Regenerative Medicine is a relatively new branch of medicine that is at the forefront of changing how we treat certain medical conditions. Traditional medical therapies have focused on the use of pharmaceuticals (medications) and other treatments to alleviate pain and disability. With regenerative medicine, the focus is on creating different solutions to help utilize the body’s own abilities to heal, repair, and restore itself. There are different components to this including cellular therapies, tissue manipulation and engineering, and the development of new biomaterials. Within our practice, we offer Regenerative Injection Therapies including Prolotherapy and Platelet Rich Plasma (PRP).

Prolotherapy has been around for 60 years. It involves injecting an “irritant” into an injured or painful joint or area of soft tissue (tendon or ligaments). The theory behind this is that the irritant will initially promote an inflammatory response leading the body to send a host of healing mediators to the area to reduce the inflammation and heal the affected area.

The use Platelet Rich Plasma (PRP) was originally developed in the late 1970’s for use on a limited basis. Now, the use of PRP has grown tremendously in the last decade. With PRP, a patient’s own blood is drawn and spun in a centrifuge to separate the components. The plasma is then combined with a special activator and is injected into a painful joint or area of soft tissue. The injected PRP is believed to draw new reparative cells into the affected area to promote healing and restoration.

The use of stem cells offers great promise in treating diseases and conditions that have previously been untreatable. Stem cells have the potential to differentiate into types of cells with specialized functions and can lead to the development of bone, cartilage, tendons, and ligaments. While promising, stem cell treatments are considered experimental. There are numerous clinical trials that are ongoing in the U.S. to evaluate to potential applications for stem cells in orthopedics. At present, we do not have good, high quality clinical and safety data to promote stem cell therapies. We offer Prolotherapy and PRP injection therapies which are have been used for years with acceptable safety profiles.

In general, Regenerative injection therapies, including Prolotherapy and PRP are normally not a first line treatment for most musculoskeletal injuries and soft tissue problems. An appropriate evaluation by an orthopaedist or physical medicine and rehabilitation physician is important to identify and diagnose the problem. Specific tests such as x-rays, MRIs, or CT scans likely be necessary to aid in confirming the diagnosing the condition.

As previously discussed, the regenerative injection therapies we offer are used to treat a wide range of orthopedic problems but are not a cure all for everyone! It is important that a trained physician accurately identify your problem before any treatment is started. Many musculoskeletal conditions can be complex and require diagnostic testing to fully understand. It is important for the physician to review your medical history with you to rule out other causes of your complaints and to make sure that you do not have any conditions that will disqualify you from having the regenerative injection therapies. Patient safety is our primary concern. Furthermore, we want to ensure that we are offering you the most appropriate treatment options.

To answer this, there are several considerations including the patient’s specific problem, degree of the condition and the presence of other medical illnesses. Prolotherapy and PRP are used to treat a multitude of orthopedic conditions. However, these injections are not indicated for everything. For example, if you have advanced arthritis (“bone on bone”) of your knee, the injections are unlikely to correct your condition. For those with less advanced arthritis or other soft tissue complaints, Prolotherapy and/or PRP is an excellent option to consider prior to contemplating surgery. The risks associated with having the injections is often much less than that of surgery. Keep in mind that not everyone is a candidate for these types of injections due to having other medical conditions.

This is certainly a very valid concern especially considering that many are not previously aware of Prolotherapy and Platelet Rich Plasma (PRP) injections. As discussed on our website under “Treatments”, both Prolotherapy and PRP treatments have been in existence for decades. The medical literature does contain a limited number high quality studies for both of these treatments for various orthopedic conditions. The results of these studies has varied. In many cases, the studies have shown positive outcomes with no significant adverse events for many injuries and chronic conditions. This area of medicine continues to develop. Based on the results of published studies and from our experience, these treatments are a good option for many who have certain orthopedic conditions and want to take a more natural approach to healing and/or want to try and avoid more invasive treatment such as surgery.

First, based on the available data from clinical studies and from experience, we believe that Prolotherapy and PRP injections are an appropriate treatment option for certain orthopedic conditions. As mentioned before, regenerative injection therapies do not necessarily work for every condition. Certain conditions have higher treatment success rates. Dr. Shim will not recommend Prolotherapy or PRP if they do not feel that there is a reasonable chance that these injections will help you. Much depends on the specific nature of your condition, other medical conditions you may have, and your willingness to follow a strict rehabilitation protocol. You are encouraged to discuss this concern during your consultation. Unfortunately, as with any treatment offered, there are no guarantees. What works for one person may not work the same for another.

As previously discussed, Prolotherapy and PRP has been used to treat a wide array of orthopedic conditions. Injections into the shoulder, elbow, knee, and ankle are the most common. Some specific conditions and joint problems have been studied more than others. For some less common problems, there may not be any good existing data to know how effective treatment may be. We encourage you to discuss your condition and concerns with the physician to determine if regenerative injection therapies may benefit you.

The cost of Prolotherapy treatments are less than PRP. With Prolotherapy, the costs include medications that are injected, medical supplies, the physician’s time and customary procedure charges. PRP therapies are more complex. This requires the physician to drawn blood from one of your veins using a specialized disposable patient PRP kit, spinning it in a centrifuge purchased by the physician, mixing the plasma with a chemical activator and injecting this into the affected joint or soft tissue. In some cases, the use of fluoroscopy (“live x-ray”) or ultrasound guidance may also be used. These are very expensive pieces of equipment that are purchased by the physician or practice, but are necessary for accuracy of injection placement and patient safety. This entire process can take 30-45 minutes. The costs you are quoted include the actual cost of the patient PRP kit, supplies, time reserved for your procedure, the use of any diagnostic equipment and the physicians technical component in performing the procedure.