Medical Journal Publishes Study on Efficacy of PRP Injections for Knee Arthritis

My colleague, Dr. Steven Sampson, recently concluded the first study in the United States on the efficacy of using platelet rich plasma (PRP) injections for arthritis in the knee. The results have just been published in the December 2010 issue of the American Journal of Physical Medicine & Rehabilitation and shows that PRP may be effective in treating primary and secondary arthritis in the knee. In addition, Dr. Sampson provided objective evidence that PRP grows cartilage in an arthritic joint.

Dr. Sampson says that “Injection of Platelet-Rich Plasma in Patient with Primary and Secondary Knee Osteoarthritis: A Pilot Study” was performed to set the foundation for a large multi-center clinical trial in 2011. I am very excited about the interest of medical researchers studying how PRP actually benefits patients who are suffering from orthopedic injuries and conditions.

An alternative or enhancement to surgery, Platelet Regeneration Therapy uses PRP, which is a concentrated form of a patient’s own blood. For more advanced conditions, PRP is combined with a patient’s own stem cells from his or her own abdominal fat or own bone marrow. In my office, Platelet Regeneration Therapy has been extremely successful in treating people with torn tendons, ligaments, and muscle injuries naturally. Prior to this treatment, patients were facing major surgery, rest, physical therapy, and up to one year of recovery time.

Thanks for reading, an feel free to leave a comment with a question or an experience with PRP.

Classical Pianist Regains Use of his Hands After Injury

Twenty-year-old Marius Tesch is a classical pianist who studies in the prestigious studio of Laurent Boukobza, professor and chair of piano studies at the University of Central Florida (UCF). Tesch has been playing piano since age five with a rigorous practice schedule of four to eight hours daily. His longtime dream has always been to become a concert pianist and to teach music to college students.

In February 2010, Tesch fell and landed on his hands while walking to class, which could have been a devastating roadblock in his quest to his reaching his dream. Unfortunately, he suffered severe pain in both wrists, was unable to play the piano or open a jar and had difficulty turning the key to start his car. In addition, he was unable to use a computer or mouse, and had to depend on his computer’s speech recognition program.

“I was depressed and devastated that my dreams of becoming a concert pianist were over,” said Tesch. “I had to change my major from music to history, believing that I would never play concert piano again.”

Tesch consulted with several physicians to try to obtain a prognosis, but none of the doctors could properly diagnose the injury to his wrists. He was told by an orthopedist that he had an overuse injury and was given cortisone injections. Another doctor advised him to rest, use ice, and take anti-inflammatory medications to alleviate the pain. When the pain did not subside, Tesch went to a chiropractor who used therapeutic techniques such as ultrasound stimulation to help reduce the inflammation. He received some relief, but was still unable to play the piano at a performance level.

In September 2010, eight months after his injury, Tesch found Alan Lazar, MD, FACS (www.dralanlazar.com) on the Internet. Dr. Lazar is an orthopedic surgeon in Plantation, Fla., who specializes in a breakthrough non-surgical treatment called Regenerative Injection Therapy with platelet rich plasma (PRP). Regenerative Injection Therapy is a treatment option for orthopedic injuries and conditions that have traditionally required surgery or other extensive treatments.

Regenerative Injection Therapy involves extracting a minimal amount of a patient’s own blood and placing it in a centrifuge, which spins the blood at a high speed to separate it into components. Dr. Lazar then injects the fluid into an injured area or an arthritic joint, which releases bioactive tissue growth factors. These growth factors lead to improved natural tissue healing. For example, when platelets are injected into an arthritic joint with cartilage damage, the new collagen stimulates the growth of cartilage.

Depending on the condition or treatment plan, Dr. Lazar may also recommend using a patient’s stem cells that are extracted from the patient’s own bone marrow or abdominal fat. The stem cells are filtered, cleansed, and then injected into an arthritic joint. PRP stimulates the body’s own stem cells to go to the injured area and make new cartilage to create a natural healing process. Because Tesch is young, and his body manufactures many natural stem cells, he did not need the additional stem cell treatment.

Tesch drove to Plantation from Orlando to visit Dr. Lazar, who examined his wrists and performed an ultrasound. He determined that there were tears in some of the tendons in each wrist.

Tesch was thrilled that he finally had a diagnosis. Dr. Lazar was the only doctor he had seen who could actually identify the tendon tears by using more sophisticated ultrasound imaging.

“I’ve had success treating many injuries similar to Tesch’s, and I felt that he was a good candidate for the PRP treatment,” said Dr. Lazar.

