With some degree of sadness I recently “outed” a former co-resident of mine who has turned to the dark side and begun putting money-making before truth and science. Without any clear evidence of benefit beyond placebo, platelet-rich plasma (PRP) is now being marketed aggressively as a cure-all for sports injuries. And at about $300 per injection (the NYT reports $2000/treatment), there’s plenty of money to be made.
Like the fake “stem cell” clinics in Russia (where, according to Sanjay Gupta’s recent book, Chasing Life, a person’s fat cells are harvested, washed, and re-injected into their blood stream), PRP also involves injection of autologous body fluids. Essentially, a small amount of blood is drawn from the patient, centrifuged, and the plasma supernatant is then injected directly into tendons and/or joints. After a series of 3 injections (one/month), most sports injuries are “cured.” Of course, most injuries would heal themselves in three months anyway.
It was bothersome enough that Steve Sampson, D.O., began a practice in Los Angeles, catering to those who could afford to do more than the usual RICE (rest, ice, compression, elevation) therapy for sports injuries. But now a nation-wide marketing initiative has begun, using sports celebrities as guinea pigs. Consider the email I received yesterday:
Val,
Superstar athletes have been fighting back from injuries with the help of a new, innovative treatment technique that has enabled them to return to action more quickly. Two players for the Pittsburgh Steelers, Hines Ward and Troy Polamalu, used this technique to lead their team to victory in Super Bowl XLIII.
Now, that same treatment method offers promising results for weekend warriors and seniors in our region suffering from osteoarthritis in their joints and spine as well as those who’ve suffered ligament and tendon injuries.
It’s called Platelet Rich Plasma (PRP) therapy and one of its leading practitioners in the country is Capitol Spine & Pain Centers, the interventional pain practice in the Washington D.C. area for more than 30 years.
PRP therapy relieves pain by rejuvenating injured tissues. The process jump-starts and strengthens the body’s natural curative signals.
Capitol Spine and Pain Centers provides PRP therapy at all eight of its locations in Virginia and the District of Columbia. We would be glad to provide you with both a representative of its medical staff and a patient to discuss the benefits of PRP therapy.
To find out more about Capitol Spine and Pain Centers, go to www.treatingpain.com. Thanks for your time and I look forward to hearing from you.
George Evanko
President
George Evanko Communications
9156 Riesley Lane
Vienna, VA 22182
Notice how this wonderful treatment is not only useful for superstar athletes, but also for seniors and weekend warriors. Yes, the market for PRP is almost unlimited! And aren’t I lucky, there’s a “leading practitioner” of PRP right here in Washington, DC. Now I too can jump start and strengthen my body’s natural curative signals.
Ugh.
As with the most successful forms of pseudoscience, there may be a grain of plausibility here. Knowing that human plasma does in fact contain growth factors that are implicated in wound healing – it’s not complete fantasy that injection of said factors may improve injuries in some way. So I decided to take a fresh look at Medline to see what sort of evidence there may be for the therapy. In my search I found:
1. One abstract discussing PRP’s use in degenerative knee arthritis. The study is not available for review in its entirety – but the abstract suggests that an improvement was noted at 6 months (in pain scores) with a significant worsening at month 12. No control group.
2. One small study that did not find a benefit to ACL healing in the presence of PRP.
3. Quite a number of studies related to the treatment of bone defects (mostly periodontal) with PRP. Most of those showed no improvement or a fleeting, temporary improvement with PRP.
Overall it seems that the dental and oral and maxillofacial surgery literature has found no use for PRP, and the orthopods simply haven’t paid too much attention to it. There is almost no published research related to tendon injuries – the major indication for PRP suggested by Dr. Sampson. So that leaves us with testimonials, celebrities, and true believers who are researching PRP “…to help further refine the treatment and demonstrate its efficacy.”
I suspect that, given Dr. Sampson’s recent appearance on The Doctors, he is well and truly committed to marketing his way to an early retirement with profits from PRP. The only thing standing in his way is this nasty little problem of evidence of efficacy. No matter, if it’s good enough for the Pittsburgh Steelers, it’s good enough for grandma.