Bone and Joint Specialists E-Newsletter Archive
Rotator Cuff Healing
Enhancing Rotator Cuff Healing with Platelet Rich Plasma
by Dr. Richard Bartholomew
Platelet Rich Plasma (PRP) is an exciting new technology emerging in orthopedics and sports medicine. Injection of PRP is currently gaining widespread use in treatment of muscle, ligament, and tendon injuries. There is promising data showing quicker recovery times and stronger healing at the repair site in areas; such as lateral epicondylitis, patellar tendinopathy, ligament tears, and achilles tendinopathy to name a few. As well, there are encouraging studies and ongoing investigations into using PRP for stronger and quicker healing of the rotator cuff after arthroscopic repair.
PRP is defined as a sample of autologous blood with concentrations of platelets above baseline values. Platelets play an instrumental role in the normal healing response via local secretion of growth factors and recruitment of reparative cells. PRP is obtained from approximately 15-30cc of the patient's blood and using a centrifuge to separate RBC's, leukocytes, and platelets. With further concentration, plasma is divided into platelet-poor and platelet-rich portions. After isolation, PRP is usually administered with an activating agent such as calcium chloride and/or thrombin immediately before injection. This initiates platelet activation, clot formation, and growth factor release at the injection site. Platelets contain seven key growth factors: TGF-B, VEGF, IGF I&II, ECGF, PDFG-A&B, FGF and EGF. Several studies have demonstrated increased collagen gene expression and increased production of vascular endothelial growth factor.
This exciting technology is showing promising results with rotator cuff healing and return to activities more quickly by creating a more favorable biological environment for tendon to bone healing. Used in conjunction with minimally invasive arthroscopic techniques, we may see even better results for the more challenging large and massive rotator cuff tears as well as revision repairs.
Again, I thank you for your continued support. I look forward to continuing to provide our patients with the most technological advances in minimally invasive shoulder and knee surgery.
Richard S. Bartholomew, D.O.
Sub-specializing in Shoulder and Knee Surgery
Dr. Bartholomew treats painful shoulder conditions such as bursitis, tendonitis, calcium deposition, advanced arthritis, rotator cuff tears and frozen shoulder.
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