Dr. Lazar placed three injections into the affected tendons in the right wrist and three injections into the left wrist. Within one week, Tesch felt a major improvement in his left wrist. He had no pain and could more easily move his hand and fingers. Four weeks after the treatment, Tesch’s right wrist began to feel remarkably better.

Tesch’s condition has improved so much that he has been able to resume his rigorous practice schedule and will soon be performing with ensembles performing contemporary compositions at UCF.

“I am thrilled because I can now pursue my dreams as a concert pianist and music professor,” said Tesch. “I’m doing so well that I re-registered to resume my music major at UCF.”

This is truly a miracle, according to Tesch. He has the highest regard for Dr. Lazar who has helped him to regain the use of his hands and return to his love of the piano. 

A $1.3 million anti-doping research grant includes focus on “blood spinning."

Last week, the Associated Press released a story about a group funded by the NFL and US Olympic Committee awarding $1.3 million in grants for anti-doping research. The research includes a project to study how “blood spinning” therapy – or Regenerative Injection Therapy as we call it – might help athletes.

Regenerative Injection Therapy involves using platelet rich plasma (PRP) injections with stem cells from fat. PRP is extracted using a patient’s own blood, similar to a lab test. The blood is placed in a special machine that spins the blood at high speeds and separates the platelets from the other blood components. The platelets are then concentrated and re-injected into the injured area or arthritic joint. In turn, the platelets release substances known as growth factors that lead to improved natural tissue healing.

Previously, PRP treatments had been banned when injected through the muscles. The World Anti-Doping Agency recently removed them from the banned list after studies showed the injections offered no possibility of performance enhancement.

In my opinion, the concern over PRP muscle injections is an overreaction to the anti-doping rule. PRP is not known to build muscle. It is known to heal damaged muscle tissue. I have performed over 1,000 Regenerative Injection Therapy with PRP treatments. The Therapy has great benefit.

Elite athletes and weekend warriors need to get back on the field, track, tennis court or golf course or in the pool as soon as possible. What needs to be studied is the ideal concentration for various ages and injuries to optimize results and minimize downtime.

I also believe that studies need to be conducted on the efficacy of using PRP for the treatment of osteoarthritis. Check back for more thoughts on that, and as always, please feel free to leave a comment or ask a question.

Pitcher’s elbow can be treated with Platelet Rich Plasma to Avoid Surgery

Recently, two college baseball pitchers came to me complaining of pain in their elbows. Prior to seeing me, several sports medicine orthopedic doctors had them undergo MRIs, but the tests came back negative. The presumptive diagnosis was over use stress of the ulna collateral ligaments (UCL). The team’s trainer heard of my success with treating many athletes with various sports injuries and brought them to me for evaluation. In addition to MRI, I use ultrasound to help with difficult diagnoses. It was my opinion that the pitchers developed partial tears in their UCL, and the ultrasound confirmed my thoughts.

Tears in the UCL are commonly known as Pitcher’s Elbow because repetitive throwing puts an excessive strain on the tendons and ligaments in the elbow. Pain usually develops on the inner side of the elbow. Your elbow joint may feel like it locks or gets stuck, and it may be difficult to move the elbow as you did before. This condition negatively affects pitching performance.

I am very excited about the positive results that I am seeing on sports injuries, including pitchers elbow, with the use of Regenerative Injection Therapy. This is a treatment option for orthopedic injuries and conditions that have traditionally required surgery or other extensive treatments. Many athletes are coming to my office to be treated for various sports injuries that would normally require surgery and keep them on the bench for up to one year. PRP involves extracting a minimal amount of the patient’s own blood, spinning it in a centrifuge to separate the blood into components, and re-injecting the fluid into the injured area or an arthritic joint. This releases bioactive tissue growth factors that lead to improved natural tissue healing and the growth of new cartilage.

Very often, when pitchers develop tears in their UCL, they are recommended for a surgical procedure called Tommy John surgery. Named after a professional baseball pitcher, Tommy John surgery is a surgical reconstruction of elbow ligaments that are often torn in baseball pitchers. This procedure requires that the injured athlete be out of commission for one year.

After the PRP treatment, I advised the college pitchers that they could resume pitching again in two weeks, but only throwing at 50% of their normal speed. They will gradually increase their speed over six weeks and return to their game.

