New treatment Modality for Orthopaedic Conditions

Platelet Rich Plasma (PRP)
Platelet-rich plasma (PRP) is a newer modality of treatment for the management of many orthopaedic conditions including sport injuries. RBC (red blood cells), WBC (white blood cells), plasma, and platelets are the major components of blood. Platelets are small discoid blood cells with granules containing clotting and growth factors which are released during the healing process. On activation, the platelets accelerate the inflammatory cascade as well as healing by the release of the granules containing growth factors. Platelets have an average lifespan of 7–10 days.
A normal blood specimen contains only 6% platelets whereas platelet rich plasma (PRP) contains a much higher concentration of platelets. A PRP injection is generally recommended in the treatment of tendon or muscle injuries with a success rate of about 70% to 80%. Four to six weeks may be required for complete healing.
Special precautions are required in individuals with low platelet count, bleeding disorders, those on blood thinning medications or anti-inflammatory medications, individuals allergic to local anesthetic agents, those with active infections and women who are pregnant or breast feeding.

What to expect during the procedure?
Your doctor will first draw 10 ml of blood from the large vein in your elbow. The blood will be centrifuged or spun to separate the platelets from other blood components. The entire process takes about 10 minutes. The platelet rich portion of the blood is then extracted.
The injured part of the body is anesthetized with a local anesthetic and PRP is injected into the affected area under ultrasound guidance.

What to expect after the procedure?

• Following the procedure, you can resume your daily routine activities but avoid strenuous activities such as heavy exercise or lifting.
• You may experience some pain during the injection which may last for a couple of days. Cold compresses and pain medication may be prescribed for pain relief. Anti-inflammatory medications are to be avoided for up to 48 hours after the injection, as they can affect the platelet function.
• Risks and complications are rare but can include infection, nerve or blood vessel injury, scar tissue formation, and calcification at the injection site following a PRP injection.

Vicsosupplementation – Gel Injection
Gel injections, or Viscosupplementation, is a treatment option for osteoarthritis pain.  There is no cure for osteoarthritis, however the pain can be alleviated in a number of ways. If other treatment methods are ineffective in relieving pain, Viscosupplementation may be recommended.
Viscosupplementation is done on an outpatient basis. After  the injection is administered, patients will be instructed to follow a physical therapy and exercise regimen. Physical therapy is vital to the treatment process and should be followed carefully.

What you can expect with Viscosupplementation?

• Viscosupplementation is a  process involving 3 to 5 (each administered once a week)  injections of hyaluronic acid into the affected joint.  In a successful case, the acid will serve as lubrication for the joint, relieving the patient of pain and increasing mobility of the knee joint.
• Some patients experience swelling, pain, heat, itchiness and bruising at the site of injection. Some reactions are normal and does not last very long, however they should be reported to doctor regardless of the level of severity.

Learn about cortisone injections
Cortisone is a type of steroid that is produced naturally by a gland in your body. Injectable cortisone is synthetically produced and can help reduce inflammation (swelling, irritation and redness) for conditions such as arthritis, bursitis and sports injuries such as sprains.

What are the benefits of cortisone injections?
Cortisone is not a pain relieving medication, but is a powerful anti-inflammatory medication. Inflammation may be an underlying problem to a patient’s pain. By injecting the medicine into a particular area of inflammation, high concentrations of cortisone can be administered while keeping potential side-effects to a minimum

• Rapid pain relief – cortisone injections typically work within a few days and pain relief can last up to several weeks.
• Quick procedure – cortisone shots are simple and quickly performed in the office. Physicians often use a very small needle, but sometimes a slightly larger needle is required if your physician is attempting to remove fluid prior to injecting the cortisone shot.
• Slight discomfort – In the hands of a skilled physician, especially in the joint area, receiving a cortisone injection is usually well tolerated
• Local analgesic – Numbing medication, such as Lidocaine, is often injected with the cortisone to provide temporary relief of the affected area.

Are there side effects to a cortisone treatment?
The most common side effect is cortisone flare, which can cause a brief period of pain lasting 1-2 days. This is best treated by icing the injected area. Rarely, an infection or ruptured tendon can occur. Certain medical conditions, such as diabetes, can be affected requiring close monitoring of blood sugar levels.