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melancholy said:
I've seen PRP advertised for hair loss lol. I wonder if you can treat the head w PRP for hair loss and migraines (like how some headache sufferers get cosmetic botox and notice it actually helps their migraine)
Click to expand...
Yes, I went to a Dermatologist and inquired about hair thinning treatments, and her brochure advertises PRP as one of their recommended treatments. I was scratching my head..

As for MSK. I had a minor rotator cuff tear, and opted to try PRP without much expectation (given the polarizing evidence), but to my surprise after 2 injections (almost a year apart), I got really good pain relief. So it worked for my situation.

It's likely that it's effective, but the research isn't rigorous enough to know under what circumstances it's effective. That's probably why the results vary so much.
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lobelsteve said:
View attachment 378894

Just finishing up my articles for MOCA/ABPMR 2023. One of the articles to read and answer questions was on ACR Guidelines for OA. PRP/Stem Cells: STRONGLY RECOMMENDED AGAINST.
Click to expand...

I’m on my phone so unable to read the article. However they are dead wrong. They recommend opioids more highly than PRP for knee injections?

The are close minded, hiding in their little bubble, unable to see what’s in front of them.

If both were covered by insurance I’d start with a PRP injection of the hand or knee every single time over CSI. PRP works far better.

The hip is trickier and doesn’t respond as reliably to PRP (or any other injection) compared to other joints.
I see an approximate 50% response rate after hip, but again a hip PRP injection would still be my first choice for an under 60 year old hip if both options were covered by insurance.
 
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lobelsteve said:
Just finishing up my articles for MOCA/ABPMR 2023. One of the articles to read and answer questions was on ACR Guidelines for OA. PRP/Stem Cells: STRONGLY RECOMMENDED AGAINST.
Click to expand...
Not much on that list that is recommended

glad NSAIDS are harmless and work so well in our patients
 
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Same article says no TENS or massage for hip and knee OA.

I make ppl better with PRP on a routine basis.
 
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lobelsteve said:
View attachment 378894

Just finishing up my articles for MOCA/ABPMR 2023. One of the articles to read and answer questions was on ACR Guidelines for OA. PRP/Stem Cells: STRONGLY RECOMMENDED AGAINST.
Click to expand...
from 2019? Maybe the rheum's should stick with fibromyalgia. I still get patients from them for spine treatment who have been getting steroid tpi's for YEARS.
 
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with regards to the study:

1. not blinded.
2. botox injection was "different" than PRP. the injection was done in the gastrocs along with the plantar fascia
3. im not clear why they chose only 50 units for the botox injection. most of the other studies that i saw (including the one listed below) used 100 u.

www.painnewsnetwork.org

Study Finds Spinal Cord Stimulation Has No Benefit for Back Pain — Pain News Network

By Pat Anson, PNN Editor A scathing new Cochrane review is raising more questions about the safety, efficacy and long-term benefits of spinal cord stimulators, medical devices that are increasingly used to treat chronic back pain. Cochrane reviews are considered the gold standard in
www.painnewsnetwork.org www.painnewsnetwork.org

4. interestingly, at 12 months, there did not appear to be clinically significant improvement in VAS between conservative treatment and PRP, and the article does note that 90% of people will get better in a year.

i do not see clinically significant difference between PRP and no injection based on their numbers.



from what the numbers show - what i got from the study is that there appears to be short term benefit with botox but long term worsening with botox and that the end results were not that much different between PRP and conservative treatment.
 
Can you link the article showing 50% with diclofenac?
 
MitchLevi said:
Can you link the article showing 50% with diclofenac?
Click to expand...
www.bmj.com

Diclofenac use and cardiovascular risks: series of nationwide cohort studies

Objective To examine the cardiovascular risks of diclofenac initiation compared with initiation of other traditional non-steroidal anti-inflammatory drugs, initiation of paracetamol, and no initiation. Design Series of 252 nationwide cohort studies, each mimicking the strict design criteria of...
www.bmj.com www.bmj.com

