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Evolving Treatment Strategy for Chronic Inflammation of the Extremities

Overuse and injury to muscles, ligaments, bursas and tendons occurs frequently in individuals of all ages and professions. Symptoms may disappear over several days or weeks, usually with rest, ice, Tylenol or Advil. However many of these common problems persist, significantly compromising activities and quality of life.

Over time chronic inflammation can cause permanent changes within the muscles, ligaments, bursa or tendons of the extremities. These problems are known as myalgias, sprains of ligaments, bursitis and tendonitis. Treatments include medications, injections, physical therapy, bracing, and surgery. Recovery can often be prolonged and frustrating.

Recently, a promising non-surgical treatment for chronic inflammations and injuries has been developed using ones own blood. This treatment gained notoriety when Troy Palamalu and Hines Ward of the Pittsburgh Steelers underwent treatment using their own blood–called platelet-rich plasma–during the 2008 NFL season to win the 2009 Super Bowl.

Platelet-rich plasma therapy is a non-surgical procedure that uses the body’s cells to heal itself. Platelets are small white cells found in blood that help to coagulate blood when active bleeding occurs in tissue following injury. Platelets have high concentrations of growth factors that stimulate multi-potential cells that can heal tissues over a period of time.  Instead of harvesting stem cells from bone marrow, platelets are harvested and concentrated from blood and have high concentrations of growth factors. The response of each patient’s
tissue to growth factors is variable and dependent on the type of injury or inflammation being treated.

This procedure takes less than twenty minutes and can be performed in the office or in the recovery area of a surgery center. 10 mls (2 tablespoons) of blood is drawn and placed into a centrifuge for 5 minutes to separate the red cells from the serum. During this time the recipient site is injected with local anesthetics. At the completion of the centrifuging, 4-5 mls of plasma is harvested that is rich in platelets and high concentrations of growth factors. This then is injected in to the patient’s prepared site.

Post-operative soreness, swelling and pain with activity are generally minimal and short-lived. There is little down time, though physical activities are modified, physical therapy employed and (at times) temporary bracing instituted. Healing is dependent on the injury treated and is usually 12 weeks.

This evolving non-surgical technique has been very effective in the treatment of chronic tendonitis of the elbow (tennis and golfers elbow), knee (jumpers or runners knee) and heel spur syndromes (plantar fasciitis and spurs) to name a few. Current research and trials are ongoing and additional sites for use pending.

Platelet-rich plasma therapy is a very promising modality for use in the common problems and injures of athletes and non-athletes alike.

Dr. Jon McLennan specializes in Orthopaedic Surgery and Sports Medicine and is located at JFK Orthopedics in La Quinta. Dr. McLennan can be reached at 760.777.8282.

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