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View Full Version : New Treatment (in USA) Available Soon


swatsurgeon
04-24-2011, 13:01
I have the good fortune of being an experiment for my trauma orthopedic surgeon.
I tore several tendons in my right elbow several years ago, did the standard: PT then 2 cortisone injections then a very long and difficult surgery reattaching several tendon and rebuilding part of the annulus of the radius...long story short, it was FUBAR'ed, acute on chronic injuries. The post op recovery kept me out of surgery for 2 months, rehab sucked and now it works fine but if re-injured, we've burned the bridges and would need cadaver parts to rebuild it.
So recently the left elbow has the same thing....lucky me. My new ortho out here in PHX, shows me a European Journal article about a non-FDA approved treatment with a 90% success rate of avoiding operative repair at 1 year!! The US literature has about a 40% success rate for avoiding surgery, so I was interested to say the least. The process is to take 30mL of your blood, spin it down to separate the components, take the platelet rich plasma off and inject that (about 4 mL) into the injured area.....OH MY GOODNESS PAIN (10:10) despite lidocaine before the injection....a blow torch sensation was about right....2 days of torture then it settles down to a 5:10 pain which is baseline for me recently. Can't take antiinflammatories because the
injection is meant to inflame and heal the injuries....Platelet derived growth factors and ? stem cells?? like reaction in the joint. The nice thing is that it should be FDA approved by summer and available for all joint areas....very expensive but high probability of avoiding surgery = a deal for me.

So wear the brace and limit motion for a month...no stressing the joint, but can use the arm, just no lifting, etc and the injected joint is still swollen and limited with range of motion. By 3 months you generally know if it worked.
Hopefully, if it does work, it will be available to fix severely injured joints/tendon lacerations, detachments/bursitis, chronic inflammation,etc.

Will post updates as they occur. I love being an experiment!!:boohoo:lifter:munchin

ss

PedOncoDoc
04-24-2011, 13:53
I have the good fortune of being an experiment for my trauma orthopedic surgeon.
I tore several tendons in my right elbow several years ago, did the standard: PT then 2 cortisone injections then a very long and difficult surgery reattaching several tendon and rebuilding part of the annulus of the radius...long story short, it was FUBAR'ed, acute on chronic injuries. The post op recovery kept me out of surgery for 2 months, rehab sucked and now it works fine but if re-injured, we've burned the bridges and would need cadaver parts to rebuild it.
So recently the left elbow has the same thing....lucky me. My new ortho out here in PHX, shows me a European Journal article about a non-FDA approved treatment with a 90% success rate of avoiding operative repair at 1 year!! The US literature has about a 40% success rate for avoiding surgery, so I was interested to say the least. The process is to take 30mL of your blood, spin it down to separate the components, take the platelet rich plasma off and inject that (about 4 mL) into the injured area.....OH MY GOODNESS PAIN (10:10) despite lidocaine before the injection....a blow torch sensation was about right....2 days of torture then it settles down to a 5:10 pain which is baseline for me recently. Can't take antiinflammatories because the
injection is meant to inflame and heal the injuries....Platelet derived growth factors and ? stem cells?? like reaction in the joint. The nice thing is that it should be FDA approved by summer and available for all joint areas....very expensive but high probability of avoiding surgery = a deal for me.

So wear the brace and limit motion for a month...no stressing the joint, but can use the arm, just no lifting, etc and the injected joint is still swollen and limited with range of motion. By 3 months you generally know if it worked.
Hopefully, if it does work, it will be available to fix severely injured joints/tendon lacerations, detachments/bursitis, chronic inflammation,etc.

Will post updates as they occur. I love being an experiment!!:boohoo:lifter:munchin

ss

Hopefully this works well for you.

Growth factors and cytokines yes; stem cells, no. Those are in the buffy coat with the white and other nucleated cels.

Looking forward to your follow up.

Red Flag 1
04-24-2011, 17:34
I wish you the best SS. I'm wondering if the pH of the injectate was altered enough to make the Lidocaine useless?? I also wonder if this will cause and adhesive changes in the joint, or change the surgical approach should that be down the road for you? I hope that this does not keep you out of the OR for too long. Keep us posted, this is really interesting.