Diclofenac v non-use​

Diclofenac initiators had a 50% increased rate of major adverse cardiovascular events compared with NSAID non-initiators (incidence rate ratio 1.5, 95% confidence interval 1.4 to 1.7). Supporting use of a combined endpoint, event rates consistently increased for all individual outcomes: 1.2-fold for atrial fibrillation or flutter, 1.6-fold for ischaemic stroke, 1.7-fold for heart failure, 1.9-fold for myocardial infarction, and 1.7-fold for cardiac death (fig 2 and eTable 5). Cardiac death was driven by death from heart failure (incidence rate ratio 2.3, 1.3 to 4.2), cardiac arrhythmia (1.9, 1.1 to 3.3), and myocardial infarction (1.7, 1.2 to 2.4).
 
essentially a critique of a study that did not show that BMAC or other cell therapy was any different in benefit from CSI

www.nature.com

Cell-based versus corticosteroid injections for knee pain in osteoarthritis: a randomized phase 3 trial - Nature Medicine

The multicenter phase 3 trial of stem cell therapy for osteoarthritis (MILES) for knee pain revealed that cell therapies showed no significant difference in knee pain outcomes, compared to corticosteroid injections, 1 year following treatment.
www.nature.com www.nature.com

he adds other studies in his discussion - kind of a no no.

he notes that "oh theres a big diff - the BMAC patients had worse disease!" and he uses a graph that is purposely good for highlighting those differences.

ie he combines the chart to lump KL2 and KL3 and show that there were more KL4 in BMAC group than CSI. valid point, but if you are going to do that, why not go the other way too? look at the numbers if combine the more severe disease together. ie combine KL3 and KL4 together.

one will find that the numbers differ by 1 point in that scenario.

(BMAC KL2: 31. KL3+4: 87)
(CSI KL2: 34. KL3+4: 86)


but... the groups didnt perform differently. so almost a moot point.



regarding the initial study -

single blinded.

no accounting for placebo effect, and this was discussed at length in the article.

there was no placebo itself, and as a side note, PRP was not included in this analysis.
 
Ducttape said:
essentially a critique of a study that did not show that BMAC or other cell therapy was any different in benefit from CSI

www.nature.com

Cell-based versus corticosteroid injections for knee pain in osteoarthritis: a randomized phase 3 trial - Nature Medicine

The multicenter phase 3 trial of stem cell therapy for osteoarthritis (MILES) for knee pain revealed that cell therapies showed no significant difference in knee pain outcomes, compared to corticosteroid injections, 1 year following treatment.
www.nature.com www.nature.com

he adds other studies in his discussion - kind of a no no.

he notes that "oh theres a big diff - the BMAC patients had worse disease!" and he uses a graph that is purposely good for highlighting those differences.

ie he combines the chart to lump KL2 and KL3 and show that there were more KL4 in BMAC group than CSI. valid point, but if you are going to do that, why not go the other way too? look at the numbers if combine the more severe disease together. ie combine KL3 and KL4 together.

one will find that the numbers differ by 1 point in that scenario.

(BMAC KL2: 31. KL3+4: 87)
(CSI KL2: 34. KL3+4: 86)


but... the groups didnt perform differently. so almost a moot point.



regarding the initial study -

single blinded.

no accounting for placebo effect, and this was discussed at length in the article.

there was no placebo itself, and as a side note, PRP was not included in this analysis.
Click to expand...

What is a placebo platelet? How do you fool and deceive a thrombocyte?
 
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He's Season 3 of Dr Death. Underwhelming season TBH.
 
Radiol Oncol. 2023 Nov 30;57(4):465-472.
doi: 10.2478/raon-2023-0054. eCollection 2023 Dec 1.

Assessment of short-term effect of platelet-rich plasma treatment of tendinosis using texture analysis of ultrasound images​

Karlo Pintaric 1 2, Vladka Salapura 1 2, Ziga Snoj 1 2, Andrej Vovk 3, Mojca Bozic Mijovski 4 5, Jernej Vidmar 1 6
Affiliations expand