Athletes are thrilled with the outcomes from PRP treatment because it allows them to return to their game quickly after injury and helps them to avoid surgery. If you are experiencing pitchers elbow or joint pain, I would be happy to evaluate you to determine whether you are a candidate for the incredible new treatment.

Platelet Rich Plasma Treatment for Sports-Related Ankle Injuries

Recently, you might have read about Andre Johnson, a wide receiver for the Houston, Texans who sustained an injury to his ankle. Soon after the initial injury, Johnson reinjured the same ankle. According to FanHouse, Johnson received Platelet Rich Plasma (PRP) to help aid and speed up the healing process http://www.huffingtonpost.com/?joinow=1&ref=aolnewsof his injury. This process, called Regenerative Injection Therapy, has been used to successfully treat many athletes who have sustained various types of sports injuries. Athletes such as Tiger Woods, Hines Ward, and Troy Polamalu have had success with this treatment.

I use Regenerative Injection Therapy containing PRP in my practice, and my patients are having a lot of success healing faster and alleviating their pain. They are returning to sports much faster and have been able to pursue a better quality of life without needing surgery. PRP is a procedure which uses the patient’s own blood that is extracted from the arm, similar to a lab test. The blood is placed in a special machine that spins it at high speeds. This process separates the platelets from the other blood components. The platelets are then concentrated and re-injected into the injured area or arthritic joint. In turn, the platelets release substances known as growth factors that lead to improved natural tissue healing. Platelets initiate repair and attract the assistance of your body’s own stem cells to facilitate the process of regeneration and remodeling of the damaged area.

Three to four weeks after the first PRP treatment, I will evaluate your progress and determine whether more therapy is needed. Depending on the severity and duration of your injury or disorder, most patients require between one and two treatments.

As PRP therapy now gains popularity in the U.S., it is gaining recognition among doctors and patients alike for having a terrific rate of success. Many believe PRP has the potential to revolutionize sports medicine, orthopedics and beyond, with new applications being discovered daily.

Please feel free to contact my office for a consultation to see if you are a candidate for this exciting natural healing process.

News Release:

BREAKTHROUGH NON-SURGICAL TREATMENT HELPS YOUNG WESTON MASSAGE THERAPIST AVOID DOUBLE KNEE REPLACEMENT AND RETURN TO AN ACTIVE, PAIN-FREE LIFESTYLE

Regenerative Injection Therapy with Platelet Rich Plasma and Stem Cells from Belly Fat is Offering an Alternative to Surgery for Many Orthopaedic Conditions

NOTE: Click here to watch Michelle and Dr. Lazar on WFOR Channel 4.

PLANTATION, FL - At just 45 years old, Michelle Nodelman was in chronic knee pain. Her pain was so extreme that she was unable to walk up the stairs in her own home. After five years of dealing with degenerative cartilage disease in both of her knees, the Weston massage therapist who used to love to run and teach Pilates was having trouble simply bending her knees to get in and out of her car.

"It was so frustrating because I was very active and on my feet nearly all the time," she said.

Every few months, Nodelman would have fluid drained from her swollen knees. Doctors offered little relief. An orthopaedic surgeon in Miami told her she would need a double knee replacement but was too young to be a candidate for the surgery. She would need to wait several years before she could even consider knee replacement surgery.

Determined not to live with the pain, Nodelman began looking for doctors who were working with alternative, non-surgical therapies focused on cartilage regrowth. She found her answer with Alan M. Lazar, M.D., F.A.C.S., a board certified orthopaedic surgeon based in Plantation. Dr. Lazar is one of few doctors using an alternative in-office treatment known as Regenerative Injection Therapy that uses platelet rich plasma (PRP) injections. PRP is derived from removing a small amount of the patient’s own blood, which is placed in a machine that operates at a very fast speed to separate the blood into components.

Regenerative Injection Therapy can be used with PRP, or when necessary, with PRP in conjunction with stem cells from fat to increase the healing process. While other doctors in South Florida use PRP, Dr. Lazar is one of very few in the nation using it in conjunction with stem cells from belly fat.

The stem cells are extracted during a mini-liposuction procedure in Dr. Lazar's office. They are then combined with the platelets, which are tiny cells that are critical to healing. When the stem cells are injected into the injured area or arthritic joint, they release substances known as growth factors that lead to improved natural tissue healing and help the process of regeneration and remodeling of the area. Combined with stem cells, there is better circulation to the affected area, which enhances a natural healing process. This procedure is not only used for knee injuries but can be used in many areas of the body, including shoulders, torn tendons, ligaments, hips, ankles, wrists, hands and many arthritic and degenerative conditions.

