Platelet–rich plasma (PRP) therapy uses injections of a concentration of a patient’s own platelets to accelerate the healing of injured tendons, ligaments, muscles and joints. In this way, PRP injections use each individual patient’s own healing system to improve musculoskeletal problems.

PRP can potentially be used to treat various orthopedic conditions. It’s often inquired about in the context of tennis elbow, patella tendonitis, osteoarthritis, and various other soft tissue abnormalities. PRP becomes an option after patients feel other conservative treatment options. The best indication for PRP at the present time, according to the best scientific evidence, would be in the field of osteoarthritis. 

There are several randomized trials that actually show PRP is better than controlled treatments or placebo treatments, or alternatively, hyaluronic acid treatments.

The evidence would suggest that PRP would be beneficial in this population, and the best time would be to pursue this would be, because there is a cost associated with it, would be to exhaust all other non-operative modalities such as physical therapy, such as bracing, and potentially other types of injections such as hyaluronic acid or cortisone. A local chiropractor may work with your local massage therapist and your local physiotherapist to create the best health or rehabilitation plan for your situation.

In the context of osteoarthritis, once again, which is likely the best indication based on the scientific literature we have today, in the orthopedic world that is, PRP would be suited for once again anybody who really feels non-operative modalities in the setting of pain, functional limitations, swelling, and an impairment of quality of life.

If someone’s pain is bad enough, PRP can help alleviate their symptoms, hopefully improve their function, and you know from a theoretical sense some people think help regenerate some of the tissues, but certainly this requires a lot more investigation before we can prove that that’s true. Local Orthopedic Surgeons 

So if you’ve been told you have osteoarthritis, you may be a candidate for PRP. You should seek an evaluation by your orthopedic surgeon, your local family doctor, Physiotherapist or a primary care sports medicine specialist. Often seeing a local family physician or a physiotherapist in conjunction with a registered dietitian and athletic therapist is a great option to take control of this condition. Smart Food Now and exercise is also optominal for overall health.    

Presenter: Dr. Jaskarndip Chahal, Orthopaedic Surgeon, Toronto, ON

Now Health Network  Local Practitioners: Orthopaedic Surgeon

Osteoarthritis is one of the most common types of arthritis. Arthritis means inflammation of the joints, osteoarthritis is the most common type of arthritis and it's different than osteoporosis, people often get those two mixed up.

Osteoporosis is thinning of the bone, and that's a separate thing. Osteoarthritis, however is the most common type of arthritis and it usually affects the bones such as the hands, hips, and knees. And it increases with age but it's not a normal part of aging, which often people think it's part of aging, but it's not. It's a separate condition.

The place where bones meet are covered by a rubbery material called cartilage. And this cartilage is normally quite smooth and it acts as a shock absorber and allows the ends of the bones to move smoothly on each other.

In osteoarthritis, the first thing that happens is this cartilage becomes thin and rough. When that happens, we feel pain in the joints, so the most common joints involved are the joints of the hands, the base of the thumbs, the knees, and the hips. But really any joint can be involved in osteoarthritis.

Now osteoarthritis really is probably more than one disease. There's one type that is often inherited, and people will notice this because they've got knobs on the small joints of their fingers, and their mom or dad might have it, and they might start to develop those knobs. That's called nodal osteoarthritis. It's often inherited, and there are things you can do to reduce the severity of that.

Other type of arthritis can occur after injury, so if you think about those joints that are covered with that rubbery material, called cartilage, if those are injured or cracked they may not heal normally or perfectly, and that roughness will progress and cause pain and damage to the joint.

So injury around the knees or hips can make osteoarthritis start and get worse, but also if there 's abnormal forces across the joint, for example, athletes or football players, or perhaps if someone is very overweight, then that's an abnormal force across that joint. So, hips and knees and foot are weight-bearing joints will have more osteoarthritis if the person is overweight.

Well, typically for osteoarthritis the most common symptom is pain. Pain, and loss of range of movement is the second issue. So if you have pain and loss of range of movement in a joint or a limb you need to see your healthcare professional because a good history and physical examination will help to diagnose osteoarthritis.

Other things can cause pain in and around joints, so it may not be osteoarthritis. So again, you need to get checked out if there is pain in and around the joints. There are more serious types of arthritis that need to be dealt with urgently such as rheumatoid arthritis. Symptoms of rheumatoid arthritis include morning stiffness and rapid onset of multiple joints.

That needs to be looked at quite quickly because if we can catch it early, we can actually prevent the damage of rheumatoid arthritis.
Other muskuloskeletal conditions can be treated differently than osteoarthritis, so if you have aches and pains in and around a joint it's quite a good idea to seek medical attention and determine what's going on.

Presenter: Dr. Kam Shojania, Rheumatologist, Vancouver, BC

Local Practitioners: Rheumatologist