Blog | Cellular Healing

New Therapy Combining Hyaluronic & PRP Maybe a Match Made In Heaven.

Written by Dr. Edward Loniewski | May 28, 2019 at 10:19 PM

Platelet Rich Plasma (PRP) - Your Body’s Natural Repair System

Specific cells within your own blood provide a healing potential through the release of specific growth factors which act as a “fertilizer” for your joint, tendon, ligament or muscle. The specific growth factors are found within cells which look like a plate under a microscope and thus were named “platelets.” These same platelets are what help form a scab over a wound as they slowly release healing growth factors to repair a cut, scrape or wound naturally. Platelet rich plasma has been used for decades to help heal surgical wounds in cardiovascular, orthopedic and even podiatric surgical procedures. Numerous studies have evaluated the use of platelet rich plasma otherwise known as PRP for osteoarthritis of the knee with very good positive results. Details of these studies are located on our web site: https://www.cellularhealing.net/services/platelet-rich-plasma. One study evaluated over 551 studies in what is called a meta-analysis and the conclusion of the study stated “This study suggests that PRP injection is more efficacious than HA injection and placebo in reducing symptoms and improving function and quality of life. It has the potential to be the treatment of choice in patients with mild-to-moderate OA of the knee who have not responded to conventional treatment.” (Kanchanatawan W1, Arirachakaran A2, Chaijenkij K3, Prasathaporn N4, Boonard M5, Piyapittayanun P2, Kongtharvonskul J6. Short-term outcomes of platelet-rich plasma injection for treatment of osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc. 2016 May;24(5):1665-77. doi: 10.1007/s00167-015-3784-4. Epub 2015 Sep 19.) Not only can PRP treat osteoarthritis, but it can also help reduce the symptoms of common orthopedic conditions such as tendonitis, bursitis, and common elbow, shoulder and hip conditions. Thus, it is a very versatile treatment for patients suffering from multiple orthopedic maladies. Platelet Rich Plasma is easy to administer in just one simple office setting within 30 minutes and you can resume your normal activities the next day. For most patients, only one injection is required and the results normally last for just about 12 months. The risks are low because this is a therapy that comes right from your own blood and there are no known side effects other than some soreness at the injection site.

Hyaluronic Acid (HA) is a Natural Oil Change

Hyaluronic Acid (HA) has FDA approval for the treatment of osteoarthritis of the knee since the 1990’s and although it’s major mechanisms of actions are to restore the normal viscosity (thickness) of the synovial fluid of the joint and to help reduce some of the inflammatory products of the joint. The mechanism of action of this therapy is multifactored, but the easiest way to understand how this works is to consider this an oil change for your joint. Interestingly enough, hyaluronic acid can be formed into many different shapes and has been used successfully to act as a scaffold for three dimensional mesenchymal stem cell growth. The problem with hyaluronic acid treatments in the past has been the low response rate. Only 50 to 60% of the patients receiving hyaluronic injections in the knee have a positive response. This has lead some organizations such as the AAOS to rescind it’s initial recommendation of this treatment for arthritis.

Combining PRP and HA is the Best Idea Since Peanut Butter and Chocolate

Remember the ads for Reese's Peanut Butter Cups™? When peanut butter collided with chocolate and a match made in heaven was born. That image came up again when I started to read the studies on the combination of platelet rich plasma with hyaluronic acid and I thought again “a match made in heaven.”

Recent studies conducted on the combination of hyaluronic acid and platelet rich plasma together in the same joint has provided some promise as simple, cost effective and safe treatment for osteoarthritis. Researchers conducted a double blinded, placebo controlled study over a 52 week period. Patients either received a placebo, hyaluronic acid, PRP or a combination of PRP and Hyaluronic Acid injection. At the end of the study, the patients receiving the hyaluronic acid injections alone had an average increase in function and a decrease in pain by 10.9 points. The PRP patients had an increase of 15.9 points, but the combination of hyaluronic acid and PRP had an amazing increase of 23.7 points! Thus, combining the two may provide superior relief for over a year period. (Yu W, Xu P, Huang G, Liu L. Clinical therapy of hyaluronic acid combined with platelet-rich plasma for the treatment of knee osteoarthritis. Exp Ther Med. 2018;16(3):2119-2125.)

This combination may be the best value in orthopedics and regenerative medicine. Normally a 15 or 18 point improvement in these scores is a very good response for patients receiving a joint replacement and thus, this combination provides similar if not superior relief. The cost is very reasonable most treatments costing under $1,000 and many at $500. In addition, this is a very convenient, safe and virtually painless procedure and no time is required off work or sporting activities. If you are interested in the best combination therapy since peanut butter and chocolate, call for an appointment at 810-299-8552 or easily inquire online right now by clicking HERE.