A recent case report published in the European Review for Medical and Pharmacological Sciences examines the effects of intra-articular PRP injections in a patient on chronic anti-platelet therapy. The study was published by researchers out of the Rizolli institute in Balogna, Italy, and includes 2014 TOBI: The Orthobiologic Institute speaker Dr. Elizaveta Kon.
The patient is a 52 year old male runner complaining of consistent left knee pain, associated with significant functional impairments and complete withdrawal from sporting activity for the past 3 months. The patient was previously diagnosed with a metabolic disorder characterized by high plasma levels of Lipoprotein A, an LDL-like particle that is a risk factor for cardiovascular disease at elevated levels. At 43 years old, the patient underwent a multiple coronary bypass surgery for blockages in the coronary arteries as a result of his metabolic condition. Following the procedure, the patient was started on anti – platelet therapy consisting of 160 mg of aspirin daily, and resumed running 3-4 times per week within pre-set cardiovascular limitations.
The patient had failed other conservative treatment methods for his knee pain, and ultimately decided to undergo a PRP injection. The patient exhibited a very positive response, with no post injection swelling and pain-free return to running at 14 days following the injection, increasing his distance as tolerated. His IKDC – subjective score was shown to increase from 45.4 to 100, and the patient participated in a 1/2 marathon just 35 days after the procedure.
The results of this case report draw into question the initial conclusions about the concomitant use of anti-platelet therapy and PRP injections. It has been widely accepted that anti-platelet therapy is a contraindication for PRP therapy, due to the fact that platelet inhibition could potentially stunt the healing potential of PRP. However, the positive clinical results in the following patient on chronic aspirin therapy suggest that PRP could potentially have significant intra-articular effects in patients who were previously not indicated for the procedure. As research continues to investigate the mechanisms of Platelet Rich Plasma’s regenerative potential, it is important to examine potential mechanisms that may not be directly linked to granule released growth factors. Although further research is needed to evaluate the effects of PRP in patients on anti-platelet therapy, the case report raises questions about PRP’s mechanism of action, and contraindications.
For all of the latest research on Platelet Rich Plasma and cutting-edge technology in Orthobiologic therapy, be sure to attend the 5th Annual TOBI: The Orthobiologic Institute PRP & Regenerative Medicine Symposium June 6th and 7th in Las Vegas, www.prpseminar.com
Article link: http://www.europeanreview.org/wp/wp-content/uploads/55-59.pdf