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PRP is a potentially incredible treatment for subacute and chronic tendinitis and arthritis. It can help restart a healing process in a damaged tendon or ligament. PRP has also been shown to relieve pain in knee arthritis. So yes PRP is a good treatment to consider for tendinitis and arthritis. But you have to take this thinking another step further. Are there better and worse types of PRP?

Cell based treatments are still at an early stage. Some details are just emerging, other still need to be discovered. But one finding that any practitioner who uses PRP can attest to is the phenomenon among some individuals to develop significant post treatment inflammation and pain after a PRP treatment. This issue is complicated. The purpose of PRP is to create a focused and directed inflammatory process that helps to restart the normal healing cascade. By initiating this process a series of growth factors essential for repairing tissue after an injury are brought into the treated area, and over time this leads to healing of damaged tissue.

Or at least that’s the idea. What happens if you create too much inflammation? Are there inflammatory cytokines/chemicals that we do not want present in the setting of a healing process? The answer is yes, there are negative potential affects if you bring in the wrong type of cytokines. A recent article showed that certain preparations of PRP that contain too many red and white blood cells can bring in too many of the wrong chemicals.

So what do we want in our PRP solution? We want a very concentrated level of platelets to bring in the pro-healing cytokines. And we want to minimize the amount of red and white blood cells in order to minimize the catabolic, or destructive, cytokines. This is a simplified solution. In the next few years as the understanding behind cell based treatments improves, the solutions will be further refined. But currently this approach is the most logical one given the available evidence. If the PRP solution you are contemplating using doesn’t fit these guidelines, you need to ask why not.

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