Abstract​

Background: Computer-aided diagnosis (i.e., texture analyses) tools are becoming increasingly beneficial methods to monitor subtle tissue changes. The aim of this pilot study was to investigate short-term effect of platelet rich plasma (PRP) treatment in supraspinatus and common extensor of the forearm tendinosis by using texture analysis of ultrasound (US) images as well as by clinical questionnaires.
Patients and methods: Thirteen patients (7 male and 6 female, age 36-60 years, mean age 51.2 ± 5.2) were followed after US guided PRP treatment for tendinosis of two tendons (9 patients with lateral epicondylitis and 4 with supraspinatus tendinosis). Clinical and US assessment was performed prior to as well as 3 months after PRP treatment with validated clinical questionnaires. Tissue response in tendons was assessed by using gray level run length matrix method (GLRLM) of US images.
Results: All patients improved of tendinosis symptoms after PRP treatment according to clinical questionnaires. Almost all GLRLM features were statistically improved 3 months after PRP treatment. GLRLM-long run high gray level emphasis (LRLGLE) revealed the best moderate positive and statistically significant correlation after PRP (r = 0.4373, p = 0.0255), followed by GLRLM-low gray level run emphasis (LGLRE) (r = 0.3877, p = 0.05).
Conclusions: Texture analysis of tendinosis US images was a useful quantitative method for the assessment of tendon remodeling after minimally invasive PRP treatment. GLRLM features have the potential to become useful imaging biomarkers to monitor spatial and time limited tissue response after PRP, however larger studies with similar protocols are needed.
Keywords: platelet-rich plasma; tendinosis; texture analysis; ultrasonography.
 
drusso said:
Dose matters...Just say "no" to weak sauce, ghetto juice PRP...


Acta Orthop Traumatol Turc. 2023 Jul;57(4):148-153.
doi: 10.5152/j.aott.2023.22077.

Factors affecting the features of platelet-rich plasma in patients with knee osteoarthritis​

Sezen Karaborklu Argut 1, Derya Celik 2, Omer Naci Naci Ergin 2, Onder Ismet Kilicoglu 3
Affiliations expand

Abstract​

Objective: The aim of this study was to present an analysis of platelet-rich plasma obtained from patients with knee osteoarthritis and reveal the factors affecting its features.
Methods: A total of 62 patients (mean age: 56.68 ± 7.13 years) with symptomatic knee osteoarthritis were included in this study. Age (years), gender, height (m), weight (kg), body mass index (kg/m2), duration of symptoms, smoking status, smoking index, general health status, and physical activity scores were recorded. Whole blood and platelet-rich plasma cell counts were performed with a hematology analyzer. White blood cell, red blood cell, and platelet counts were recorded. According to the dose of injected platelets, efficiency of the procedure, purity of platelet-rich plasma, and activation classification, dose of platelets, efficiency of the procedure (platelet recovery rate, %), and purity of the obtained platelet-rich plasma product (relative composition in platelets, %) were calculated. Correlation analysis between the features of platelet-rich plasma and the patient-related variables, including age, gender, body mass index, smoking status, smoking index, presence of other health conditions, physical activity scores, duration of symptoms, and pain levels, was performed.
Results: Dose of injected platelets, efficiency of the procedure, purity of platelet-rich plasma, and activation analysis showed that the dose of injected platelets was 3.25 billion, the efficiency of the process was 77%, and the purity rate of the platelet-rich plasma was 98.4%. Platelet-rich plasma platelet count was correlated with whole blood platelet count (r = 0.81, P < .001), whole blood white blood cell count (r = 0.39, P = .002), smoking status (r = 0.56, P = .03), smoking index (r = -0.63, P = .002), and the presence of hypertension (r = -0.31, P=.04). Platelet-rich plasma white blood cell and purity of platelet-rich plasma were correlated with the smoking status of the patients (r = 0.52, P = .01; r = 0.64, P = .003, respectively).
Conclusion: This study has demonstrated that high dose and very pure platelet-rich plasma with medium efficiency was yielded with this platelet-rich plasma preparation procedure; whole blood platelet count, the presence of hypertension, and the smoking status of patients affect the features of the obtained platelet-rich plasma.
Level of evidence: Level IV, Diagnostic Study.

