LAURA N. SCIARONI MD

Fellow of the American Academy of Orthopedic Surgery
Member of the San Francisco Multispecialty Medical Group,
Part of the IPM Medical Group family
Board Certified, Fellowship Trained in Sports Medicine

Cutting Edge Technologies

I’m not an early adopter of new technologies, though I am interested in them. I like to see a lot of evidence before I offer a new treatment to my patients.  I get asked a lot about these in the office, so here is some information.

 

Orthobiologics – treatments using biological components that come from the patient to treat the patient – are in the news a lot lately.  These technologies include stem cell therapy and PRP.  Both of these are very exciting areas of research and study.  While stem cell therapy is a fascinating area of research, I don’t see enough convincing evidence yet to adopt it myself and offer it to my patients. I would not pay the thousands required to try this treatment myself until I see a lot more data.  I’ll wait until there is more data before suggesting my patients pay that kind of money to try it.

 

PRP (Platelet Rich Plasma) injection has been well established for over 10 years and there is a great deal of clinical data available.  I have been offering this in the office for a couple of years now.  It is far less expensive than stem cell therapy, and there are many more years of data to back up it’s effectiveness.  I have seen great results using this treatment on a number of different conditions.

 

PRP is an orthobiologic treatment for many conditions that do not respond to traditional methods of treatment such as anti-inflammatories, physical therapy or cortisone injection, and in some cases, may be an alternative to surgery. We take a sample of the patient’s blood, spin it down in a centrifuge to concentrate the platelets (which are full of growth and healing factors), and add a stabilizing agent that prevents them from rupturing immediately.  When we inject them into an area that needs to heal, the platelets rupture gradually and bathe the area in those growth and healing factors.

 

This solution is not for acute inflammation or conditions which can resolve well with more conservative treatment, but has been very helpful in resolution of recalcitrant cases of tennis elbow, achilles tendonitis, hip bursitis, and some types of hip and knee joint pain including arthritis.  Unlike cortisone, there are no long term negative effects from repeated injection, though most conditions will respond to only one injection.

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