Kobe Bryant, Tiger Woods together with Platelet Rich Plasma

According to published reports, Kobe Bryant has had iii arthroscopic (scopes) surgeries on his correct knee.  (2003, 2006 in addition to 2010)  This is like to the iii surgeries that Tiger Woods has had on his left knee.  Both of these athletes are inwards their 30s in addition to the enquiry for both of them is:  What is going on within these elite human knee joints in addition to why did they both plough to platelet rich plasma to potentially aid them?

BLOODCURE thinks it is prophylactic to assume that both of them convey only about arthritic changes inwards their knees.  This agency that they convey lost only about of both the smoothen cartilage roofing the os (articular cartilage) in addition to only about of the cushioning cartilage betwixt the thigh in addition to shin bones (meniscus cartilage).  In Tiger's case, he may convey been treated for patellar tendonitis afterwards an ACL reconstruction but at that topographic point is no presented or published data well-nigh the specifics of his treatment.  In Kobe's case, he may convey been treated for human knee arthritis but despite BLOODCURE contacting its many sources inwards the USA in addition to Europe, no 1 has come upwards frontward amongst specific data well-nigh his treatment.  What did he convey done in addition to why did he move to Federal Republic of Federal Republic of Germany to acquire it done?  Plenty of physicians within the USA in addition to specifically California convey sense amongst PRP.  So, did he acquire only about shape of PRP that is non available inwards the USA?

Answers to these questions volition aid us all amend empathize the value of PRP for iconic professional person athletes in addition to for sports medicine inwards general.  Importantly, nosotros too require to larn what type of PRP (many exist) they received.  Here is a video of a PRP Classification System.  

If anyone has data well-nigh these cases, delight postal service a comment below.

AM
Total Tendon.com
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Kobe Bryant Platelet Rich Plasma

Kobe Bryant returns to play amongst LA Lakers afterwards beingness treated amongst platelet rich plasma derivative. See video. 



More PRP information
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Kobe Bryant Orthokine Treatment Explained

Kobe Bryant (LA Lakers) is averaging 29 points per game inwards his 15th flavor inwards the NBA.  Is it because of a blood derived handling he had done on his knee?  Other elite athletes such equally Alex Rodriguez (NY Yankees) together with Fred Couples (PGA Golfer)  have been treated amongst Orthokine inwards Germany.  But what is Orthokine?  That is a enquiry that needs to endure answered.


Orthokine is a cast of autologous conditioned serum (ACS) that contains a high concentration of a molecule called IL-1 RA.  This stands for interleukin-1 receptor antagonist (IL-1 RA).  Interleukin-1 (IL-1) is an of import mediator of inflammation together with tissue damage.  Balancing IL-1 amongst IL-1 RA is important.  Read to a greater extent than almost IL-1/IL-1 RA


Orthokine to the best of my cognition is exclusively available inwards Deutschland together with has mainly been used to process articulatio genus osteoarthritis.  A study of 376 patients was done comparison Orthokine (ACS) amongst hyaluronic acid (HA) together with saline injections for articulatio genus osteoarthritis.  The "effects of ACS were significantly superior to those of HA together with saline for all resultant measures together with fourth dimension points."  See Abstract of Article


From the available evidence, it appears equally though this is a reasonable treatment.  I compass not, however, know many of the details.  This handling is non available inwards the United States.  It is produced past times incubating a patient's blood inwards a sterile container amongst beads over a catamenia of 6-8 hours or more.  The IL-1 RA together with other increment factors are concentrated together with injected dorsum into the patient.


This is unlike than platelet rich plasma (PRP) inwards that PRP is made at the signal of help together with tin laissez passer on notice endure delivered dorsum to the patient inside 15-20 minutes.  No incubation catamenia is needed.  


I volition endeavour to larn to a greater extent than almost Orthokine together with written report back.  Please post service whatsoever comments that may contribute to the conversation together with help us all meliorate sympathise the potential value of this approach.