View attachment 376541

Key takeaways:
  • Platelet count in whole blood (Wb_Plt) strongly correlates with platelet count in PRP (PRP_Plt). This is expected, as PRP is prepared by centrifuging whole blood to enrich the platelet fraction.
  • White blood cell count in whole blood (Wb_WBC) and red blood cell count in whole blood (Wb_RBC)** are also correlated with PRP_Plt, but to a lesser extent. This suggests that other factors, such as the centrifugation protocol, may also play a role in determining PRP_Plt.
  • Platelet distribution width (Wb_Pdw) is negatively correlated with PRP_Plt. This means that patients with narrower platelet distributions tend to have higher PRP_Plt.
  • Gender, age, and BMI correlate with PRP_Plt, but the correlations are weaker.
  • Dose of injected platelets, process efficiency, and PRP purity are all positively correlated. This suggests that these factors are all important for achieving high-quality PRP.
The heatmap shows that several patient-related variables correlate with PRP quality. This suggests that it is crucial to consider these variables when preparing PRP for clinical use.

Here are some specific recommendations for how the heatmap can be used to improve PRP quality:
  • Select patients with high platelet counts and narrow platelet distributions.
  • Use a centrifugation protocol that is optimized for platelet enrichment.
  • Monitor the efficiency of the PRP preparation process and make adjustments as needed.
  • Use a quality control protocol to ensure that the PRP is pure and meets all required standards.
Click to expand...

More evidence that Dose Matters...

Marx, Platelet Concentration, and Fake PRP - Regenexx

Regenexx offers non-surgical, regenerative orthopedic treatment options for pain related to osteoarthritis, joint injuries, overuse conditions, spine pain, and common sports injuries.
regenexx.com regenexx.com
 
drusso said:
More evidence that Dose Matters...

Marx, Platelet Concentration, and Fake PRP - Regenexx

Regenexx offers non-surgical, regenerative orthopedic treatment options for pain related to osteoarthritis, joint injuries, overuse conditions, spine pain, and common sports injuries.
regenexx.com regenexx.com
Click to expand...
How do we make real PRP?
License fees and franchise fees to Regenexx must be the only right way.....
Are there any reliable methods to test PRP concentration at POS?
What is the cost of this?
Who does this?

If you do this once and use the same technique for all, is there a reason to do this regularly?

PRP and the industry is such a shtshow hodge podge and studies as noted by Centeno were done using fake PRP more than real PRP.
 
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lobelsteve said:
How do we make real PRP?
License fees and franchise fees to Regenexx must be the only right way.....
Are there any reliable methods to test PRP concentration at POS?
What is the cost of this?
Who does this?

If you do this once and use the same technique for all, is there a reason to do this regularly?

PRP and the industry is such a shtshow hodge podge and studies as noted by Centeno were done using fake PRP more than real PRP.
Click to expand...

Not at all. There are many sound "tabletop" systems with reliable results, provided you know baseline platelets on a simple CBC.

You can test your PRP on a hematology analyzer but recognize that you're operating outside the calibration curves for these instruments so YMMV.

We're past the "Does PRP work?" stage of scientific discovery. We know it works for a myriad of conditions. Now, it's about dialing in the proper indications and use cases. PRP has been around since the 1970s. There is nothing new under the sun.
 
drusso said:
Not at all. There are many sound "tabletop" systems with reliable results, provided you know baseline platelets on a simple CBC.

You can test your PRP on a hematology analyzer but recognize that you're operating outside the calibration curves for these instruments so YMMV.

We're past the "Does PRP work?" stage of scientific discovery. We know it works for a myriad of conditions. Now, it's about dialing in the proper indications and use cases. PRP has been around since the 1970s. There is nothing new under the sun.
Click to expand...
Actually, we are still on the what is PRP and can we agree on a technique to make optimal PRP for the indications.
 
So mcdonalds franchisee has more personal integrity than the wagu beef hamburger shop down the street?

When you do 17 PRP shots in the spine at once how does that outcome tracking work? P&L statement seems best way to track.
 
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nvrsumr said:
So mcdonalds franchisee has more personal integrity than the wagu beef hamburger shop down the street?

When you do 17 PRP shots in the spine at once how does that outcome tracking work? P&L statement seems best way to track.
Click to expand...

In aggregate, we've tracked NPS and FRI over lumbar 14,000 procedures. But, our data only go out for 6 years so that's a limitation.

