Time to Stress Test PRP and Stem Cell Products

For years platelet-rich plasma (PRP) has been used to treat tendons for injury and degeneration—with more anecdotal evidence than high level scientific study based evidence. The same has been true of the use of stem cells. Recently researchers at Hospital for Special Surgery (HSS) have been awarded a $100, 000 grant from the National Football League (NFL) Charities to research the use of PRP and stem cells as treatments for tendon injury. NFL players and other athletes suffer from tendon overuse injuries and they need new treatments.

“We don’t have a treatment that works 100 percent of the time, so there is room for improvement, ” said Scott Rodeo, M.D., co-chief of the Sports Medicine and Shoulder Service for Hospital for Special Surgery in New York City. “Many people are weekend warriors and they suffer from tendon overuse injuries. Hopefully, our study will be able to help a lot of these people.” Rodeo, who will be heading up the research, has been associate team physician for the New York Football Giants since 2000.

Researchers hope that their work will lead to the development of an effective therapeutic strategy for tendinopathy that will allow NFL players to return to competition more quickly. It may also lead to a decrease in complications related to tendinosis, such as tendon ruptures. Tendinosis is caused by repetitive microtears in the connective tissue in and around the tendon along with a failure of the body to mount a full healing response. Over time tendinosis leads to pain, reduced tensile strength and the chance of tendon rupture.

The grant money will be used to investigate how degenerated tendons respond to PRP and bone marrow-derived stem cells as well as if these two treatments will be synergistic if they are combined. Among the goals of the research are to examine the structural and mechanical properties of the treated tendon tissue to see how it responds to PRP and stem cells.

In recent years, physicians have found that some, but not all, patients with tendon disorders respond to treatment with PRP. PRP contains cells and growth factors that may stimulate healing of bone and soft tissue. Researchers surmise the mixed results may be caused by variations in preparation, timing, dosage and delivery of platelets, or differences in bioactivity.

Different PRP preparations contain different amounts of cell and growth factors. The researchers speculate that the studies that had negative results may have used PRP preparations with low bioactivity. To test this theory, researchers will test the bioactivity levels of the preparations used. Further, the researchers hope to be able to address the question of whether PRP treatments actually help heal the tendon structure or just ameliorate the pain.