PRP and PRF
FAQ:
What is PRP/PRF
Platelet Rich Plasma and Platelet Rich Fibrin are treatments which involves drawing your blood, separating the platelets and plasma from the red blood cells. The platelets are cell fragments that are involved in healing and repair.
PRP and PRF treatments that involve concentrating the platelets and injecting them in tissues, such as joints, ligaments, and tendons.
The platelets have potent growth and healing factors that help alleviate pain and inflammation associated with the conditions such as tendonitis, arthritis, and injuries.
The platelets are capable of promoting healing, reducing pain and inflammation, and improving function a musculoskeletal concerns.
You don’t need to know this, but these are the known growth factors of PRF/PRP
PDGF (platelet derived growth factor) stimulates cell growth and promotes cells such as stem cells into the region.
TGF (transforming growth factor) controller of inflammation, growth of tissue and helps stem cells transform into mature tissue specific cells.
VEGF (vascular endothelial growth factor) promotes healing of damaged tissues, growth of blood vessels, and also promotes new cells into the area.
What is the difference between PRP and PRF?
PRP, or platelet rich plasma is the legacy form of platelets. In many cases the platelets are inactivated and may not able to release as many growth factors as with PRF.
PRF is a more advanced form of platelet rich plasma. PRF preserves the growth factors of platelets, and does not involve any additives. PRF is more potent and lasts longer than PRP.
At Allure Medical we only use PRF. We may interchange the words PRP and PRF but our FDA approved devices make PRF, and we have always used PRF (again, referring to it as the more generic term “PRP”).
Is PRP and PRF FDA approved?
No the FDA does not consider PRP or PRF to be a drug so they are not regulated. The FDA does regulate the machines that create the PRP or PRF. At allure medical we use FDA approved devices to create PRF.
When was PRP and PRF discovered?
PRP was first described about 70 years ago, but most of the published literature regarding PRP and PRF for arthritis and musculoskeletal conditions has been in the last 10 years.
At Allure Medical we began using PRP in 2011. Doctor Mok was our first patient who had a torn subscapularis tendon (70% torn) and was scheduled for a rotator cuff surgery. He bought the equipment to do PRP it had an orthopedic doctor inject PRP into his tendon 2 times in a two-month period which led to 100% resolution of the torn rotator cuff. He has had no problems with that rotator cuff in the years since that time.
How effective is PRP and PRF for orthopedic conditions?
For arthritic pain, particularly of large joints such as the knees and hips, the majority of patients will experience reduction in pain and improvement in function with a series of PRP or PRF injections. There are factors such as severity of arthritis, joint deformities, and other medical conditions that can lead to variations into success rate. To achieve a high success of pain reduction for arthritis, typically three sessions about a month apart are scheduled.
The statement “majority of patients will experience reduction in pain” is vague. Studies have shown between 60-90% of people respond, but this is based on studies over a 15 year time span, with various protocols. Currently we expect that over 80% of properly screened and treated patients will experience greater than 50% reduction in discomfort. Some people with more advanced disease may then opt for other regenerative treatments such as a nanofat or Wharton’s jelly (stem cell) based therapy to improve outcomes.
For ligament injuries such as rotator cuff injuries and tendonitis these treatments are highly effective in reducing discomfort reducing the size of tears improving function and in many cases resolving torn tendons. There may be cases where PRP is not likely to be effective and your medical provider can help you determine the likelihood of success.
How long do PRP and PRF treatments last?
After a series of PRP/PRF treatments results are expected to last 6 months to 2 years. The injections can be done as soon as every week to every month and in most cases will involve a series of three sessions. Doing less than three sessions would be expected to give you a shorter duration of results and less robust results.
Is PRP or PRF covered by insurance?
No, there is no medical insurance coverage for these services.
Is there any guarantee of success?
Results are guaranteed. If at the 9 months from initiating treatment the pain is not less than the starting point, the patient can receive an additional treatment at no cost of PRF. If the patient does not notice an additional benefit, they are referred for surgical evaluation, and not recommended to continue the membership. The guarantee only applies if the treatment performed aligns with the primary treatment recommended by your provider.
What is the cost for PRF?
We offer a range of flexible packages designed to help you reach your goals—including our popular Peak Performance packages. To ensure you get the most current pricing and access our latest specials, we invite you to schedule a free consultation. Our team will walk you through your options and recommend the best package for your needs. Contact us today to get started!
For multiple joints, a custom quote will be offered.
What other treatments are commonly offered with PRF?
Cross linked Hyaluronan (HA)with mannitol. This is generally only needed on the first session and acts as a scaffolding and lubricant. It can be done on additional sessions, but it generally will give relief for about 12 months after one session. The cross linked hyaluronan is a different product than typical joint injection due to the cross linking delaying breakdown of the HA from days (normal HA’s) to 9-12 months.
Stem cell and Cellular Therapy
While PRP/PRF are cellular fragments used in regenerative medicine, other cellular techniques have been used to restore or improve function and reduce symptoms associated with degeneration.
Adipose Derived Stem Cells (ADSC), Stromal Vascular Fraction (SVF), and Nano fat have all been investigated in the treatment of conditions such as degenerative joint disease.
What these three cellular therapies have in common is the presence of mesenchymal stem cells (MSC’s), an abundant supply in our body, And extensive clinical research.
Nano fat is obtained through a standard liposuction procedure and the fat is processed in such a way that the mature fat cells are disrupted and tiny cells such as stem cells and vascular stromal cells, as well as various growth factors remain intact.
For a nano fat procedure, the best example is the FDA cleared Lipogems® system which has been used in over 50,000 orthopedic procedures. There are numerous other systems that work in a similar fashion. While this is not called a stem cell procedure, clinical studies have shown that it is the stem cells and other growth factors that account for the success of the procedure.
SVF is a very common type of stem cell procedure which involves obtaining fat through liposuction and separating the stromal vascular fraction (SVF) which is rich in mesenchymal stem cells.
There are laboratories in the United states that are inspected by the FDA that take fat obtained through liposuction, separate out the mesenchymal stem cells and expand them (ie grow them). These labs then bank these cells for later use as determined by you and your physician.
Wharton’s Jelly is a birth product from donated placentas. This may commonly be referred to as umbilical stem cells, but it really is a tissue product that is rich in stem cells but also has other factors. There is extensive literature on the use of this tissue in regenerative medicine.
Exosomes are obtained from birth products and are commonly confused with stem cells. The idea is that the exosomes carry the important messaging signals from mesenchymal stem cells. The clinical data on exosomes to treat degenerative arthritis is generally lacking at this time.
Bone marrow derived stem cells are harvested generally from the hip bone and have been used in regenerative medicine as well. While bone marrow derived stem cells may work similar to fat derived tissue we choose not to use it because other options are more comfortable and we have extensive experience with obtaining fat.
Dr. Charles Mok, D.O.
Kenny Lofton Regenerative Medicine Journey