Allan Mishra, MD

@
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Meta-analysis of Viscosupplementation for Knee Osteoarthritis Reveals Little Benefit

In the study outlined below, handling alongside viscosupplementation (typically diverse forms of hyaluronic acid) was studied inward over 12,500 patients.  This is an injection therapy used inward patients alongside articulatio genus osteoarthritis.  It is commonly reserved for patients that neglect other forms of treatment.  Here is the determination of this study of studies:  "In patients alongside articulatio genus osteoarthritis, viscosupplementation is associated alongside a modest as well as clinically irrelevant create goodness as well as an increased run a jeopardy for serious adverse events."

Clearly, the information shows this handling does non render transformative value.  We withdraw ameliorate options for patients alongside mild to moderate articulatio genus osteoarthritis.  Biologic therapies such every bit platelet rich plasma and autologous stalk cells are evolving only nonetheless withdraw significantly ameliorate studies to endure used for articulatio genus osteoarthritis widely.  

It is oft NOT discussed only patients alongside articulatio genus osteoarthritis tin hand the axe oft create goodness from weight reduction as well as leg strengthening via an practice wheel program.  Perhaps nosotros should focus on these patient driven solutions first.

AM

Total Tendon

Viscosupplementation for Osteoarthritis of the Knee: A Systematic Review as well as Meta-analysis 

Anne W.S. Rutjes, PhD; Peter Jüni, MD; Bruno R. da Costa, MSc; Sven Trelle, MD; Eveline Nüesch, PhD; as well as Stephan Reichenbach, MD, MScBackground: Viscosupplementation, the intra-articular injection of hyaluronic acid, is widely used for symptomatic articulatio genus osteoarthritis.

Purpose: To assess the benefits as well as risks of viscosupplementation for adults alongside symptomatic articulatio genus osteoarthritis.

Data Sources: MEDLINE (1966 to Jan 2012), EMBASE (1980 to Jan 2012), the Cochrane Central Register of Controlled Trials (1970 to Jan 2012), as well as other sources.

Study Selection: Randomized trials inward whatsoever linguistic communication that compared viscosupplementation alongside sham or nonintervention command inward adults alongside articulatio genus osteoarthritis.

Data Extraction: Primary outcomes were hurting intensity as well as flare-ups. Secondary outcomes included share as well as serious adverse events. Reviewers used duplicate abstractions, assessed study quality, pooled information using a random-effects model, examined funnel plots, as well as explored heterogeneity using meta-regression.

Data Synthesis: Eighty-nine trials involving 12 667 adults met inclusion criteria. Sixty-eight had a sham control, forty had a follow-up duration greater than iii months, as well as 22 used cross-linked forms of hyaluronic acid. Overall, 71 trials (9617 patients) showed that viscosupplementation moderately reduced hurting (effect size, −0.37 [95% CI, −0.46 to −0.28]). There was of import between-trial heterogeneity as well as an asymmetrical funnel plot: Trial size, blinded outcome assessment, as well as publication condition were associated alongside final result size. Five unpublished trials (1149 patients) showed an final result size of −0.03 (CI, −0.14 to 0.09). Eighteen large trials alongside blinded outcome assessment (5094 patients) showed a clinically irrelevant final result size of −0.11 (CI, −0.18 to −0.04). Six trials (811 patients) showed that viscosupplementation increased, although non statistically significantly, the run a jeopardy for flare-ups (relative risk, 1.51 [CI, 0.84 to 2.72]). Fourteen trials (3667 patients) showed that viscosupplementation increased the run a jeopardy for serious adverse events (relative risk, 1.41 [CI, 1.02 to 1.97]).

Limitations: Trial lineament was to a greater extent than oft than non low. Safety information were oft non reported.

Conclusion: In patients alongside articulatio genus osteoarthritis, viscosupplementation is associated alongside a modest as well as clinically irrelevant create goodness as well as an increased run a jeopardy for serious adverse events.

Link to Abstract

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Regenokine featured on ABC's Nightline

ABC's Nightline newsmagazine, inwards a flush past times Ron Claibourne, discussed Regenokine.  This therapy was developed inwards FRG too focuses on incubating blood inwards drinking glass beads to concentrate an anti-inflammatory poly peptide known equally IL-1 RA.  (Long name:  Interleukin Receptor Antagonist)  It has been used to process osteoarthritis too dorsum pain.

