innovative and safe therapy for rheumatology patients

Due to its healing properties, PRP has gained great popularity in different areas of medicine that require tissue regeneration.

Dr. Oscar Soto Raíces, rheumatologist and president of the Puerto Rican Foundation for Rheumatic Diseases (FER) and Dr. Paloma Alejandro, rheumatologist from Soto-Raíces Mindful Rheumatix and Medical Research Group. Photo: Journal of Medicine and Public Health. Fabiola Plaza.

Not all patients show a change in their lifestyle once they start treatment for a rheumatological condition. This has forced science to look for more effective alternatives that can counteract tissue damage caused by these diseases, one of these is the application of platelet rich plasma (PRP).

This therapy consists of using the healing benefits of the blood to be able to repair or even regenerate all the tissue affected by the disease. It is often used in patients with osteoarthritis of the knee and hip, although it is also possible to use it in other joints.

Through a conversation held by the Revista de Arthritis and Rheumatology, an allied portal of the Journal of Medicine and Public Health, the Doctor Oscar Soto Raíces, rheumatologist and president of the Puerto Rican Foundation for Rheumatic Diseases (FER) and Dr. Paloma Alejandro, rheumatologist at Soto-Raíces Mindful Rheumatix and Medical Research Group assured that this therapy is an innovative alternative for patients who did not perceive a significant improvement with traditional treatments.

“Usually what people start to do is take painkillers such as paracetamol or non-steroidal anti-inflammatory drugs, but the problem with these drugs is that we are affecting the entire system, and it must be metabolized through the liver and kidney,” explained Dr. Soto. “We have already begun to think about other more effective alternatives, because we do them in the affected area so that they do not have systemic effects.”

Generally, when the patient presents a picture of inflammation and acute pain, hot and cold therapies are performed, rest of the affected joint and its protection are recommended. On the contrary, when it comes to a chronic condition, especially in patients diagnosed with some type of arthritis or osteoarthritis, the aim is to protect the joint, strengthen nearby tissues and determine strategies to reduce weight or pressure on the affected area.

“The platelet rich plasma it is a third alternative that we can offer our patients with osteoarthritis or tendon problems”, assured Dr. Alejandro. “Blood is drawn from the patient and that same blood is used to extract those growth factors and blood platelets that help regenerate cartilage tissue or heal wounds.”

When we speak of plasma, we refer to the liquid component of the blood that is the medium for red and white blood cells, and other material, to be able to move through the bloodstream. It includes proteins, nutrients, glucose, antibodies, among others.

Also, platelets are a normal component of blood. By themselves, they do not have healing or restorative properties, but they do secrete growth factors and other proteins that promote healing and tissue regeneration.

“You have to centrifuge the blood to be able to isolate these components and the liquid. It is injected directly into the joint, but it can also be injected into tendons, ligaments and around joints”, argued the expert.

“This procedure is safe, but it is not for all patients. We want to choose patients who have a mild to moderate type of osteoarthritis, because I don’t think that in patients with severe disease it will help them a lot, maybe if it relieves their pain, but it is not a significant change in their daily life ”, added Dr. Alejandro.

PRP is not for all patients

Experts say that this therapeutic method carries risks and contraindications, just like the others. These points are already established and must be taken into consideration when offering it.

“For example, a patient with stage 5 cancer cannot receive this procedure because they are at risk of us introducing malignant cells from the extracted blood into the joint. Likewise, patients with thrombocytopenia, liver problems, coagulation problems, with active infections in the blood or who are being treated with anti-inflammatories are not suitable patients for this practice”, stressed Dr. Alejandro.

Similarly, it is important to follow a series of recommendations once the procedure is done, such as avoiding the consumption of anti-inflammatories so that the stimulus for creating clots in the joint is not stopped, and taking rest.

Application of PRP in alternate areas of medicine

PRP began being used in sports medicine, physiatry and rehabilitation, and in dermatology, under the premise that it helps reduce inflammation. “Seeing that this process is accelerating, it has been extrapolated to more aesthetic cases, hair loss and skin problems,” confirmed Dr. Soto.

Additionally, this technique is also being used to improve patient recovery in orthopedic surgery, anything to regenerate the tissue or increase its healing time, and thus reduce complications.

“It is certainly very fashionable, it is being used in various phases of medicine and we would like to see more rigorous clinical studies comparing it with other joint injection modalities. It is an extremely safe procedure for the patient, taking into account that the right patient is performed to try to delay that knee or hip replacement for a few years”, concluded Dr. Paloma Alejandro.