One of the newest non-surgical treatments is the injection of platelet-rich plasma. They are intended for the treatment of various injuries and a number of diseases of the musculoskeletal system.
Using method
Currently, treatment with these injections is becoming increasingly popular in the world. Indeed, platelet-rich plasma contains special growth factors. They play one of the most important roles in the restoration of bones, muscles, ligaments and tendons. The specified method promotes wound healing, intraarticular restoration of hyaluronic acid, coagulation and hemostasis. It also has analgesic, anti-inflammatory and antibacterial effects.
Such therapy is most effective in the following diseases: epicondylitis, tendonitis, enthesopathy, tendenosis. It can also be prescribed for the appearance of false joints, with the slow growth of broken bones, damage to the cartilage, which is often observed with injuries and osteoarthritis. But this is not a complete list when platelet-rich plasma is used. It also helps to accelerate healing after surgical interventions, such as arthroplasty or arthroscopic surgery.
Indications
Currently, there are many areas where enriched plasma injections can be used. This technology has become the most popular among sports doctors and in dentistry. But increasingly you can hear about its use in cosmetology.
For example, it can be used as an prevention of aging or for recovery after plastic surgery, aggressive cosmetic procedures or prolonged exposure to the sun. Platelet injections are used to treat skin suffering from a patient’s bad habits , nightlife, taking certain medications, or worsening the condition.
The technology is also used to treat seborrhea, acne, and cicatricial changes in the skin. Good results are achieved with injections to improve hair growth.
Procedure execution
Many are afraid to inject platelet-rich plasma, since they believe that donor blood is used to prepare it. But in most clinics specializing in such procedures, they will explain to you that this is not so.
The specialist takes the venous blood of the patient. It is necessary to draw at least 20 ml immediately into a special test tube, which is placed in a centrifuge. In this case, the blood does not contact with the external environment, which excludes the possibility of infection. In the process of processing it in a centrifuge, 3 ml of platelet-rich plasma is obtained.
It is injected directly into the problem place. Many recommend an injection under the supervision of an ultrasound in order to get directly into the damaged tissue. It is also important to understand that it is impossible to obtain enriched plasma from clotted blood. Indeed, when a clot forms, all platelets will remain in it, and their quantity will remain in serum. Therefore, to preserve blood in a liquid state, a special anticoagulant is used.
Enriched Plasma
Using this method was a breakthrough. But for its application it is necessary to understand what constitutes a platelet-rich plasma. Normally, the concentration of these plates in the blood is from 150 to 350 x 10 9 / L. On average, each person has about 200. But experts have found that to achieve a therapeutic effect, it is necessary that their concentration reaches 1000 x 10 9 / L.
When the content of these plates reaches the indicated level, then the human blood plasma is considered enriched. At a lower concentration, no therapeutic effect was observed. But it was also not proved that exceeding the dosage established at the level of 1000 x 10 9 / l does not lead to the acceleration of recovery processes.
Growth factors
Injection of blood, which is enriched in platelets, has a noticeable therapeutic effect. They contribute to an increase in the concentration of growth factors. Specialists distinguish 4 indicators.
So, there are vascular endothelial growth factors, epithelium, as well as transforming and platelet. They are always in certain proportions among themselves. But one must understand that the enriched plasma contains adhesive molecules necessary for the attachment of plates to subendothelial cells. But it contains the same number of them as in an ordinary clot. Therefore, such plasma and blood serum do not become fibrin glue.
It is also important to understand that it does not have an osteoinductive effect. Enriched plasma cannot form bone without the presence of appropriate cells. She can just speed up their growth.
Operating principle
Platelet-rich plasma has a stimulating effect. It helps to accelerate vascular growth, the so-called angiogenesis. It also stimulates mitosis of cells involved in regeneration processes. But such a plasma cannot improve non-cellular bone materials.
To achieve the effect, activation should be carried out immediately before injection. After all, the secretion of 70% of growth factors passes during the first 10 minutes. All of them are released within an hour. But even after this, platelets continue to synthesize them for about 8 more days, and only after this period they die.
Growth factors contribute to the normalization of hemodynamics, improving tissue respiration and metabolism in them.
Contraindications
Unfortunately, there are situations in which injections are not recommended. So, the method is contraindicated in patients with malignant neoplasms, serious mental problems, systemic blood diseases. Also, before the procedure, it is important to clarify whether the patient is allergic to sodium citrate. This anticoagulant is used to prevent blood clotting.
It is also worth familiarizing in detail with the technology of the procedure in the selected clinic. For example, the use of special systems is necessary to activate platelet aggregation . In some of them, bovine thrombin is used as a folding factor. It is impossible to exclude situations in which antibodies of blood plasma to it can be developed. Of course, this happens extremely rarely, but it can lead to serious complications. Other systems have now been developed using other folding agents. For example, it will be safer to use the so-called fibrin matrix or type II collagen.
Use in Dentistry
There are several options for how platelet rich plasma can be used. So, with its help it is possible to stop the progression of periodontitis, strengthen periodontal tissues, prevent tooth loss and their loosening. Plasma also helps relieve bleeding gums and eliminate bad breath. In addition, it is used in implantology and for rehabilitation after maxillofacial surgery.
Indications for the use of this technology are as follows:
- localized and generalized periodontitis;
- periodontitis;
- gingivitis;
- periimplantitis;
- operations to remove teeth, implantation.
The therapeutic effect is already visible about a week after using this technology. The composition of the plasma enriched with platelets allows you to stop inflammation and reduce pain, increase the chances of implant engraftment, improve tissue healing after surgery, and reduce bleeding gums.
Sports medicine
Quite often, platelet-rich plasma is used to treat and accelerate the recovery period after injuries. Many sports doctors opt for this method of therapy.
So, if necessary, the plasma can be introduced into the damaged muscle, into the tendon sheath (after restoration of its rupture), or directly into the joint. Each of these injections contributes to the fact that the processes of tissue regeneration are started, and stimulation of the synthesis of necessary components to restore their structure begins. This method has become an optimal alternative to the introduction of hormonal drugs.