Blood is made up of red blood cells, white blood cells, plasma and platelets. An average platelet count is generally between 150,000 and 450,000 platelets per cubic centimeter. This amount is known as a baseline concentration. The platelets release a multitude of growth factors, which call other cells to the area to initiate the healing cascade. One of the types of cells called to the area is a progenitor cell, which is pleuripotent, meaning that it can differentiate into other cell types, such as tendon, muscle, cartilage, bone and nerve cells. When more of a progenitor cell load is required, the progenitor cells are directly added to the PRP via fat (adipose) and/or bone marrow, which is obtained directly from you, making this an autologous treatment. The obtained progenitor cells can become any of the types of cells in this mesenchymal cell line, which includes: muscle, tendon, cartilage, bone, ligament, intervertebral disc and nerve cells. Often, we use an Autologous Regenerative Matrix (ARM©) consisting of a combination of these biologics to take full advantage of the different healing properties of each biologic. These tissues are processed on-site and re-implanted on the same day. Typically, you are in the office for 1-2 hours. Our cutting-edge technology in regenerative medicine fills the need for a successful treatment option in patients who have failed more traditional therapies.

PRP stands for Platelet Rich Plasma. “Let’s say you cut your arm. Platelets are released, white blood cells are released, red blood cells are released, because the vein has been opened up. Platelets help stop the bleeding. For a long time that’s all we thought they did. Now we know that platelets release many growth factors that call other cells to the site to help the healing. Some of these types of cells are progenitor cells. Those cells help create whatever is needed, whether it’s veins, arteries, bone, skin muscle, tendon, cartilage etc. It’s all pre-programmed to do that. This is actually an inflammatory reaction that is a healing response. When we
give anti-inflammatories, we actually interfere with the healing process. Inflammation is the process through which the healing begins. So when we take PRP and inject it into an injury site, the inflammatory response starts the healing.” – Dr. Joseph Albano

Advantages of Biologics

i. All Natural

ii. Safe

iii. Shorter Recovery

iv. No Scarring

v. Cost Effective

vi. Surgery Is Still An Option

vii. Short Procedure Time

viii. Progenitor Cells

ix. It works!

Insurance companies typically deny coverage for regenerative medicine procedures.

i. Tendon Injuries- include tendinosis, partial thickness tears, and full thickness tears that are not significantly retracted.

ii. Muscle Injuries – Chronic muscle fibrosis (scarring) and acute muscular tears or strains.

iii. Ligament Injuries – Include chronic and acute sprains.

iv. Cartilage Conditions

v. Nerve Injuries – Include mild to moderate compression neuropathies.

i. Musculoskeletal Ultrasound may be used to help diagnose problems with:

1. Soft Tissue

• Tendinopathy/partial tears
• Tennis elbow, Achilles tendinosis, plantar fasciosis, patellar tendinosis, rotator cuff tendinosis and partial to full thickness tears

2. Muscle Ligaments

• Chronic strains/sprain, muscle fibrosis (scar)
• Acute strain/sprain
• Cysts (such as a Baker’s Cyst behind the knee), bleeding or other fluid collections within the muscles, bursae or joints

3. Bone

• Stress fractures, medial tibial stress syndrome (shin splints)
• Joints
• Cartilage problems: meniscal tears

4. Nerves

• Compression neuropathies, such as carpal tunnel syndrome (wrist) and cubital tunnel syndrome (elbow)

5. Tendons

• Tendinosis, as in tennis elbow, patellar tendiand tears, such as in the rotator cuff in the shoulder or Achilles tendon in the ankle

6. Cysts, bleeding or other fluid collections within the muscles, bursae and joints

7. Early changes of rheumatoid arthritis

• It is noninvasive and painless
• There is no use of ionizing radiation, which is used in X-rays and CT scans, and is potentially harmful if done repeatedly
• It is dynamic with images captured in real-time showing the motion of tendons, muscles and joints
• It is much less expensive than other imaging methods, such as MRI or CT
• It shows soft tissues very well, whereas X-rays do not
  vi. It is the choice imaging modality for patients with cardiac pacemakers, who cannot get an MRI
• It is an excellent alternative to MRI for claustrophobic patients
• Ultrasound may have advantages over MRI in seeing tendon structure, which is better appreciated by ultrasound than MRI
• Ultrasound provides real-time imaging, making it a good tool for guiding minimally invasive procedures such as aspiration (withdrawing fluid) and injection

There are no known harmful effects on humans

• It is unable to see deep tissue structures very well, especially in obese individuals (MRI would be a better choice)
• It is unable to “see through” bone. (MRI would be better to image structures deep to bone)
• It is very operator-dependent, which means it requires much skill and practice to become good at the evaluations and interpretations