Author – Dr. Kevin Arlett
Osteoarthritis is one of our most common diseases, unfortunately. It can range from a small ache, right through to severely debilitating pain, with joint deformities and swelling. It is often described as a “wearing out” of the joint and there is loss of cartilage in the joint, some people ending up with “bone on bone” in the joint. It can usually be diagnosed by your Doctor clinically and with a plain X-Ray.
The standard treatments include Paracetamol and other analgesics, Anti-inflammatory medications, physiotherapy, exercise, supportive garments, and relative rest. Some patients have to go on to Cortisone injections, other injections or even surgery.
However, there is a relatively new treatment available at TSMP called PRP. This stands for Platelet Rich Plasma and has an amazing effect on the majority of patients who receive it. The PRP is collected from the patient’s own blood (autologous), and is prepared in the surgery. Blood is collected from the patient, usually from one of the large veins in the elbow and then spun in a centrifuge, to separate the various components. The PRP component is then collected by the Doctor and injected into the affected joint.
There are very few side effects, but sometimes the injection can be a little bit painful, but only in a minority of patients. Sometimes patients can get a flare of their arthritis before it settles down, but this is very unusual. Paracetamol, plus or minus Codeine usually is sufficient for pain relief, if it occurs. The pain is transient and passes quickly.
The majority of patients get relief within a few days, but some patients feel better almost instantaneously. It is important to stress that this is not a cure for arthritis, but it does give good symptom control in the majority of patients that we treat at TSMP. The treatment from collection of blood, through to injection takes about 30 minutes and usually patients require either one or two injections. The benefits last for 6-12 months usually, but some patients have had lengthier control of symptoms.
It is advisable to refrain from using anti-inflammatory medications, such as Mobic, Celebrex, Naprosyn, Nurofen etc for 7-10 days prior to the injection of PRP
So, how does it work? Basically we are tricking the body into healing itself. The platelets in the PRP are the important components. They “activate” when they come in contact with the joint surface and release a number of growth factors and other hormones that would normally tell the body to mop up any blood clot and repair the tissues after an injury. However, because we are tricking the joint into thinking there is an injury, these growth factors encourage the laying down of a new cartilage layer (called fibrocartilage), which is not exactly the same as normal joint cartilage, but does a good job at covering raw areas of exposed bone and providing cushioning for the joint. There are other hormones that encourage other cells to move in and mop up any debris as well and this reduces friction even more.
PRP injection is also used in many other patients, including those with sporting injuries, both acute and chronic and this will be the subject of a later blog article.
So, if you are suffering with your arthritis and want to discuss this further, please ring and make an appointment with one of the doctors at TSMP and see if you would benefit from a PRP injection. Please remember to bring any X-Rays with you to the initial assessment appointment.
© Townsville & Suburban Medical Practice, 2015.
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