate regeneration. These are the growth factors:
- epidermal;
- epithelial growth;
- endothelium;
- fibroblasts;
- insulin-like;
- transformative.
These substances have a polypeptide (protein) structure. They have different purposes. But all of these compounds take part in tissue regeneration. They stimulate the mitotic activity of cells, accelerate their growth and division.
Plasmolifting (PRP therapy) of the knee joint makes it possible to significantly increase the intensity of reparative processes of both soft and bone tissues. In medicine, platelet-rich plasma is increasingly used. It is used for any injuries: soft tissue damage, muscle and ligament ruptures, bone fractures. All types of tissues regenerate faster if a sufficient number of platelets are present.
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Indications
Among knee joint diseases, the following diseases and conditions are considered indications for the use of PRP:
Arthrosis of the knee joint or gonarthrosis. A degenerative disease associated with the gradual degradation of articular cartilage. The use of PRP at stages 1-2 can improve regenerative processes in cartilage tissue. Thanks to this effect, a significant slowdown in the development of the pathological process is achieved. With the help of PRP, doctors are able to eliminate many symptoms of arthrosis, delay the need for knee replacement, or even abandon the operation completely if an effective conservative therapy regimen is used, in which PRP is one of the elements.
Injuries. The knee is often injured by athletes. Most often these are ligament ruptures and meniscus damage. Intra-articular fractures occur. If the doctor determines that conservative treatment is sufficient, he or she may use PRP to speed up the healing of the lesions. Otherwise, they can take a very long time to recover. This process takes weeks, or even months.
Operations. After arthroscopic surgery on the knee, a rehabilitation period follows. It continues until all tissue damage is restored. PRP can be used to speed up this process.
Defects of the articular surface. PRP is used for cartilage deficiency of articular surfaces of any origin. The cause may be injuries, arthrosis, inflammatory diseases of the knee, metabolic pathologies, psoriasis, systemic connective tissue lesions and other diseases. With a small defect, it is possible to enhance the regenerative processes of PRP. If there is a significant area of cartilage thinning, surgical treatment is indicated.
Advantages
PRP has many advantages over other therapeutic modalities. They are as follows:
- Simultaneously symptomatic and therapeutic effects. A person feels the results of therapy within 2 weeks after its start, and after a few months receives good long-term results, consisting in strengthening of regenerative processes.
- The procedure is completely safe. It is not technically difficult for a doctor. Your own blood does not cause complications or immune reactions.
- The treatment is well tolerated by patients, judging by their reviews of the procedure.
- PRP of the knee allows you to delay and sometimes even avoid the need for surgical treatment (for example, for arthrosis or meniscal damage).
- Low cost of treatment compared to surgical methods.
- Plasma therapy makes it possible to reduce the dosage of non-steroidal anti-inflammatory drugs that are toxic to the gastrointestinal tract.
* Article source: https://koleno.su
How do they do it?
Blood is taken from the patient from the cubital vein. He then waits for 20 minutes for the intra-articular injection. During this time, the drug is prepared. Centrifugation is used. It can be one- or two-stage. In the first case, it is possible to better preserve the integrity of platelets, in the second, their higher concentration is obtained.
After preparing PRP, the resulting plasma is administered intra-articularly. The injection site is numbed with an anesthetic. Therefore, the patient does not feel significant pain during the procedure. In terms of tolerability, it can be compared to an intramuscular injection - unpleasant, but quite tolerable.
Some patients feel a feeling of fullness inside the joint. Especially in cases where a large volume of plasma is administered. After the injection, the doctor asks the patient to perform flexion and extension movements in the knee joint so that the plasma is better distributed in the joint cavity. After 10 minutes the patient goes home. He does not require hospitalization or additional observation.
Plasma can be used in courses of varying durations. Most often, PRP is administered once a week. A total of 3 to 7 injections are required. The treatment regimen is selected individually. The doctor forms it based on the clinical situation and the purposes of using platelet-rich plasma.
Price
On the one hand, the cost of the procedure is low, since the only thing needed is a centrifuge, an ultrasound machine, and inexpensive instruments. The “bottleneck” is the presence of a doctor who can quickly and accurately perform an injection into the area of the intervertebral disc. It is also quite a fashionable and popular technique, and the price can be quite high.
On average, the cost of one session in Moscow starts from 4,000 rubles, and may well reach the upper mark of 9,000 rubles. At the same time, the high cost does not guarantee that all the rules for plasma preparation and patient preparation will be followed. Typically, the price depends on competition, the flow of patients to the clinic, service, rental or ownership of premises, and the location of the clinic.
In large cities of Russia prices are lower, but not always:
- Saratov, at ArthroMedCenter: 2350 rubles per session;
- Volgograd,: plasma therapy session – 2500 rubles;
- Krasnodar, prices at the Euro LPS clinic: 4,000 rubles per session.
Effectiveness for arthrosis
When to expect results depends on the purpose of using PRP and the indications for treatment. In any case, it does not develop instantly. PRP is not a pain reliever. Platelet-rich plasma only enhances tissue regeneration, and this process takes quite a long time.
For arthrosis of the knee joint, the maximum effect develops 3-6 months after the start of treatment. Only a few patients report a decrease in pain after the first injection. For others, the first results are achieved within a month from the start of therapy.
In comparative studies, PRP shows much better results than intra-articular glucocorticoids. These differences are especially noticeable in grade 3 gonarthrosis. Pain syndrome in patients with this method of treatment is less pronounced. In addition, PRP has a more beneficial effect on cartilage - plasma stimulates its regeneration, while glucocorticoids, on the contrary, have a chondrotoxic effect.
