FAQ in Stem Cell and PRP Treatment
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What are the Potential Benefits of Treatment?
Patients can see a significant improvement in symptoms. This may eliminate the need for more aggressive treatments such as long term medication or surgery, as well as a remarkable return of function.
How many PRP treatments & How often is this therapy?
While responses to treatment vary, most people will require 3-6 sets of injections. Each set of treatments is spaced approximately 4 weeks apart. There is no limit to the number of treatments you can have. The risks and side effects do not change with the number of injections.
Is PRP right for me?
If you have a tendon or ligament injury and traditional methods have not provided relief, then PRP therapy may be the solution. The procedure is less aggressive and less expensive than surgery. It will heal tissue with minimal or no scarring and alleviates further degeneration of the tissues. There will be an initial evaluation with the doctor to see if PRP therapy is right for you.
Are there any special instructions?
You are restricted from the use of non-steroidal anti-inflammatory medications (NSAIDs) one week prior to the procedure and throughout the course of treatments.
Initially the procedure may cause some localized soreness and discomfort. Most patients only require some extra-strength Tylenol to help with the pain. Ice may be applied to the area as needed.
The first week after the procedure, patients will continue their home or physical therapy program.
How soon can I go back to regular physical activities?
PRP therapy helps regenerate tendons and ligaments but it is not a quick fix. This therapy is stimulating the growth and repair of tendons and ligaments requiring time and rehabilitation. Through regular visits, the doctor will determine when you are able to resume regular physical activities.
What types of problems can be treated?
Fractures that have failed to heal, joint cartilage problems, partial tears of tendons, muscles, or ligaments, chronic bursitis, avascular necrosis of the bone, and disc bulges.
What body areas have you treated?
Knee, hip, shoulder, ankle, hand, foot, neck and lower back.
What is the success rate? How many people respond? What is the cure rate?
Approximately 86% of the patients who responded said that they were satisfied with their treatment and would do it again. More detailed data from early patients is being collected. The following is in knee and hip patients with severe arthritis who were told they needed a joint replacement surgery:
-89% of knee patients reported more than 50% relief of symptoms and more than half of them had greater than 75% relief.
-75% of hip patients reported more than 50% relief and 88% of them reported more than 75% relief.
Will enough stem cells be obtained or should the stem cells be cultured in a lab?
- Culturing stem cells in a lab can dramatically reduce their effectiveness and there is strong evidence that culturing the cells can change its genetic make-up, possibly resulting in tumors. Also, culturing the cells makes the patient miss out on various growth factors and multipotential cells that are invaluable in the regeneration process.
- By utilizing fat mesenchymal stem cells, we are greatly increasing the stem cells injected into the area. Our abdominal fat is one of the richest sources of stem cells in the body. Plastic surgery taught us this trick years ago.
- HGH and the supplements that we use can dramatically increase stem cell production which results in more stem cells going to the area in need of regeneration.
Will the stem cells possibly act like a tumor?
There have been no reported cases of autogenous (the patient’s own) stem cells causing any types of tumors as long as the cells have not been reproduced outside of the body.
Who is not a candidate for stem cells or PRP injections?
- Patients with active cancers and/or infections.
- If bone marrow stems cells are to be utilized and a patient had a history of a bone marrow derived type of cancer (i.e. lymphoma), this would be considered a relative contra-indication. However, many times those patients can utilize PRP injections and fat stem cells, but the ultimate decision maker should be their oncologist.
- Patients taking Plavix. Plavix seems to have a detrimental effect on the platelets making them less likely to release their growth factors and signaling proteins. The use of Coumadine is ok, but if possible we would like its use suspended for a few days prior to the fat cells harvest and stem cell harvest.
- Anyone who consistently uses NSAIDs, we require their suspension a few days before the injection and 1-3 months afterwards.
Is a bone marrow draw painful?
Because we extensively numb the area, patients say that the marrow draw was not painful and would do it again.
How long does a marrow draw take?
The total procedure may take up to 1 ½ to two hours.
What are some Questions to ask a Clinic that Professes that they use Stem Cells in their Office?
There are a number of clinics including some in the South Florida area that profess that they are using bone marrow and fat stem cells. They call this an exciting new technique. THIS WAS A NEW TECHNIQUE TO US A FEW YEARS AGO AND A FEW THOUSAND PATIENTS AGO. They are using a fat tissue graft that we have been using on our cases for many years. The question to ask is if they are actually extracting the fat stem cells from the fat tissue thus producing what is called Stromal Vascular Fraction (SVF) or fat stem cells. The chances are they will only be injecting fat tissue into the area and hoping that some of the fat stem cells may be released. Certainly this is better than just performing a PRP injection but it is certainly not cutting edge. Unfortunately, most of these fat stem cells cannot be released from the fat tissue. They remain quiescent and quietly die We will typically extract the stem cells from 60cc’s of fat producing 1-2cc’s of fat stem cells typically equaling 75-150 million cells .These other clinics are lucky if they get a hundred thousand or so fat stem cells. When these clinics are pressed they will admit that they are not extracting fat stem cells. Our process is a properity method to extract fat stem cells from fat. It is used in a hand full of clinics in the United States.
Ask these clinics what they give their patients to help boost the number of stem cells that the body produces and what PRESCRIPTION drugs and supplements they use to increase stem cell production and help stabilize and increase cartilage production. Are they using medications that address not only stem cell production but are they considering the underlying bone (called sub-chondral) problems in the joint. Typically the bone problems in a joint need to be addressed in order achieve a higher degree of success. Chances are they will have no idea what you are talking about.
Ask these clinics how familiar they are with extracting bone marrow stem cells in their office. Have they done large numbers of these cases? Do they go to the expense of using very expensive kits designed to separate the bone marrow stem cells from the bone marrow aspirate? Do they use fluoroscopy to help pinpoint the area to extract the bone marrow aspirate? Do they use fluoroscopy to inject certain joints such as the hip which is difficult to inject with ultrasound (we do use ultrasound on many different cases)?
Ask these clinics which profess to use “sterile” conditions to process the cells how they insure sterility. Many clinics use semi sterile techniques to obtain the cells but it ends there.
Do they make use of Laminar Flow Hoods to Maintain Strict Sterile Environments?
Although these hoods are very expensive and time consuming to use they are mandatory if one is to maintain strict sterile conditions. Are their technicians certified in sterile technique and preparation of the cells? Does the clinic follow GMP (good manufacturing practices) parameters? Are the components used produced in the United States or meet United States standards?
Ask these clinics if their personal have taught courses on these various techniques to other physicians. We have had physicians from five different continents (North and South America, Europe, Asia, and Australia) visit our clinic in the last year to learn our techniques. They are interested in our use of both stem cells and our unique way of performing PRP injections. Due to our pioneering techniques we were asked to collaborate and have subsequently signed joint ventures with physicians from India where we are in the process of setting up a series of stem cell clinics. We have also become involved with physicians from the Dominican Republic who have sought us out due to our expertise.
Furthermore ask other clinics where their physicians have been invited to give formal lectures to a large number of physicians at professional meetings that are sponsored by recognized medical organizations? In the last year Dr. Purita has been invited to give lectures to physicians at ten different scientific meetings throughout the world. Presenting to one’s peers at a scientific meeting is much different than giving a five minute interview on a local TV station. Ask them if in addition to the physicians if their technicians have lectured on these topics (our technicians have lectured both nationally and internationally).
When these questions are asked one will then be able to see what separates our institute from these other clinics trying to perform similar procedures.