The flush features Tracy McGrady too how it helped him supply to an elite score inwards the NBA subsequently a articulatio genus injury.  Kobe Bryant, Alex Rodriguez too Fred Couples are likewise discussed inwards the flush equally successes.  This handling too technology are promising only to a greater extent than score i show is needed to confirm its value.

Blood derived treatments such equally this or platelet rich plasma have straight off been used for to a greater extent than than a decade amongst superior security profiles.  Data continues to emerge suggesting these types of treatments accept meaning clinical value at a reasonable cost.

Allan Mishra, MD
@




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Platelet Rich Plasma together with Knee Arthritis

Knee arthritis is a really mutual work for patients worldwide.  With the aging of the population this volition run i of the most of import medical issues to address amongst biologic therapies.

Conflicting results convey of late been published nearly the role of platelet rich plasma inwards the handling of human knee arthritis.  Filardo, Kon et al constitute no pregnant differences betwixt PRP as well as hyaluronic acid injections.  (see amount abstract).  Conversely, Cerza et al did abide by significantly ameliorate clinical outcomes when patients were treated amongst PRP vs hyaluronic acid injections. (see amount abstract) The version of PRP used inwards these ii studies were different.  The kickoff written report likewise used iii injections as well as the minute 4 weekly injections.  Clearly, to a greater extent than inquiry is needed to clarify the value of PRP for human knee arthritis as well as attain upwards one's take away heed the optimal formulations as well as techniques.

AM
TotalTendon

See the video below for a brief description of human knee arthritis


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PRP beats Placebo for Knee Arthritis

The American Journal of Sports Medicine of late published the results of unopen to other written report supporting the usage of Platelet Rich Plasma for arthritis.  In this really good done study, 2 dissimilar doses of PRP were given to patients too and then compared to a saline injection.  One grouping recieved a unmarried injection of PRP, unopen to other 2 PRP injections spaced three weeks apart too the tertiary grouping a unmarried injection of saline or sterile tabular array salt water.  The tertiary grouping served the placebo control. 

Statistically pregnant improvements inward hurting too component were noted inward the PRP groups inside 2-3 weeks too lasted vi months.  The saline treated grouping noted worsening of symptoms.  There were no pregnant differences betwixt the 2 PRP groups alongside both showing improvement. 

Overall, this prospective, randomized trial adds to the mounting evidence that specific forms of PRP tin live helpful for patients alongside human knee osteoarthritis.  See abstract below for details. 

The usage of PRP for human knee osteoarthritis is apace evolving.  There are at in ane trial 37 articles on PubMed discussing that specific topic.  (Link to abstracts)  Over the class of 2013, to a greater extent than presentations too papers volition assist clarify the role of PRP for this really mutual problem.

AM
Total Tendon

Treatment With Platelet-Rich Plasma Is More Effective Than Placebo for Knee Osteoarthritis: Influenza A virus subtype H5N1 Prospective, Double-Blind, Randomized Trial.

Patel S, Dhillon MS, Aggarwal S, Marwaha N, Jain A.
Am J Sports Med. 2013 January 8. [Epub ahead of print]
SourceDepartment of Orthopaedics, Post Graduate Institute of Medical Education too Research, Chandigarh, India.