RF 1

Peregrino
04-24-2011, 20:50
I wish you well. I'm also shaking my head in disbelief. 22 years ago I watched a veterinarian inject a horse with (its own) blood extracted from a neck vein for exactly the same reason - to excite inflamation and "trick" the body into accelerating the healing process. When I questioned her (that's really why I was there :p) she quoted an English Equine Vet manual from the 1880's (lot's of strange things in that one - wish I could remember the name but she had an American reprint from the 20's IIRC that she showed me). No centrifuge involved - it was whole blood - but remarkably similar in method and purpose. Fascinating that it's now available from Europe for humans.

PedOncoDoc
04-24-2011, 21:19
I wish you well. I'm also shaking my head in disbelief. 22 years ago I watched a veterinarian inject a horse with (its own) blood extracted from a neck vein for exactly the same reason - to excite inflamation and "trick" the body into accelerating the healing process. When I questioned her (that's really why I was there :p) she quoted an English Equine Vet manual from the 1880's (lot's of strange things in that one - wish I could remember the name but she had an American reprint from the 20's IIRC that she showed me). No centrifuge involved - it was whole blood - but remarkably similar in method and purpose. Fascinating that it's now available from Europe for humans.

I believe they are doing whole blood injections for, among other things, cosmetic procedures as an alternative for Botox now.

wandering_idiot
04-25-2011, 01:22
If you could take a guess about how it would work with osteoarthritis of the spine and DDD, I'd like to hear more about this procedure.

Gypsy
04-25-2011, 18:22
Best wishes on your recovery, swatsurgeon. I hope this works out for you!

Red Flag 1
04-25-2011, 18:36
I believe they are doing whole blood injections for, among other things, cosmetic procedures as an alternative for Botox now.

We have been doing this for decades to treat post dural puncture headaches, aka spinal headaches. 30 ml of the patients blood injected into the epidural space at the site of the dural puncture. I've not seen one fail if the diagnosis is correct.

RF 1

The Reaper
04-25-2011, 19:53
We have been doing this for decades to treat post dural puncture headaches, aka spinal headaches. 30 ml of the patients blood injected into the epidural space at the site of the dural puncture. I've not seen one fail if the diagnosis is correct.

RF 1

Isn't that commonly called a blood patch?

TR

swatsurgeon
04-26-2011, 21:33
yes, that is a standard blood patch, what I had was just the platelets in serum.
This type of technology has been used in spine surgery...when I was doing the anterior exposures of the spine for a neurosurgeon, he would routinely aspirate bone marrow and mix it with autologous bone and pack it into the fusion area for a better /faster fusion around the implanted device.
Injecting it into a working joint for osteoarthritis may cause fibrosis, but I'm not an expert in this field. My use is to fibrose the torn tensons in the hopes of avoiding surgical repair.

ss

orion5
04-27-2011, 00:54
So wear the brace and limit motion for a month...no stressing the joint, but can use the arm, just no lifting, etc and the injected joint is still swollen and limited with range of motion. By 3 months you generally know if it worked.

All the best to you, ss.....I'm sure you'll make a fine, overachieving guinea pig. ;)

So what kind of desk jockeying (online shopping for more knives) do you have to look forward to as you "limit motion for a month"? Or will you still be somewhat functional since you are right-handed...

swatsurgeon
04-27-2011, 16:49
learn to overcome.....and achieve the stated objective, demonstrate leadership, teamwork, creativity, and buy more knives!!

ss

Boomer-61
04-28-2011, 07:29
SS,
The Physiatrists at our practice have been using the process for about 8 months with varying success. This is totally anecdotal. Their most successful pt's seem to be the ones that have been the least injured. I.e. the tendonitis, bursitis seem to do well whereas the more traumatized the tissue the less likely it is to help. Unfortunately I don't have any numbers for you and am not sure if and or when they will publish their results. I do know that in my foot and ankle clinic we seem to get the failures for plantar fasciitis and achilles tendonitis. A surgeon with upper extremity issues can be in a bad way. I wish you all the best. If I hear of any consistantly successful protocols I will get them to you. Good luck.

swatsurgeon
05-11-2011, 16:02
update time....
it's been 3 weeks since injection and significantly limiting use and range of motion. Some days it feels better and some days it hurts. The information we read about is that you need to give it 30 days of little/no use and 2 months of limited use and then you see whether or not it worked.
I can now say I have experienced, from this, the entire pain scale range of 10 out of 10 to a 1 out of 10. The last week it's about a 3:10 whereas the first 2 days it was a 10:10, a blow torch on the elbow is the best description i can use.
I was hoping for more constant relief by now (I still get flairs of pain to 6-7:10 in the joint) but time will tell. I'm not ready to tell everyone to go get this done for tendon injuries but after the 3 month mark, I'll let everyone know if it's a success or a way to delay surgery.

ss:munchin

Boomer-61
05-12-2011, 11:28
Thanks for the update. Wish the news were better but, the verdict is still out....

