Stem cell injections, platelet rich plasma (PRP), prolotherapy, and cartilage regeneration techniques are examples of regenerative medicine treatments physicians use to treat sports injuries. This page describes those treatments.
Regenerative medicine treatments may be used independently or together. For example, PRP can be used alone in a therapeutic injection or applied during cartilage regeneration surgery.
4 Types of Regenerative Medicine Treatments
All of these treatments are outpatient procedures and may not be covered by insurance. More than one treatment session may be required before results are felt and, as with any treatment, results are not guaranteed.
1. Stem Cell Treatments
A stem cell does not serve a specific bodily function, but it can develop into a cell that does, such as a cartilage cell or a tendon cell. Physicians who use stem cell therapy believe that, when placed into a certain environment, stem cells can transform to meet a certain need. For example, stem cells that are placed near a damaged Achilles tendon are hypothesized to develop into healthy Achilles tendon cells.
Note: Physicians usually collect the stem cells used for treatment from the patient’s fat, blood, or bone marrow. Some companies sell doctors stem cells from amniotic fluid, placenta- or cord-tissue, but without close oversight these cells usually die during storage and transport—making the product ineffective.
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2. Platelet Rich Plasma (PRP)
Many experts believe that the natural healing properties found in the blood’s platelets and plasma can be used to facilitate the healing and repair of sports injuries. PRP can be injected or applied to the injured area during a surgery
To make PRP, blood is taken from the patient and then processed—often using a centrifuge—to create a concentrated solution of platelets and plasma (PRP).
Note: All PRP is not the same. PRP therapy varies, depending on factors such as differences in patients’ blood, the method of blood processing, and the use of other substances, such as anesthetics (e.g. lidocaine).
Inflammation increases blood flow and attracts cells—granulocytes, monocytes, macrophages and fibroblasts—that can repair and heal damaged tissues. Sports injuries usually cause inflammation, but in some cases inflammation subsides before the injury has healed. During prolotherapy, a physician injects an irritant into the injured area, which temporarily increases inflammation. The hope is that the additional inflammation will facilitate further healing.
Prolotherapy sometimes uses PRP as an irritant, but prolotherapy is not by definition a cellular therapy. In fact, the most commonly used irritant is dextrose, a simple sugar. Substances such as glycerine or saline may also be used.
Note: Compared with other regenerative medicine treatments, such as stem cell and PRP injections, there is not a lot of clinical research regarding prolotherapy and its effectiveness.
4. Surgeries for Cartilage Regeneration
Because cartilage does not contain blood vessels, it does not have a reliable blood supply, which prevents damaged cartilage from healing well naturally. Different techniques may be used to try to repair cartilage, including but not limited to:
- Making small cuts or abrasions in the bone directly below the cartilage injury. The aim is that the blood from the damaged bone will facilitate new cartilage cell growth.
- Transplanting cartilage from another part of the patient’s body, a donor, or animal.
- Implanting engineered tissue made from stem cells and an artificial scaffold—a sort of microscopic netting that holds the cells until they mature and grow.
Note: These techniques are typically used to treat damaged articular cartilage, which covers bone at the joints, not other types of cartilage, such as the knee meniscus.