PRP (Platelet Rich Plasma) is a new treatment method. It is a promising solution which can naturally accelerate the healing of musculoskeletal system injuries and diseases without imposing a serious risk. Blood is composed of red blood cells, white blood cells, plasma and platelet. Platelets are generally known to be responsible for the blood clotting (coagulation). We have known for thirty years that platelets secrete healing proteins named as growth factors when they are activated. Growth factors in a well-prepared composition heal and regenerate the tissues. Besides, they activate “silent local stem cells”. From this point of view, by increasing the concentration of platelets in our blood, we can obtain a strong cocktail of growth factors which expedite the tissue healing dramatically. Platelets are gathered by processing the blood through various stages. Gathered platelets are separated from other parts, and PRP is derived. While normal blood includes 150,000-400,000 platelets per milliliter, this number rises over 1 million in PRP. PRP’s philosophy is to combine the natural healing capability availability within the body itself and advanced technology. Concentrated platelets have high dose bioactive proteins such as growth factors which are essential for the reparation and regeneration of tissues. Quality of PRP depends on the survival capability of platelets. PRP should be prepared and administered by a team of specialists. Because it is vital to keep the liveliness of platelets in the preparation process. Otherwise, platelets which lose their liveliness cannot be activated. In the same manner, if PRP isn’t prepared appropriately, platelets become activated early, and their growth factors may be lost even in the preparation stage. Regenerated cells and tissues need to adapt the three-dimensional organization and compose an extracellular matrix. This may require a structural support in a shape of scaffold which can resorb. We can resemble this scaffold to a ready-made wax comb installed into hives. Bees put nectar they collect from flowers in the honeycombs, and thus, they accomplish the three-dimensional organization. Cells that are obtained from the person’s own fat and bone marrow can be separated and used as a scaffold.
Diseases which PRP is effective
- Osteoarthritis: Knee, shoulder, hip, neck and low back.
- Shoulder pains: Rotator cuff tears
- Chronic plantar fasciitis (with or without heel spur)
- Anterior cruciate ligament injuries
- Pelvic pain and instability
- Neck and low back pains
- Tennis and golfer’s elbow
- Ankle sprain
- Ligament sprains
- Torn meniscus
- Muscle rheumatism
- Cosmetic applications: Wrinkles and hair loss
How PRP works?
Our body’s immediate response to soft tissue damage is to call platelets. Platelets loaded with growth and healing factors start to pull the reparative elements and stem cells to the damaged region. At the same time, they increase the blood buildup in this region by supporting the forming of new veins. Blood buildup means that that damaged region is nourished better and harmful residues are discarded. PRP’s another interesting property is that it is a highly balanced growth factor cocktail. Almost all the required factors are provided with PRP.
How frequent is PRP used? When does it start to be effective?
In general, PRP is injected 3 times with 2 or 3-week intervals during a 6-month period. A complete recovery can usually be achieved after the first or second injection. PRP treatment is not a temporary solution that is immediately effective. Regeneration and reparation of injured tissues would take some time. In order to expedite the tissue recovery after the treatment, patient may receive physical therapy. Since the goal of PRP treatment is to heal the tissues and relieve the pain, it may take a long time to accomplish the desired results. First signs of recovery may be experienced in a couple of weeks, and recovery increasingly continues over time. After the first implementation, PRP injections may be repeated every six or twelve months.
Side effects of PRP is little, if any. As injecting PRP involves using a person's own platelets, they do not usually experience any adverse reactions to the injections. There is no infection risk, and allergic reaction probability is very low.
CGF (Concentrated Growth Factor)
CGF is derived by concentrating growth factors (GFs). GFs are the proteins which regulates the injury recovery. They play the main role in cell migration, cell reproduction and vein forming in the tissue regeneration phase. GFs are found mainly in blood plasma and platelets. They are used in tissue regeneration and repair.
Cells that form the organism differ from one another in terms of dividing, multiplying and growing. Some cells keep themselves “silent” to divide when simulated with appropriate signals. Cells that can be divided for a long time in a living body, can renew themselves and at the same time can differentiate based on a need to convert to other tissue cells are named “stem cells”. Stem cells can transform from a single cell to more than one cell line and can restructure a tissue functionally.
Stem Cell Types
Stem cells obtained from one tissue have been demonstrated to have the capability to transform to different tissue cells with appropriate stimulations. Embryonic stem cells are the first cells in the fertilization process and they have the potential to transform to all other cells in the body. These cells can differentiate to all other cell types which can form a living thing who is fully functional. Besides, adult stem cells are found in small numbers in most adult tissues, such as bone marrow or fat. These cells can produce the cell type in the tissue where they are located. Compared with embryonic stem cells, adult stem cells are seen in the later stages of development, and they can regenerate themselves throughout the life, though they have more limited ability. They have the ability to differentiate to the undifferentiated cell and specialized cells in adult tissues. Adult stem cells which can differentiate to a few cell types in the organism can be differentiated to many different cell types when necessary environment and signals are provided in laboratory conditions. In a normal physiological condition, adult stem cells can stay in “silent period” for a long time. When they leave this silent period, depending on the stimulant signals that are received from internal and external sources, they can regenerate themselves or transform to undifferentiated cells. It was reported that pluripotent stem cells derived from fat tissue has almost the same capability to differentiate as the stem cells derived from bone marrow.
In adults, there are adult stem cells in many organs and tissues. Proportion of CD34 stem cells are less in our circulating blood as compared to the bone marrow and belly fat. In comparison to the peripheric blood, 100 times more stem cells are available in the bone marrow, and 600 times more stem cells are available in the belly fat. CD34 stem cells have the potential to form bone, cartilage, nerve and epithelial cells.
How is PRP, CGF and CD34 Stem Cell derived?
40-80 ml of blood drawn from the patient is derived by being centrifuged in a special four-cycle centrifuge. In our center, PRP, CGF and stem cells are prepared in a microbiological safe cabin with HEPA filter and laminar air flow, which has high environmental and product standards and is compliant with asepsis and antisepsis principles. They can be derived in the same day when your blood is taken. The implementation process is completed in almost one hour. Materials which are retrieved from the bone marrow are also prepared by using the similar procedures. Naturally, more effective results are expected from these cells.
Diseases which PRP, CGF and Stem Cells are used for:
- All degenerative and inflammatory joint diseases
- Cartilage, tendon, meniscus, ligament and bone lesions
- Musculoskeletal disorders
- Diabetes Mellitus treatment
- Cardiovascular diseases
- Central nerve system diseases such as Parkinson’s disease and Alzheimer
- Spinal cord injuries
- Cosmetic applications
- Hair loss
- Removing scars
Nevertheless, use of stem cells in many diseases are in an experimental stage or limited to cases.