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Biological therapies are techniques for treating injuries, and wear and tear of joints, using the natural healing constituents of the patient’s own blood. Current and emerging biological approaches include the use of growth factors, platelet-rich plasma, and stem cell therapy.
The body usually repairs injured tissues rapidly and automatically. However, what seems to be a common, routine process is actually a very complex series of events. Numerous growth factors and cells are deployed and activated by the body in a carefully orchestrated sequence to bring about healing. Biologic therapy aims to reproduce and accelerate the healing process by taking these critical factors and injecting them directly into the injured region to stimulate a more rapid healing response.
Platelet rich plasma (PRP) is one form of biological therapy. More than 300 critical growth factors involved in healing are packaged within the platelets, which circulate normally in the blood. PRP is a preparation of blood which has been enriched for platelets, and is prepared entirely from a person’s own blood; no artificial chemicals or drugs are involved. Approximately 15mls of blood is drawn and the white and red blood cells are removed, leaving a high concentration of platelets in plasma.
Biologics have been used to treat a wide variety of conditions including tennis elbow, Achilles tendon and rotator cuff tendonitis, acute ligament tears, and arthritic joints. Many professional sportsmen have claimed that biologics have helped their injuries to heal and allowed them to return to sport faster. Biologics are also used in the surgical reconstruction of damaged joints in order to increase the speed and efficiency of post-operative healing.
A number of growth factors have been shown to have positive effects on tissue healing in laboratory studies. However, clinical trials using different PRP formulations for a range of sports injuries have so far yielded conflicting results. A number of papers suggesting efficacy have been published in the orthopaedic and sports science journals, but they comprise small cohorts of patients. Further evidence is needed to be sure that biologics are as effective as many claim. One of the principal limitations of the current literature is that a wide variety of different biologic preparations are being reported, and it remains unclear what the optimal constituents of any biologic preparation should be for any given condition.
The risks of biological therapy appear to be very low. No ‘foreign’ substances or drugs are used. Everything that is injected has come from your own body. As for any injection, the most important risk is the possibility of introducing infection from the skin surface at the time of injection. It is also important to appreciate that the treatment may simply not being as effective as hoped.
The consultant surgeons at Joint Solutions are actively involved in the scientific development of biologic therapies. Our principal interest is in establishing the most effective formulations of PRP (in terms of cells and growth factors) for specific indications and we collaborate with international experts in biological therapies. We aim to provide this service responsibly to those who want it, whilst maintaining rigorous scientific oversight. As a standard part of your treatment, we will analyse a small sample of the PRP preparation in our laboratories to monitor what we are injecting, and we will ask you to complete questionnaires to establish how effective the treatment has been.
Biologics are an exciting new treatment for musculoskeletal injuries. Whilst more evidence is needed to establish how they can be used to best effect, good results have been reported by many centres. There appears to be very low risk. We can offer you expert treatment that we hope will not only improve your condition, but will also help to increase scientific understanding of biological therapies for future generations.