According to E.Kon, 80% of people were satisfied with the results of the treatment after a series of injections of platelet-rich plasma for osteochondrosis. Results were assessed after 5 weeks. Another study found that treatment results were rated as positive by 67.3% of patients six months after undergoing PRP therapy for knee arthrosis. In the control group this figure was only 4.3%.
Another study calculated the average amount of time that elapses from the first injection until the therapeutic result is obtained. Patients considered this to be a reduction in clinical symptoms. This period was 17.63 days.
It should be noted that PRP has two main effects: anti-inflammatory and reparative. When surveying patients, only short-term symptomatic effects are taken into account. It develops more quickly after administration of platelet-rich plasma, but goes away more quickly after completion of the course of therapy. The first results of treatment are due to hyperplasia of the synovial membrane and modulation of the level of cytokines in the articular cavity.
At the same time, the main effect of PRP is chondrogenesis. But this process is happening too slowly. Patients cannot feel it. Only by comparing the symptoms and radiological parameters of the main and control groups are researchers able to obtain data on the effectiveness of PRP therapy for the knee joint several months after the course of treatment.
Contraindications
Despite the good tolerability and absence of side effects, the new method has contraindications.
Absolute
Conditions for which PRP treatment is strictly contraindicated:
- pregnancy;
- lactation;
- period of menstruation;
- oncological and autoimmune diseases;
- violation of the blood clotting process;
- low platelet count (thrombocytopenia);
- hemoglobin level is less than 90 g/l;
- state of immunodeficiency.
If the patient has one of the listed conditions, the course is either postponed or cancelled.
Relative
These are passing phenomena, after which you can begin procedures. In this list:
- acute infectious and viral diseases - FLU, ARVI, herpes, intestinal infections, etc.;
- high body temperature exceeding 38C;
- taking medications that affect clotting.
After recovery or drug withdrawal, a person has the opportunity to use plasma therapy.
After operation
PRP knee therapy is used after ligament and meniscus surgery. There are many studies demonstrating the effectiveness of this procedure for accelerating the recovery of intra-articular structures.
One common area of application remains rupture of the anterior cruciate ligament of the knee. She herself cannot fully recover from a complete rupture. Therefore, to normalize its fusion (ligamentization), surgical treatment is used. Free autografts are used.
There are different types of them. STG (intrinsic tendon) and BTV grafts (“bone-tendon-bone”) are used. In both the first and second cases, the introduction of PRP into the knee allows one to achieve significant positive treatment results.
First of all, PRP is performed to speed up the rehabilitation period. Studies show that when using STG grafts, the ligamentization period is on average 369 days (about 1 year), while the use of PRP reduces this period to 177 days (6 months). That is, the terms are reduced by 2 times.
Even more significant results can be achieved when using PRP therapy for the knee after using a VTV graft to reconstruct the anterior cruciate ligament. The average time for ligamentization is about 1 year. When using PRP it was possible to reduce it to 3.5 months.
Studies demonstrate that ligamentization after surgery is significantly better in patients receiving PRP therapy than in the control group. True, the results are better only 4-6 months after surgery. The examination of patients after 1 year shows that the final results are the same.
However, PRP therapy can significantly reduce the recovery time for patients after surgery. This is especially important for professional athletes who want to return to training as quickly as possible.
Plasmolifting in traumatology
The plasma lifting procedure is quite in demand in traumatology. The introduction of autoplasma for fractures, ruptures of muscle fibers, ligaments, tendons that occur during intense training or as a result of accidents allows you to relieve pain, speed up the healing process and the rehabilitation period. This therapy method does not imply the use of medications prohibited for use by athletes. Therefore, orthoplasma injections are often prescribed in the treatment of injuries sustained by football players, tennis players, basketball players and other athletes.
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Safety
PRP therapy for the knee joint is one of the safest treatment methods. There is no risk of complications. The exception is the human factor. The doctor may miss the needle into the joint or cause an infection if he does not follow the rules of asepsis and antisepsis.
But if you turn to a highly qualified specialist who has extensive experience in performing this type of medical manipulation, the procedure will go smoothly. If a joint is deformed, if it is difficult for a doctor to get into its cavity, ultrasound can be used. Therefore, there is no risk of damage to healthy tissue during PRP therapy.
The drug itself for injection into the joint cavity is prepared from the patient’s blood. Therefore, the risk of transmission of infection or allergic reactions is eliminated. Your own blood does not carry an antigenic load. It is completely safe.
Compatibility with other therapeutic procedures
In our clinic, plasma therapy is combined with other non-surgical methods of treating the musculoskeletal system:
- acupuncture;
- manual therapy;
- different types of massage – acupressure, classic, Thai, etc.;
- hirudotherapy - treatment using leeches;
- exposure to vacuum cans;
- kinesiotherapy under the influence of loads;
- kinesio taping (using cotton tapes);
- blockades with painkillers and anti-inflammatory drugs.
A comprehensive course of joint treatment, using prp therapy and other methods, gives the fastest and most lasting effect.
Themes
Joints, Treatment methods Date of publication: 12/09/2019 Date of update: 06/08/2020
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Features of the procedure
The PRP technique is carried out by injecting enriched bioplasma into small and large joints. The specifics of the injection depend on the area of the joint affected:
- Hip. Bioplasma is administered through a lateral or anterior approach.
- Knee. The injection is placed in the area of the joint gap in front or in the lateral part of the patella.
- Ankle. The plasma is introduced into the joint cavity, at a distance of 3-4 cm from the ankle area.
- Brachial. The landmark is selected depending on the characteristics of the pathology. For example, for periosteal tendinitis, the injection is performed from the front.
- Elbow. They puncture near the olecranon process.
- Radiocarpal. The articulation cavity on the rear surface is involved.
- Interphalangeal. To ensure complete accuracy, injections are given with the patient's fingers bent.