Gypsy
05-12-2011, 19:34
Continued prayers for a successful treatment outcome, ss.

tom kelly
05-17-2011, 08:28
Doctor, I hope you are back in the OR at 100% and better than you ever were...Regard's, tom kelly

greenberetTFS
05-17-2011, 08:45
Doctor, I hope you are back in the OR at 100% and better than you ever were...Regard's, tom kelly

Same here SS...........:D;)

Big TEddy :munchin

Shadow1911
05-17-2011, 08:51
Same here Doc, Best wishes for a complete recovery.

swatsurgeon
07-11-2011, 10:52
10 week update........

as though a switch was flipped, about 3 weeks ago, I was going about a normal day at the hospital, was in the operating room and went to move an O.R. light and without realizing it, did it with my left arm....the bad one. After I moved the light I consciously remembered that I should not have used that arm; but there was no pain to remind me!!
I had no pain with activities that had hurt it for so long.....it appears that the PRP Rx worked for me....about 100%. I am amazed that I can use it without pain and feel 'back to normal'. As advertised, this treatment may not work for all injuries (tendon, ligament, torn muscle, etc) but whether it is luck or fate, it worked for me. I haven't heard if the FDA has officially approved it yet so that insurance companies will pony up the tab but hopefully it will be approved. I'm a believer. My orthopod was correct that it takes up to 3 months....I was beginning to doubt it's ability to heal me at the 8 week mark, but patience paid off and it just happened. Was frustrated a lot on the course because of the continued pain but for 3 weeks it has been a pleasure.:D

I will try to find if the FDA has approved this but it is now something I would recommend under certain circumstances/specific injuries to avoid surgery.:lifter:lifter

ss

Dusty
07-11-2011, 11:04
10 week update........

as though a switch was flipped, about 3 weeks ago, I was going about a normal day at the hospital, was in the operating room and went to move an O.R. light and without realizing it, did it with my left arm....the bad one. After I moved the light I consciously remembered that I should not have used that arm; but there was no pain to remind me!!
I had no pain with activities that had hurt it for so long.....it appears that the PRP Rx worked for me....about 100%. I am amazed that I can use it without pain and feel 'back to normal'. As advertised, this treatment may not work for all injuries (tendon, ligament, torn muscle, etc) but whether it is luck or fate, it worked for me. I haven't heard if the FDA has officially approved it yet so that insurance companies will pony up the tab but hopefully it will be approved. I'm a believer. My orthopod was correct that it takes up to 3 months....I was beginning to doubt it's ability to heal me at the 8 week mark, but patience paid off and it just happened. Was frustrated a lot on the course because of the continued pain but for 3 weeks it has been a pleasure.:D

I will try to find if the FDA has approved this but it is now something I would recommend under certain circumstances/specific injuries to avoid surgery.:lifter:lifter

ss

:cool: Praise the Lord.

Barbarian
07-11-2011, 15:07
That is awesome news, SS.:lifter

Gypsy
07-11-2011, 16:28
Fantastic news, so glad to hear it.

Vinny_ND
01-25-2012, 21:40
swatsurgeon,

what you are getting is called 'Prolotherapy'. I shadowed with a MD who does it in Chicago who does PRP which is exactly what you're saying with a 90% success rate. His name is Dr. Ross Hauser. He's an excellent physician.

Sarski
01-26-2012, 00:30
10 minutes and 10 seconds of pain (10:10), and then 5 minutes and 10 seconds of pain (5:10)...seems worth it to me. ;)

Hang in there, swatsurgeon, and good luck with all!

PedOncoDoc
01-26-2012, 04:52
10 minutes and 10 seconds of pain (10:10), and then 5 minutes and 10 seconds of pain (5:10)...seems worth it to me.



The (10:10) and (5:10) were pain ratings on a scale of 10, not durations of time.