1702402580898.png


regenexx.com

Patient Results - Regenexx

Regenexx maintains an active patient registry. Explore the outcomes database and see the number of currently tracked procedures as well as patient-reported results.
regenexx.com regenexx.com

We'll see if the results can replicated prospectively.

regenexx.com

Study for Patients with Lumbar Degenerative Disc Disease - Regenexx

Regenexx offers non-surgical, regenerative orthopedic treatment options for pain related to osteoarthritis, joint injuries, overuse conditions, spine pain, and common sports injuries.
regenexx.com regenexx.com
 
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pretty graphs!

nice data!

great improvement!



wait...

um....


why did 50% of your patients not report results after 6 months?

were these patients followed longitudinally?


at 6 years, you only have what 447 to 450 patients, compared to starting with 11134. thats 4% of the starting patients. what happened to 96% of the patients who got injections?


and how does that compare to people who got conservative treatment?

oh snap they werent studied at all.... so no idea how treatment would have done compared to standard of care.



and improvement only from 50% to 72%. not 100%?



but still pretty.

(pretty misleading)
 
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Ducttape said:
pretty graphs!

nice data!

great improvement!



wait...

um....


why did 50% of your patients not report results after 6 months?

were these patients followed longitudinally?


at 6 years, you only have what 447 to 450 patients, compared to starting with 11134. thats 4% of the starting patients. what happened to 96% of the patients who got injections?


and how does that compare to people who got conservative treatment?

oh snap they werent studied at all.... so no idea how treatment would have done compared to standard of care.



and improvement only from 50% to 72%. not 100%?



but still pretty.

(pretty misleading)
Click to expand...
When you only report outcomes for those getting 50% relief and 80% relief you get great outcomes.
 
ad hominem fallacy. but ill respond.

i "track" my epidurals because they all get a 3 month follow up. the expectation is that these injections will last 3 months.

but i am not selling a product that is supposed to last a lot longer, or posting misleading graphs regarding treatments that are not standard of care. huge difference.
 
Ducttape said:
ad hominem fallacy. but ill respond.

i "track" my epidurals because they all get a 3 month follow up. the expectation is that these injections will last 3 months.

but i am not selling a product that is supposed to last a lot longer, or posting misleading graphs regarding treatments that are not standard of care. huge difference.
Click to expand...

What registry are you using?
 
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Ducttape said:
ad hominem.

i guess you didnt read the message, even though you copied it.
Click to expand...

www.ncbi.nlm.nih.gov

Quality in practice: implementation of a clinical outcomes registry in regenerative medicine

The aim of this didactic article is to describe the implementation of a clinical outcomes registry within a clinical setting for musculoskeletal regenerative medicine. A patient-centred clinical registry, designed and implemented into the practice of ...
www.ncbi.nlm.nih.gov www.ncbi.nlm.nih.gov

If my regen practitioner didn't track outcomes in a registry, I'd be pissed.
 
drusso said:
If my regen practitioner didn't track outcomes in a registry, I'd be pissed.
Click to expand...
i can agree with this.

because regen is still considered experimental.

and thats one of the reasons i have not pushed admin (their unwillingness is the main reason) for regen for tendonitis and peripheral joint.

even if i had a process, the vast majority of my patients will not be able to afford regen.

id say 98%.
 
What needle size (gauge) do you guys use for blood collection & joint injection? Rep said 21g preferred (and 23g being smallest to use) for collection/injection due to possible shearing of RBCs/platelets. Any truth to this? I want to minimize patient discomfort with blood collection & injection.
 
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drusso said:
In aggregate, we've tracked NPS and FRI over lumbar 14,000 procedures. But, our data only go out for 6 years so that's a limitation.

View attachment 379720

regenexx.com

Patient Results - Regenexx

Regenexx maintains an active patient registry. Explore the outcomes database and see the number of currently tracked procedures as well as patient-reported results.
regenexx.com regenexx.com

We'll see if the results can replicated prospectively.

regenexx.com

Study for Patients with Lumbar Degenerative Disc Disease - Regenexx

Regenexx offers non-surgical, regenerative orthopedic treatment options for pain related to osteoarthritis, joint injuries, overuse conditions, spine pain, and common sports injuries.
regenexx.com regenexx.com
Click to expand...

Here is my issue with Centreno.

If he really cared about this stuff - he would let the world know exactly what he was doing so others could also benefit and replicate results.