BACKGROUND:Specific increment factors accept been proposed equally therapeutic proteins for cartilage repair. HYPOTHESIS:Platelet-rich plasma (PRP) provides symptomatic relief inward early on osteoarthritis (OA) of the knee. STUDY DESIGN:Randomized controlled trial; Level of evidence, 1. METHODS:A full of 78 patients (156 knees) alongside bilateral OA were divided randomly into three groups. Group Influenza A virus subtype H5N1 (52 knees) received a unmarried injection of PRP, grouping B (50 knees) received 2 injections of PRP three weeks apart, too grouping C (46 knees) received a unmarried injection of normal saline. White blood jail cellular telephone (WBC)-filtered PRP alongside a platelet count three times that of baseline (PRP type 4B) was administered inward all. All the groups were homogeneous too comparable inward baseline characteristics. Clinical outcome was evaluated using the Western Ontario too McMaster Universities Arthritis Index (WOMAC) questionnaire earlier handling too at vi weeks, three months, too vi months after treatment. They were too evaluated for hurting past times a visual analog scale, too overall satisfaction alongside the physical care for too complications were noted. RESULTS:Statistically pregnant improvement inward all WOMAC parameters was noted inward groups Influenza A virus subtype H5N1 too B inside 2 to three weeks too lasting until the concluding follow-up at vi months, alongside slight worsening at the 6-month follow-up. The hateful WOMAC scores (pain, stiffness, physical function, too full score) for grouping Influenza A virus subtype H5N1 at baseline were 10.18, 3.12, 36.56, too 49.86, respectively, too at concluding follow-up were 5.00, 2.10, 20.08, too 27.18, respectively, showing pregnant improvement. Similar improvement was noted inward grouping B (mean WOMAC scores at baseline: 10.62, 3.50, 39.10, too 53.20, respectively; hateful WOMAC scores at concluding follow-up: 6.18, 1.88, 22.40, too 30.48, respectively). In grouping C, the hateful WOMAC scores deteriorated from baseline (9.04, 2.70, 33.80, too 45.54, respectively) to concluding follow-up (10.87, 2.76, 39.46, too 53.09, respectively). The three groups were compared alongside each other, too no improvement was noted inward grouping C equally compared alongside groups Influenza A virus subtype H5N1 too B (P < .001). There was no divergence betwixt groups Influenza A virus subtype H5N1 too B, too at that spot was no influence of age, sex, weight, or torso volume index on the outcome. Knees alongside Ahlback degree 1 fared improve than those alongside degree 2. Mild complications such equally nausea too dizziness, which were of brusk duration, were observed inward vi patients (22.2%) inward grouping Influenza A virus subtype H5N1 too eleven patients (44%) inward grouping B. CONCLUSION:A unmarried dose of WBC-filtered PRP inward concentrations of 10 times the normal total is equally effective equally 2 injections to alleviate symptoms inward early on human knee OA. The results, however, deteriorate after vi months. Both groups treated alongside PRP had improve results than did the grouping injected alongside saline only.




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Kobe Bryant Tears Achilles Tendon

Kobe Bryant terminal dark inwards made a cutting on the basketball game courtroom he has made a 1 chiliad one thousand times as well as felt similar "somebody kicked" him.  He unfortunately sustained an achilles tendon tear.   See the video below of the injury:



He volition probable cause got surgical physical care for inwards the close future.  The surgical takes most an hour.  Rehabilitation typically takes anywhere from 9-12 months.  Some surgeons are augmenting achilles repairs amongst platelet-rich plasma pointing to anecdotal testify suggesting PRP could accelerate recovery.

Here is a video of how to clinically diagnosis an achilles tendon tear:



Below are simply about pictures that outline the steps inwards an Achilles tendon repair  
Torn tendon, suture repair, closure

If anyone tin laissez passer the sack come upwards dorsum from this injury, Kobe can.  The NBA as well as all of basketball game are wishing him the the best for his surgical physical care for if needed as well as for his total recovery.

AM
TotalTendon
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Platelet Rich Plasma Significantly Improves Outcomes for Tennis Elbow inward a 230 Patient Study

The American Journal of Sports Medicine (AJSM) has merely published the largest study evaluating platelet-rich plasma.  The 230 patient study was conducted over the course of education of to a greater extent than than 5 years together with represents the locomote of dozens of clinicians together with researchers.  Overall, it is clear from the information that the purpose of PRP to process chronic lawn tennis elbow results inward important reductions inward hurting together with elbow tenderness compared to an active command of needling of the elbow without PRP.  It is every bit good security together with toll effective compared to cortisone together with surgery.  This type of study is fourth dimension consuming together with expensive but volition assistance guide patient together with physicians decisions nearly how to best process chronic lawn tennis elbow.

