Mr Mark Webb

WHAT TO KNOW ABOUT Orthobiologics?

WHAT IS HIP Orthobiologics ?

Orthobiologics are substances that can be used to help treat sports and orthopaedic injuries, helping to improve symptoms and facilitating healing.

About Viscosupplementation

Viscosupplementation is when a thick fluid called hyaluronate is injected into the joint. Hyaluronate is thought to improve the lubricating properties of the synovial fluid which in turn can reduce the pain from osteoarthritis, improve mobility and help to remain active.

This treatment may be suitable for people with early osteoarthritis, who want to avoid more invasive treatment. Depending on the type of injection used, either a single injection or a short course of three injections is recommended.

Orthobiologics

About PRP

Platelet Rich Plasma (PRP) is a concentration of natural growth factors within the blood that the body can use to heal tissue. Research has shown that PRP is both a safe and effective treatment option for a variety of conditions and has become increasingly popular in recent years. PRP is extracted from your own blood and is then administered in the clinic using an ultrasound guided injection.

There are two main groups of PRP: PRP-LP (Leukocyte Poor) where the majority of white blood cells are removed and PRP-LR (Leukocyte Rich) where a proportion of the white blood cells remain. PRP-LP is anti-inflammatory and is used to treat conditions such as early osteoarthritis. PRP-LR is pro-inflammatory and there is a growing body of evidence that this type is useful in treating certain types of tendon injuries.

This treatment may be suitable for people with early osteoarthritis, who want to avoid more invasive treatment. Depending on the type of injection used, either a single injection or a short course of three injections is recommended.

About Cell therapy- ACPSVF

The field of ‘regenerative cell therapy,’ also referred to as ‘stem cell therapy,’ is evolving rapidly. There is still limited published scientific evidence available due to the treatments being relatively new, however, this is changing.

These injections are reported to help reduce pain and inflammation by providing an environment for the tissue to heal.

The procedure is performed under sedation and fat cells are taken from the abdomen. The stem cells are then separated from the fat cells and these are then injected into the desired area such as a joint or tendon.

It is important to understand that these treatments do not reverse the damage that occurs due to wear and tear. There is no evidence available that demonstrates that the cells transform after they are injected into a joint or tendon. However, patients undergoing these treatments can have significant symptom improvement.

If someone wishes to consider this type of therapy, it is important to ensure that they do not have moderate or severe osteoarthritis as it is unlikely that they will benefit from any potential improvement. It is also important to ensure that they are kept under review and that your clinician monitors your outcome.

There are two main groups of PRP: PRP-LP (Leukocyte Poor) where the majority of white blood cells are removed and PRP-LR (Leukocyte Rich) where a proportion of the white blood cells remain. PRP-LP is anti-inflammatory and is used to treat conditions such as early osteoarthritis. PRP-LR is pro-inflammatory and there is a growing body of evidence that this type is useful in treating certain types of tendon injuries.

This treatment may be suitable for people with early osteoarthritis, who want to avoid more invasive treatment. Depending on the type of injection used, either a single injection or a short course of three injections is recommended.

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MR MARK WEBB

How is a PRP injection performed?

Mr Webb will go through the risks and benefits of the procedure and you will have an opportunity to ask any questions. Mr Webb firmly believes in providing the best evidence for each treatment option so that you can make the best decision for you.

Blood Sample and Preparation

Approximately 15 millilitres (mls) are taken in the same way as you have had your blood taken before, but into a purpose made syringe. This sample is then placed into the machine which spins the sample to separate the components. After about five minutes the sample is ready. Fifteen millilitres of blood normally produces approximately 5mls of PRP.

Injection (PRP)

You will be asked to lie in a certain position depending on what is being injected. The surrounding area is cleaned and an ultrasound scan is then used to ensure that the needle is being placed in the desired location. The injection usually only takes one minute to perform.

Is it painful?

The PRP injection can be uncomfortable. Injections into a joint can cause some discomfort but are normally easily tolerated. Injections for soft tissue problems are more uncomfortable. A local anaesthetic is thought to reduce the effect of PRP and therefore is avoided. A ‘freeze’ spray is used to numb the skin prior to injection.

What should I expect after the injection?

PRP can be painful in the days following the injection. Anti-inflammatory medications, such as ibuprofen, diclofenac, naproxen and aspirin, should be avoided as these may reduce the healing potential. Normally paracetamol is enough to keep you mobile.

It is important to understand that these injections will not provide immediate pain relief. They rely on the body’s own healing and therefore can take a number of weeks before an improvement is seen.

There are normally no limitations after the injection and people should be guided by comfort and common sense. It is recommended that you work with a physiotherapist to help guide you through a rehabilitation programme. This is most important for tendon problems, where the course of physiotherapy to help re-load the injured tendon is advised.

How many injections can I have?

Unlike corticosteroid injections, there is no limit on the number of PRP injections you can have. A course of three PRP injections spaced one to two weeks apart is recommended to optimize the results, however, a single injection can still provide significant relief.

PRP-ACP for Osteoarthritis - Mark Webb

ACP SVF for Osteoarthritis - Mark Webb

PRP-ACP for Soft Tissue Injuries - Mark Webb

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