We have seen this story over and over.

My favorite restaurants give out their recipes to their "special" jalapeno white sauce, or whatever - because they know even with the recipe out there, people will still want them to make it for them and they will lose ZERO revenue.

If Chris's special sauce works, he should tell people to try and replicate it. He should want the pain world to follow him down this path of glory. But if he is worried about losing revenue to a guy in Kansas because they won't send their patients to Cayman Islands, then I think that provides us with clear evidence of his real motive, and his real belief in his special sauce.
 
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PRP (and much of pain medicine) is like a brachistochrone curve.

Sure, if we look at a silly endpoint like 2 years later - it looks like there is no difference.

The ball gets there eventually.

But it's better to get there (pain relief while time marches on) quicker.

​



IM docs are dumb with their studies.

They compare an ESI with something (like PT) and look at outcomes months later and conclude since they are the same - there is no benefit to an ESI.

That is like giving a Tylenol pill for broken toe vs a placebo, then asking a week later if the foot hurts less between the two. Obviously, it will feel the same a week later.
 
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that analogy is good, but misses that the epidural is only going to last 3 months. i agree there is an issue with how IM may study epidurals, but it is more of an endpoint problem (study based on far after epidural is expected to last).

which kind of makes your tylenol analogy not completely apropos.

---

with regards to the patient ending up at the same spot in the end.

they will have spent lots of money for the perceived short term benefit.

why do PRP if you can equally get by with something a lot less expensive - for example, back brace and gabapentin? and it is not as if PRP is better for short term pain relief - multiple studies drusso has posted have suggested that steroid injections reduce short term pain better than PRP.

(edit PRP would be the middle curve, ESI with repeats because of faster initial pain relief would be the steepest)



---

again, the other problem with this "data" is that those who do not get to the same spot are not included in the graph.
 
epidural man said:
Here is my issue with Centreno.

If he really cared about this stuff - he would let the world know exactly what he was doing so others could also benefit and replicate results.

We have seen this story over and over.

My favorite restaurants give out their recipes to their "special" jalapeno white sauce, or whatever - because they know even with the recipe out there, people will still want them to make it for them and they will lose ZERO revenue.

If Chris's special sauce works, he should tell people to try and replicate it. He should want the pain world to follow him down this path of glory. But if he is worried about losing revenue to a guy in Kansas because they won't send their patients to Cayman Islands, then I think that provides us with clear evidence of his real motive, and his real belief in his special sauce.
Click to expand...

All of the recipes for all of the secret sauces are published in the peer review literature. There is no secret sauce...

pubmed.ncbi.nlm.nih.gov

A Randomized Controlled Trial of the Treatment of Rotator Cuff Tears with Bone Marrow Concentrate and Platelet Products Compared to Exercise Therapy: A Midterm Analysis - PubMed

Injectable regenerative therapies such as bone marrow concentrate (BMC) and platelet-rich plasma (PRP) may represent a safe alternative in the treatment of rotator cuff tears. This is a midterm review of a randomized, crossover trial comparing autologous BMC and platelet product injections...
pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov

"Patients randomized to the treatment group, and patients after crossover, received ultrasound-guided injections of BMC and platelet products to the targeted rotator cuff tear area. All patients completed a bone marrow aspiration (BMA). The BMA procedure and processing protocols utilized for this study have been previously described [20]. In brief, bone marrow aspirate of 5-15 mL from six-nine sites was collected from the bilateral posterior superior iliac crests for a total volume of 60-90 mL into heparinized syringes. This was serially centrifuged with a resultant 1-3 mL of buffy coat collected. In addition, 60 mL of intravenous blood was drawn to isolate PRP and platelet lysate (PL). PRP was prepared by centrifugation and stored at -20°C, and PL was isolated via recentrifugation of the PRP. Total nucleated cell count (TNCC) of BMC was obtained using the TC20™ Automated Cell Counter (Bio-Rad, 2000 Alfred Nobel Dr. Hercules, CA). A 10 μL sample of BMC was pipetted into 450 μL of sterile water which was then mixed with 450 μL of sodium chloride for a total dilution of 1 : 100. 10 μL of this mixture was then placed into a microcentrifuge tube and gently mixed with 10 μL of trypan blue and pipetted onto a cell counting slide. The slide was loaded into the slot of the TC20™ Automated Cell Counter which gave a total cell count per mL, as well as a live cell count per mL. This number was multiplied by the inverse of the dilution of the BMC sample (100) and then multiplied by the total volume of the BMC sample to obtain the TNCC. For the treatment procedure, under sterile conditions, ultrasound was used to localize the patient's supraspinatus tendon deficit. Under ultrasound guidance, 1-2 cc injectate consisting of 60% by volume of BMC, 20% by volume of PRP, and 20% by volume of PL was then percutaneously injected into the area of the tear."