Nodelman had only two injections. She had the most recent one in May 2010 and says she feels as good as new. She is still marveling over the fact that she does not need surgery or the painful rehabilitation and downtime associated with major surgical procedures. She is exercising once again, walking steps, and even went for a 15-mile bike ride with no discomfort.

"The swelling is gone, the pain is gone. I am a firm believer," Nodelman said.

For more information, visit www.dralanlazar.com or call (954) 476-9494.

News Release:

South Florida Tennis Pro Back on the Court After Receiving Regenerative Injection Therapy for Tennis Elbow

Platelet Rich Plasma and Stem Cells from Belly Fat are Healing Many Orthopaedic Conditions

PLANTATION, FL– Tennis is Tom Mendenhall’s life and livelihood. The 56-year-old from Fort Lauderdale has been a tennis player and instructor for his entire adult life. He currently works with select players at the Fort Lauderdale Tennis Club as a professional instructor and trainer.

Mendenhall’s career was threatened in January 2009 when he developed a moderate medial tendon tear inside his elbow. A medial tear usually occurs on the outside of the elbow, but his occurred inside his elbow. He went to see an orthopedic surgeon who told him he would need surgery to repair and reattach the tendon.

“The surgeon told me that I would be out of commission and off the courts for close to one year,” said Mendenhall. “I would be immobilized and then would need intensive post-surgery rehabilitation. The thought of being off the courts for that long was depressing.”

Mendenhall began exploring his options. He heard about platelet rich plasma (PRP) injections for football injuries and researched the treatment on the Internet. He found Alan M. Lazar, MD, FACS, a board certified orthopedic surgeon based in South Florida. Dr. Lazar is one of few physicians using an alternative in-office treatment known as Regenerative Injection Therapy that uses PRP injections. PRP is derived from removing a small amount of the patient’s own blood, which is placed in a machine that operates at a very fast speed to separate the blood into components.

Dr. Lazar ordered an MRI for Mendenhall, examined him, and told him that he was a candidate for Regenerative Injection Therapy. Mendenhall had one injection in his elbow, and within four weeks, he was back to playing matches and teaching tennis.

In January 2010, Mendenhall felt another pop in an area close to where he had the previous injury. Dr. Lazar was not sure if it was the same tear or another area within the same region, so this time he used Regenerative Injection Therapy with PRP and stems cells for optimum healing. While other doctors in South Florida use PRP, Dr. Lazar is one of very few in the nation using it in conjunction with stem cells from belly fat.

The stem cells are extracted during a mini-liposuction procedure in Dr. Lazar's office. They are then combined with the platelets, which are tiny cells that are critical to healing. When the stem cells are injected into the injured area or arthritic joint, they release substances known as growth factors that lead to improved natural tissue healing and help the process of regeneration and remodeling of the area. Combined with stem cells, there is better circulation to the affected area, which enhances a natural healing process. This procedure is not only used for knee injuries but can be used in many areas of the body, including shoulders, torn tendons, ligaments, hips, ankles, wrists, hands and many arthritic and degenerative conditions.

Within four weeks of the second treatment, Mendenhall was back to playing again.

“I am thrilled with the results,” he said.

For more information, visit www.dralanlazar.com or call (954) 476-9494.

Platelet Rich Plasma Injections May Improve Ankle and Shoulder Instability

Many of us have had the horrible feeling of the ankle "giving way" while walking or stepping off of a curb. Some people have the same feeling occur in the shoulder. When this happens time and time again, it is called ankle instability or shoulder instability.

People with chronic instability experience repeated turning of the ankle or shoulder; persistent discomfort and swelling; pain or tenderness; and/or the ankle or shoulder feeling wobbly. Ankle or shoulder instability might develop from a sprain or injury that did not heal properly or that was not rehabilitated completely. When a person sprains an ankle or injures a shoulder, the connective tissues, or ligaments, are stretched or torn. Each subsequent sprain or injury leads to further weakening or stretching of the ligaments, resulting in greater instability and the likelihood of developing additional problems in the ankle or shoulder.

Treatment usually involves physical therapy, bracing and/or medication. If the instability continues, there are minimally invasive surgery options available. However, I am most excited about the potential of Regenerative Injection Therapy using a patient's own platelet rich plasma (PRP) and growth factors from fat for healing ankle and shoulder instability. Regenerative Injection Therapy is a new, non-operative treatment that enhances surgical repair and provides and option for orthopedic conditions that have traditionally required surgery or other extensive procedures. We draw the patient's blood, similar to a lab test, and place it in a special machine that spins the blood at high speeds, which separates the platelets from the other blood components. When treating instability, the platelets are then concentrated and re-injected into the ankle or shoulder. In turn, the platelets release substances known as growth factors that lead to improved natural tissue healing.

