Does testosterone replacement which affects inflammation have any bearing? Testosterone cypionate specifically. Concerned it would be a strong negating influence. What do you think?
TRT is known to cause weakening of tendon fibres. Lots of patients on TRT are at higher risk of tendon tears etc.. So that is something to be aware of. In terms of its effect on PRP (well TRT does increase the Hgb level), however I cannot comment on the specifics effects of TRT on PRP product.
Late to comment but … I’m thinking about both PRP and hyaluronic acid. One for the healing benefits and the later for the lubrication. I’ve read that the best results come from staggering the treatments. If so, which might come first and how long between treatments? Enjoy your videos. Hmm. Guess hyaluronic acid to get off the NSAIDs and then PRP?
This one is more of an art of medicine question as HA and PRP combination has not been widely studied. There are some papers of this, but they are quite limited. From our understanding there is a synergistic effect of combining HA and PRP. I will actually do this one of two ways. In some patients I will start with HA since their plan covers it, if they find that they are not fully responding in 4-8 weeks, we can consider topping up with PRP. This is when they want to maximize their insurance drug coverage first. If the coverage is not an issue, usually I prefer starting with PRP and then considering an HA injection 4-8 weeks later. But to be very honest, this is a grey zone and there is no documented protocol for this. This is where we use our tools to best help our patients. Both PRP and HA have different mechanisms of action so they work together and not against each other.
You still can but it can just diminish the response theoretically. I'm not sure if this has been proven with studies, but I air on the side of caution.
These are very tricky to treat regardless. It will really depend on the location of the tear, the size of the tear, and how long it has been present. Usually PRP injections into the plantar fascia are quite painful, so I do warn my patients and have them prepare for this. In most cases, I will ask my patients to wear a boot for a certain amount of time following the treatment. Unfortunately, for your specific case, it will be important to speak with your treating provider for personalized recommendations.
That’s a good question. Alcohol can affect your blood and bleeding. Usually we do recommend people avoid and abstain from alcohol a few days before and a few days after the injection.
Any advice on increasing platelets prior to procedure. Also, I didn’t hear anything about drinking caffeine but read it best not to have any 1-5 days before or after procedure. Agree or disagree ?
I wish I knew why prp/hyaluronic mix is so expensive and FDA will not approve it. My whole case is $2,100!!! I'm still thinking about it because it's so expensive but not really long lasting.
Curious about the blood draw amount. How many cc’s are you normally drawing for one knee injection? It’s a knee that has had a full ACL reconstruction surgery 25 years ago and we are trying the PRP to see if it helps or if we need knee replacement. Want know until we do X-rays next week how bad her knee is.
@@SonamMD are you using a single or double spin protocol? Also can you answer about drinking caffeine please. Is it recommended you don’t drink it before injection ?
First I heard about not taking Warfarin prior to PRP. It’s not in the literature I have read. That’s something to bring up when I meet with Doctor in a few weeks.
Its a tricky question because theoretically warfarin workings on the vitamin K pathway and not platelet. In my patient population I will not perform PRP in anyone who is anti-coagulated as the quality of their blood and platelets will be affected. Definitely speak with your doctor about this.
We have to consider other options for treatment including cortisone, HA, exercise therapy. Unfortunately being on blood thinners excludes you from this treatment.@@richardgunter4677
I’m not convinced that any injection can fully heal a meniscus tear, or a labrum tear. But I do think that they help things scar in, to help settle down symptoms. Even surgery is limited in fully repairing these structures as well. The issues with repair and healing is that there’s limited blood flow in the joint. I do think so that PRP can help stimulate decreased inflammation and potential scarring down of the labrum if it is the primary concern.
Great info! Really appreciate your before and after videos. Having a hip PRP injection Wednesday. Have been off all pain meds, no alcohol. Now, I’m curious about inflammatory foods after procedure. I’m going to really limit sugar ( excluding some fruit) do you have any further thoughts on this part of the equation?
Has anyone had a PRP procedure completed on themselves. How was the experience? For those who haven't, what questions do you have about it?
Thank you!
Having PRP done on my shoulder next week !
you are welcome. Good Luck!
Amazing video. Very informational.
Glad you found it helpful!
Just the information I needed right now.
Does testosterone replacement which affects inflammation have any bearing? Testosterone cypionate specifically. Concerned it would be a strong negating influence. What do you think?
TRT is known to cause weakening of tendon fibres. Lots of patients on TRT are at higher risk of tendon tears etc.. So that is something to be aware of. In terms of its effect on PRP (well TRT does increase the Hgb level), however I cannot comment on the specifics effects of TRT on PRP product.
😊
Thanks for watching
Late to comment but … I’m thinking about both PRP and hyaluronic acid. One for the healing benefits and the later for the lubrication. I’ve read that the best results come from staggering the treatments. If so, which might come first and how long between treatments? Enjoy your videos. Hmm. Guess hyaluronic acid to get off the NSAIDs and then PRP?
