Platelet Rich Plasma Therapy – better in the OR (and left off the grid iron)

Funny thing how celebrities and sport stars can dictate what’s considered fashionable in everything from wardrobes to medical treatments. Over the past year, there has been debate on whether or not platelet-rich-plasma-therapy (PRPT) is an effective, viable treatment for orthopaedic injuries, a topic most recently voiced in the New York Times Well Blog, “Does Platelet Rich Plasma Therapy Really work?” PRPT has made the news and put the bug in many-an-ear as a viable successful sports injury-buster when professional athletes like Philadelphia Eagle and NFC pro-bowler Jon Dorenbos and Troy Polamalu from the Pittsburgh Steelers are reported as receiving the somewhat experimental treatments. But now, in the words of The New York Times, “rather belatedly, science is showing up to spoil the fun.”

Well, where the science is showing that PRPT is losing in the sports arena, it’s also showing where it’s winning in operating room. Samir Mehta, MD, chief of the the Orthopaedic Trauma and Fracture Service at the Hospital of the University of Pennsylvania and assistant professor of Orthopaedic Surgery at the University of Pennsylvania School of Medicine has been successfully using PRPT to treat traumatic bone loss – and some very severe cases - by augmenting commercially available bone grafts in patients like a tri-athlete, veteran competitor of Iron-women competitions whose shoulder was completely shattered after being hit by an automobile, and a motorcycle policeman who, after losing control of his bike completely shattered his tibia, and a mother of two who was struck by a truck resulting in massive bone loss in both her femurs.

The treatment involves injecting portions of the patient’s own specially processed blood directly into the injured areas with bone grafting. The injection acts like a catalyst in the body to get it to instinctively repair bone and surrounding tissue.

So why do we hear so little about the demonstrated successes of PRPT for healing bones and only its failures for other sports injuries? The facts are generally unclear to the public so to help shed some light on the issue Dr. Mehta outlines the following fast facts:

• PRPT is only FDA-approved as a bone graft extender – all other uses, including those touted in the media being used by pro athletes – is “off-label” use.
• As the science has shown so far, there is limited anecdotal success in off label use.
• Many basic science (animal) studies so far are supportive of fracture healing with PRP. 
• There has been anecdotal success in using PRPT in recalcitrant (long-bone) fracture healing and used judiciously, especially in patients who have failed other biologic augments, to incite fracture healing.

To read more about Dr. Mehta - who just recently was announced as one of the 2011 "Top 40 Under 40" award winners by the Philadelphia Business Journal - and his successful use of PRPT, check him out in a recent issue of SJ Magazine:  SJ Magazine.net/2011