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12 Questions to Ask Your Doctor About PRP

Platelet rich plasma therapy augments your body’s natural healing capacity to reduce pain and improve function after a tendon, joint, disc or ligament injury.  PRP may also reduce the pain from inflammation and osteoarthritis.

At San Diego Orthobiologics Medical Group, we use the latest in cellular biology and orthopedic clinical research to optimize your care.  We use advanced technology to harvest, process and administer PRP to maximize your results.  Because we use your own blood to stimulate healing, each treatment is unique and must be customized to your personal situation.

QUESTIONS FOR YOUR DOCTOR

Regenerative Medicine is an exciting new field that will forever change the way we treat orthopedic injuries.  Many physicians are excited to leap into this field with varying levels of knowledge and experience.

So how do you, the patient, decide if you are a good candidate for this therapy.  And who should you decide to use as your treating physician?  We suggest that you ask your doctor the following questions to help you understand your care.  Dr. Rogers has provided his responses to these questions below.

How much experience do you have treating musculoskeletal injuries?

Musculoskeletal injuries are best managed by specialists in the field of sports medicine.  These include board certified physical medicine and rehabilitation physicians (physiatrists), orthopedic surgeons, and fellowship trained sports medicine physicians.  It takes years to gain the experience and knowledge necessary to appropriately treat these kinds of injuries.

Accurate diagnosis is essential to successful treatment.  And, in many cases, it is necessary to exhaust all conventional forms of treatment before even considering PRP therapy.

Dr. Rogers graduated as chief resident of the University of Texas, Health Science Center in San Antonio, Texas Physical Medicine, and Rehabilitation program in 1997.  He completed a nonsurgical interventional spine fellowship in 1998 before joining the University of California, San Diego Orthopedic Surgery Department as an assistant clinical professor.  He has practiced nonsurgical musculoskeletal medicine in private practice since 2000 and has treated more than 80,000 people just like you.

How much experience do you have with PRP?

PRP is a relatively new technology to orthopedics and our field is learning more about it all the time.  Dr. Rogers was one of the first physicians in San Diego to use PRP for his patients in 2009.  The protocols and algorithms that he uses have been shaped by his experience and the current medical literature to produce the best results possible.  Dr. Rogers teaches PRP therapy to physicians at the Regenerative Medicine Therapy Institute, the BREG musculoskeletal ultrasound course, and The Orthobiologic Institute (TOBI) courses.

It is not a bad idea to ask your doctor how he or she stays up to date on Regenerative Medicine.  As this is a new field, most physicians did not receive any specialized training in medical school. Doctors advance their knowledge by participation in continuing medical education, reading medical journal articles or attending Regenerative Medicine conferences.  This discussion will give you an idea of the commitment your doctor has made in this emerging field.

How much experience do you have with diagnostic musculoskeletal ultrasound?

Administration of PRP with high precision and comfort leads to better outcomes and reduces the likelihood of additional expensive or risky procedures.  Diagnostic ultrasound has radically changed the practice of orthopedic medicine allowing for better diagnostics and improved comfort with office based treatments.

For more than a decade, Dr. Rogers has trained his fellow physicians in the proper use of diagnostic musculoskeletal ultrasound.  Dr. Rogers currently teaches musculoskeletal ultrasound at the BREG ultrasound courses, the American Academy of Physical Medicine and Rehabilitation workshops, and the OrthoBiologic Institute (TOBI) courses.  He utilizes the most advanced diagnostic ultrasound equipment for his patient care.

What kind of PRP will you use? 

There are many methods used to harvest, process and deliver PRP therapy.  The cost and clinical results of each method vary widely as well.  For example, the platelet concentration may range from two to fifteen times baseline in the blood depending upon which process is used.  The healing response is largely determined by the concentration and quality of the proteins released from the platelets.  Improvements in your condition may be slower or faster depending upon the method used to concentrate your platelets.

White blood cells are helpful in reducing the risk of infection and eliminating debris from a chronic injury.  They also stimulate resident cells to produce healing proteins.  However, these cells also release cytotoxic proteins and free radicals that can lead to cellular damage and a delayed healing response.  Your doctor will need to assess the risk and benefit of using white blood cells in your PRP therapy.

Nutritional status, hormonal status, exercise, medications, and supplements all influence the quality of the cells and proteins in your blood.  Prior to performing PRP therapy, we will often need to assess and modify these factors to improve your results.

What system (s) do you use to produce your PRP?

There are several commercially available products that assist in the production of PRP.  The cost of each system varies and more sophisticated systems are generally more expensive.  However, more sophisticated systems will allow your physician to customize your treatment and optimize the results.  At San Diego Orthobiologics Medical Group we use three different cell concentrating systems depending upon the goals of treatment.  Furthermore, we can measure the cell concentration which allows us to better understand why treatment results may vary from one person to the next.

Will you combine PRP therapy with any other form of therapy?

PRP often functions very well as a stand-alone treatment.  However, many times additional forms of treatment need to be performed at the same time to maximize outcomes.

How many treatments will I need?

More than 90% of our patients only require one treatment.  More challenging conditions may require additional PRP treatments or be combined with other cellular-based therapies.

Have you ever had a complication?

PRP is generally a very safe procedure.  It is certainly safer than most other orthopedic treatments and surgery.  Potential complications include pain, infection, fever, allergic reaction, swelling, tissue injury, and a failure to relieve symptoms.  At the San Diego Orthobiologic Medical Group, we have never had a significant complication with any procedure in more than 20 years.

Do I have any reason to not consider PRP therapy?

Contraindications to PRP therapy include infection, very low platelet count, fever, anemia with symptoms, or use of anti-platelet medications, anti-inflammatory medications, steroids or statin medications.

Will you combine exercise or physical therapy with my PRP therapy?

This important step is often overlooked by some medical clinics.  Exercise is crucial to expedite and maximize healing with PRP therapy.  PRP simply addresses incomplete healing of a specific tissue, whereas stretching and strengthening are necessary to restore function to the entire joint.  We have developed physical therapy protocols that you can do at home or with your therapist to allow the restoration of mobility, strength, and endurance.

How long will it take for my condition to improve after treatment with PRP?

This depends on the severity of your injury and your ability to regenerative healthy tissue.  Some people heal very quickly and others more slowly.  However, on average most people feel some significant improvement within six to eight weeks.  Healing will continue for many more months after treatment.  Many studies have demonstrated continued healing for up to a year.

What are your clinical results?

Very few medical practices track clinical outcomes.  Although there are several clinical outcome studies in the medical literature, consensus regarding the exact type of PRP to use for a specific condition does not exist.  Therefore, it is critical that each physician tracks the results of their treatment and share this information with prospective patients.  At San Diego Orthobiologics Medical Group we have been tracking our results for years.