This one is more of an art of medicine question as HA and PRP combination has not been widely studied. There are some papers of this, but they are quite limited. From our understanding there is a synergistic effect of combining HA and PRP. I will actually do this one of two ways. In some patients I will start with HA since their plan covers it, if they find that they are not fully responding in 4-8 weeks, we can consider topping up with PRP. This is when they want to maximize their insurance drug coverage first. If the coverage is not an issue, usually I prefer starting with PRP and then considering an HA injection 4-8 weeks later. But to be very honest, this is a grey zone and there is no documented protocol for this. This is where we use our tools to best help our patients. Both PRP and HA have different mechanisms of action so they work together and not against each other.
When avoiding anti-inflammatories does that include fish oil and turmeric?
I do advise people too. It affects blood quality and they are natural anti-inflammatory supplements.
Is it possible to still see benefits of PRP treatment if you had Ibuprofen? My doctor didn't tell me to stop it.
You still can but it can just diminish the response theoretically. I'm not sure if this has been proven with studies, but I air on the side of caution.
What doesing is recommended how many cc or prp for knee joint
This varies depending on the machine. Mine range from 3-5mL. Also each persons blood produces different levels of PRP.
👌Thank you for all the info! I'm considering prp injections in both hips. X-rays show arthritis:(
Good luck
Great videos full of information. Thank you.
Thanks for watching!
I’m getting a PRP done tomorrow I have a ACL tear and meniscus tear to the knee. Wish me luck.
good luck!
How would you proceed with a plantar fascia tear -50 percent with a prp injection ? Crutches or Boot or can you walk ?
These are very tricky to treat regardless. It will really depend on the location of the tear, the size of the tear, and how long it has been present. Usually PRP injections into the plantar fascia are quite painful, so I do warn my patients and have them prepare for this. In most cases, I will ask my patients to wear a boot for a certain amount of time following the treatment.
Unfortunately, for your specific case, it will be important to speak with your treating provider for personalized recommendations.
very helpful
Glad it helped
What’s your take on alcohol affecting prp? I’ve heard to stop drinking 3 days prior to the injection. Thx Dr
That’s a good question. Alcohol can affect your blood and bleeding. Usually we do recommend people avoid and abstain from alcohol a few days before and a few days after the injection.
@@SonamMD Thank you for your response dr.
Does it matter if provider spins our sample down twice? I am referencing Kakudo study
Hello Doc. Love your channel. Can a person still use CBD before getting an injection? Does CBD interact.
Thx
I have a hip PRP injection tomorrow morning. Should I play in my hockey game tonight?
Any advice on increasing platelets prior to procedure. Also, I didn’t hear anything about drinking caffeine but read it best not to have any 1-5 days before or after procedure. Agree or disagree ?
great information, thank you.
I wish I knew why prp/hyaluronic mix is so expensive and FDA will not approve it. My whole case is $2,100!!! I'm still thinking about it because it's so expensive but not really long lasting.
Yea the coverage issue can be hard for many people. It really does limit who can access some of these procedures.
Very well described. This presentation shows the doctor's capabilities and high skill and professional experience.
Thank you.
The thumb? Would trigger finger in the thumb fit the osteoarthritis?
How do you use it? High potency kit? Number of doses and amounts? Don't want to waste my money and want to be well educated. Thank you
Curious about the blood draw amount. How many cc’s are you normally drawing for one knee injection? It’s a knee that has had a full ACL reconstruction surgery 25 years ago and we are trying the PRP to see if it helps or if we need knee replacement. Want know until we do X-rays next week how bad her knee is.
This depends on the PRP kit. For myself, I will use anywhere from 30 to 60 ML of blood per knee.
@@SonamMD are you using a single or double spin protocol? Also can you answer about drinking caffeine please. Is it recommended you don’t drink it before injection ?
🥰
First I heard about not taking Warfarin prior to PRP. It’s not in the literature I have read. That’s something to bring up when I meet with Doctor in a few weeks.
Its a tricky question because theoretically warfarin workings on the vitamin K pathway and not platelet. In my patient population I will not perform PRP in anyone who is anti-coagulated as the quality of their blood and platelets will be affected. Definitely speak with your doctor about this.
How do you treat patients unable to have PRP due to taking blood thinners?
We have to consider other options for treatment including cortisone, HA, exercise therapy. Unfortunately being on blood thinners excludes you from this treatment.@@richardgunter4677
We have to maximize other therapies such as exercise, physiotherapy, cortisone injections and HA injections. @@richardgunter4677
Very informative!
Glad it was helpful!
❤thank you
Your welcome
can prp heal a hip labrum tear fully?
I’m not convinced that any injection can fully heal a meniscus tear, or a labrum tear. But I do think that they help things scar in, to help settle down symptoms. Even surgery is limited in fully repairing these structures as well. The issues with repair and healing is that there’s limited blood flow in the joint. I do think so that PRP can help stimulate decreased inflammation and potential scarring down of the labrum if it is the primary concern.
Great info! Really appreciate your before and after videos. Having a hip PRP injection Wednesday. Have been off all pain meds, no alcohol. Now, I’m curious about inflammatory foods after procedure. I’m going to really limit sugar ( excluding some fruit) do you have any further thoughts on this part of the equation?