Here is a lay press article on the article from Healio.

Read the total AJSM Abstract below.

AM
Total Tendon


Platelet-Rich Plasma Significantly Improves Clinical Outcomes inward Patients With Chronic Tennis Elbow
A Double-Blind, Prospective, Multicenter, Controlled Trial of 230 Patients

1. Allan K. Mishra, MD*,†, 
2. Nebojsa V. Skrepnik, MD, PhD‡,
3. Scott G. Edwards, MD§, 
4. Grant L. Jones, MD‖, 
5. Steven Sampson, DO¶,
6. Doug A. Vermillion, MD#, 
7. Matthew L. Ramsey, MD**, 
8. David C. Karli, MD, MBA†† and 
9. Arthur C. Rettig, MD‡‡

1. ^†Department of Orthopedic Surgery, Menlo Medical Clinic, Stanford University Medical Center, Menlo Park, California
2. ^‡Tucson Orthopaedic Institute, Tucson, Arizona
3. ^§Division of Hand together with Elbow Surgery, Georgetown University Hospital, Washington, District of Columbia
4. ^‖Department of Orthopaedic Surgery, The Ohio State University, Columbus, Ohio
5. ^¶The Orthohealing Center together with The Orthobiologic Institute, Los Angeles, California
6. ^#Orthopaedic Research Clinic, Anchorage, Alaska
7. ^**Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania
8. ^††The Steadman Clinic, Vail, Colorado
9. ^‡‡Methodist Sports Medicine, Indianapolis, Indiana
10. Investigation performed at Department of Orthopaedic Surgery, Menlo Medical Clinic, Stanford University Medical Center, Menlo Park, California

1. *Allan K. Mishra, MD, Department of Orthopedic Surgery, Menlo Medical Clinic, Stanford University Medical Center, 1300 Crane Street, Menlo Park, CA 94025 (e-mail: am@totaltendon.com).

Abstract

Background: Elbow tenderness together with hurting amongst resisted wrist extension are mutual manifestations of lateral epicondylar tendinopathy, every bit good known every bit lawn tennis elbow. Previous studies bring suggested platelet-rich plasma (PRP) to live a security together with effective therapy for lawn tennis elbow.

Purpose: To evaluate the clinical value of tendon needling amongst PRP inward patients amongst chronic lawn tennis elbow compared amongst an active command group.

Study Design: Randomized controlled trial; Level of evidence, 1.

Methods: A total of 230 patients amongst chronic lateral epicondylar tendinopathy were treated at 12 centers over 5 years. All patients had at to the lowest degree three months of symptoms together with had failed conventional therapy. There were no differences inward patients randomized to have PRP (n = 116) or active controls (n = 114). The PRP was prepared from venous whole blood at the quest of attention together with contained both concentrated platelets together with leukocytes. After receiving a local anesthetic, all patients had their extensor tendons needled amongst or without PRP. Patients together with investigators remained blinded to the handling grouping throughout the study.

Results: Patient outcomes were followed for upwards to 24 weeks. At 12 weeks (n = 192), the PRP-treated patients reported an improvement of 55.1% inward their hurting scores compared amongst 47.4% inward the active command grouping (P = .094). At 24 weeks (n = 119), the PRP-treated patients reported an improvement of 71.5% inward their hurting scores compared amongst 56.1% inward the command grouping (P = .027). The percent of patients reporting important elbow tenderness at 12 weeks was 37.4% inward the PRP grouping versus 48.4% inward the command grouping (P = .036). At 24 weeks, 29.1% of the PRP-treated patients reported important elbow tenderness versus 54.0% inward the command grouping (P < .001). Success rates for patients amongst 24 weeks of follow-up were 83.9% inward the PRP grouping compared amongst 68.3% inward the command grouping (P= .012). No important complications occurred inward either group.

Conclusion: Treatment of chronic lawn tennis elbow amongst leukocyte-enriched PRP is security together with results inward clinically meaningful improvements compared amongst an active command group.

The Biomet Biologics GPS device was used to produce the PRP for this study.

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