Wednesday, May 17, 2023

 

Orthobiologic Therapies PRP & micronized fat (Lipogems): How it works and Why it’s worth it!



Many people with musculoskeletal pain are familiar with corticosteroid (i.e. “cortisone”) injections, which are meant to reduce inflammation.  However, inflammation is often necessary for healing...it's a good thing!  Inflammation after injury recruits the body’s own natural healing factors. 

Another approach is to deliberately induce the body’s own healing mechanisms to repair damaged tissue.  These methods, often termed "orthobiologics,"  can be a longer-term method of musculoskeletal treatment, and is a great alternative to the more well-known corticosteroid injections.  The subtypes of orthobiologic therapies that Drs. Hyman and Chimes perform are platelet-rich plasma injections (PRP) and micronized fat aka 'm-fat' aka Lipogems.   

PRP or platelet-rich plasma directly stimulates the body's healing factors to come and pay attention to an injured area.  Drs. Hyman and Chimes perform PRP or platelet-rich plasma injections to treat arthritis and tendon/ligament or cartilage tears.  This technique involves using high-resolution ultrasound to inject the solution, involving a high concentration of a person’s own platelets, directly into or around damaged tissue.  Platelets, when activated, secrete a number of different growth factors that stimulate and regulate inflammation in the damaged tissue, resulting in a natural healing response. The blood is drawn from the patient at the time of the visit, placed in a centrifuge where it is spun in order to separate and concentrate the platelets from the rest of the blood, and this “platelet-rich plasma” is then injected into the injury site.  The aim is to inject healing growth factors directly into the damaged area, providing the patient’s body with the tools needed to naturally heal itself.  When effective, the improvement can last for 1-2 years.

Micronized fat, or Lipogems, involves harvesting a patient's own fat (adipose tissue), usually from the belly or flank, and breaking down the fat into smaller parts.  We harvest the healing factors that include a large number of healing factors and some stem cells, and once processed (after ~30-45 mins) we inject that micronized fat into the injured area.  Drs. Hyman and Chimes prefer this method for more advanced arthritis and large ligament, tendon or cartilage tears.  This can be effective enough to be surgery sparing in many cases.  When effective, the improvement can last for up to 3 or more years.

The two methods listed above are a means of strengthening ligaments and tendons, providing longer-term relief for a multitude of chronic musculoskeletal problems including, but not limited to knee pain, hip pain, shoulder pain, osteoarthritis, and different varieties of joint pain.  We have had great success using orthobiologic therapy in many of our patients.   These therapies are not covered by traditional health insurance companies.  Patients  who have invested money in their own care, however, find that orthobiologic therapy may provide them long-lasting relief and help them to avoid future visits, ultimately lowering their medical bills.  

Because we respect the time and money of our patients at Lake Washington Sports & Spine, we take several measures to optimize the patient’s experience when having orthobiologic therapy performed. These include:
1.       An initial consultation, to make sure that orthobiologice therapy is the right choice for the patient
2.       A discussion about which form of orthobiologic therapy is the best choice for the patient
3.       Always using ultrasound-guidance to make sure we are placing the solution in the correct location
4.       Coordinating the patient’s care team, including physical therapists, chiropractors, personal trainers, physicians and other clinicians
Drs. Hyman and Chimes hope that by utilizing these cutting-edge, non-surgical techniques they can help their patients overcome chronic issues that impede their ability to live an active and healthy lifestyle!