I recently observed a colleague treat shoulder instability with PRP and have adopted the procedure in my practice as a solo treatment or to enhance surgery when necessary. The procedure is called a peppering technique, which involves multiple small injections into the loose ligament or tendon. This technique causes the stretched tissue to contract, which resolves the instability. The results are impressive, and my patients are benefiting after only one or two treatments.

I have more information about instability and Regenerative Injection Therapy on my Web site. Thanks for reading! 

Sharing Liposuction and Fat Grafts Knowledge with Colleagues

Recently, Dr. Steven Sampson invited me to share my unique knowledge of a particular platelet rich plasma (PRP) procedure with colleagues at a seminar in Los Angeles. Dr. Sampson moderated the seminar. He gave an overview of the basic science/literature and discussed indications and protocols behind PRP.

For my part, I lectured about fat grafts and a mini-liposuction technique that I perform on the abdomen. We all learned about ultrasound for diagnosing orthopedic injuries and conditions as well as needle-guided ultrasound PRP injections. In addition, the group was given an opportunity to observe live patient PRP injection procedures at Dr. Sampson's office in Santa Monica.

I enjoyed the beautiful Southern California scenery and a visit with family. I also enjoyed networking with other physicians who are implementing Regenerative Injection Therapy with PRP in their practices. It was great to meet doctors from the United States and other countries. Although I was the only orthopedist who participated, I met physiatrists, sports medicine physicians, rheumatologists, and other specialists who wanted to learn about leading-edge tendon and cartilage techniques to care for their patients. The field of platelet rich plasma therapy is growing, and I am excited to be a part of it.

Thanks for reading. If you are a physician, and you missed out on this seminar, please stay tuned for future seminar and lecture opportunities!

Platelet Regeneration Therapy helping athletes, weekend warriors, arthritis sufferers and many more

Athletes, including Tiger Woods, have received the most media coverage from seeking platelet rich plasma (PRP) treatments for orthopaedic injuries. However, a March 30, 2010 article by Melinda Beck of the Wall Street Journal –

“Spinning Blood Isn’t Just for Athletes” – highlights the use of PRP for non-athletes as well.

Medical researchers are reporting remarkable results using Platelet Regeneration Therapy using PRP in the treatment of common injuries, including tendinitis; the regeneration of cartilage in osteoarthritis of the thumbs, knees and hips; and in non-surgical repair of rotator cuff tears. Published studies show restoration and smoothing of roughened cartilage; improved range of motion; and resolution of pain in osteoarthritis of hips, knees and shoulders.

We commonly use Platelet Regeneration Therapy on tendons, ligaments and joints throughout the body, including: 

•Sports injuries, including tennis elbow and golfer’s elbow

•Tendonitis

•Ligament and meniscal injuries

•Lower back

•Arthritic joints

•Rotator cuff tear of the shoulder

•Osteoarthritis of the hip, knee andd shoulder

If you would like to share a success story about Platelet Regeneration Therapy or have a question, please leave me a comment below. Thanks for reading!

“Fat graft” is an excellent source for stem cells in Platelet Regeneration Therapy

For many orthopedic injuries and conditions, my staff and I utilize an alternative in-office treatment known as Platelet Regeneration Therapy using Platelet Rich Plasma (PRP) injections.

A recent study determined that fat obtained from liposuction produced potent stem cells. These are autologous stem cells and have nothing to do with embryos or embryonic research. Stem cells are defined as cells with the unique capacity to self replicate throughout our lives and to change into cells of various types. This new method is much more efficient than a previous practice that used skin cells.

Currently, we are one of only several orthopaedic practices in the United States who are performing in-office mini liposuction – usually in the abdomen – to extract stem cells from fat. This “fat graft” is an excellent source of stem cells. We combine these stem cells with the platelets to create the PRP injection.

The growth factors from the platelets and the stem cells function to repair damaged tissue and they both participate in the repair process. It takes approximately six weeks for significant repair to occur where the pain is diminished and stress activity can be resumed at the previous desired level, but it really takes two to three months for complete recovery to occur.

Do you have any questions or an experience to share about “fat graft?” If so, please leave me a comment below