If you want Centeno's results, just use his sauce recipe.
 
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drusso said:
All of the recipes for all of the secret sauces are published in the peer review literature. There is no secret sauce...

pubmed.ncbi.nlm.nih.gov

A Randomized Controlled Trial of the Treatment of Rotator Cuff Tears with Bone Marrow Concentrate and Platelet Products Compared to Exercise Therapy: A Midterm Analysis - PubMed

Injectable regenerative therapies such as bone marrow concentrate (BMC) and platelet-rich plasma (PRP) may represent a safe alternative in the treatment of rotator cuff tears. This is a midterm review of a randomized, crossover trial comparing autologous BMC and platelet product injections...
pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov

"Patients randomized to the treatment group, and patients after crossover, received ultrasound-guided injections of BMC and platelet products to the targeted rotator cuff tear area. All patients completed a bone marrow aspiration (BMA). The BMA procedure and processing protocols utilized for this study have been previously described [20]. In brief, bone marrow aspirate of 5-15 mL from six-nine sites was collected from the bilateral posterior superior iliac crests for a total volume of 60-90 mL into heparinized syringes. This was serially centrifuged with a resultant 1-3 mL of buffy coat collected. In addition, 60 mL of intravenous blood was drawn to isolate PRP and platelet lysate (PL). PRP was prepared by centrifugation and stored at -20°C, and PL was isolated via recentrifugation of the PRP. Total nucleated cell count (TNCC) of BMC was obtained using the TC20™ Automated Cell Counter (Bio-Rad, 2000 Alfred Nobel Dr. Hercules, CA). A 10 μL sample of BMC was pipetted into 450 μL of sterile water which was then mixed with 450 μL of sodium chloride for a total dilution of 1 : 100. 10 μL of this mixture was then placed into a microcentrifuge tube and gently mixed with 10 μL of trypan blue and pipetted onto a cell counting slide. The slide was loaded into the slot of the TC20™ Automated Cell Counter which gave a total cell count per mL, as well as a live cell count per mL. This number was multiplied by the inverse of the dilution of the BMC sample (100) and then multiplied by the total volume of the BMC sample to obtain the TNCC. For the treatment procedure, under sterile conditions, ultrasound was used to localize the patient's supraspinatus tendon deficit. Under ultrasound guidance, 1-2 cc injectate consisting of 60% by volume of BMC, 20% by volume of PRP, and 20% by volume of PL was then percutaneously injected into the area of the tear."

If you want Centeno's results, just use his sauce recipe.
Click to expand...
If you do regenexx training, you don’t sign an NDA?
 
I've done one of their courses. It was okay. I actually didn't learn anything, but it was fun to listen to other ppl talk about procedure technique. That was beneficial.

If you sign onto Regenexx, they own your behind.
 
My linked in page is telling me Joann borg stein and Spaulding has jumped way onto the prp bandwagon..as has mayo, Kessler, etc

Must be something to that “secret” sauce
 
Dr. Ice said:
My linked in page is telling me Joann borg stein and Spaulding has jumped way onto the prp bandwagon..as has mayo, Kessler, etc

Must be something to that “secret” sauce
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that's not new......Borg Stein wrote papers years ago....i remember reading it and mentioning it here
 
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Doctodd said:
that's not new......Borg Stein wrote papers years ago....i remember reading it and mentioning it here
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She has been into regenerative medicine for a long time. During my residency there I learned prolotherapy with her and another resident did a study (with her as the faculty advisor) using PRP for lateral epicondylitis.

This was 15 years ago.
 
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