Hello Dr. Peng. I have AGA Alopecia. I went twice to start the hair PRP but both times after withdrawing blood, my plasma was cloudy and I didnt move forward with as I was not sure if it will be effective even though the Dr. who was doing the procedure said he himself not sure if it will be effective. So im asking, can I still use my cloudy plasma to do hair prp?
@errolflynn1952
8 ай бұрын
Dr Peng- In 1 of your PRP videos you showed a chart/spreadsheet comparing the volume of blood drawn with the amount of total platelets. Could you refresh my memory as to which specific video contains the chart?
Two questions, doc: #1- Do you think high platelet count PRP injections, or PRGF injections, are more likely to regenerate cartilage? And #2- do you think either of those, or, umbiblical cord stem cells, are? I am a 45 year old man with a recent 3cm2 articular cartilage lesion from a patella dislocation, but otherwise healthy cartilage. I've done tons of research, and it looks like the stem cell method with the greatest evidence of hyaline cartilage regeneration, is umbiblical cord stem cells. I'm likely flying to Central America to get those injections, but since they can't take me for a few months, I may get some initial injections of either high platelet PRP, or PRGF, and I'm trying to figure out which is better.
@productivecough7148
Жыл бұрын
Dr. Peng. GREAT CONTENT. What kit do you use? What version of PRP do you use for chronic plantar fasciitis? (LR) PRP or (LP) PRP / PPP? What Platelet count and ML’s have you found to be optimal for plantar fascia injections? I am in North Carolina trying to find someone as knowledgeable as you on PRP therapy. Want to have my ducks in a row.
@venuswarrior8456
2 ай бұрын
I have pain in the back of my knee that runs into my calf. Hurt it while kicking a ball. 2 yrs later no doctor can find the reason on this problem. No arthritis, no meniscus damage nothing. All test day extraordinary. Nobody knows nothing. Sucks. With this helped for me😢
@028fn48dne
Жыл бұрын
When I did PRP the doc told me to do moderate aerobic exercise right before my appointment. Me being me, I overdid it. I ran to the appointment, and I ran up the stairs to the office…in a 12 story building. I was extremely fatigued. And the result? The doc said “I’ve never seen PRP this thick before.” So do intense aerobic exercise before your appointment, not moderate, if your health allows.
@JeffreyPengMD
Жыл бұрын
Wow!
@koayphekhoon4206
4 ай бұрын
Good day ,Dr Peng Frm every 3 wks my doc appointment do Prp treatment advice me to do 4 times treatment for both knees as my stage OA stage Lt knees more serious stage 4 , right knees stage 2 and till this mth coming no 4 treatment .For my condition is prp injection can help as last yrs i go private hospitals injection hy gel treatment no cure?
@coreyap1
9 күн бұрын
How do I know or improve me platelet count prior to injection??
@stevensaporito6966
10 ай бұрын
Hello Dr. Peng. Thank you for your content, it's really helpful. Just one question if I may. When selecting a provider, should we pay attention to whether the preparation is leukocyte rick or poor? Let me know. THANKS!
@steviel2118
8 ай бұрын
Dr. Peng, thank you so much for all these videos, i learn so much from them. i would like to get the high dose PRP for my knee but after seeing a Mayo clinic doctor and a banner doctor, i discover they only do low dose PRP. i have contacted over 15 different doctor's office and no one seems to do high dose PRP in the phoenix area. would you happen to know anyone in my area that does high dose PRP? thank you Dr. Peng
@LukeLittler-hf4zt
4 ай бұрын
how u know when its 10 billion? is it amount of blood drawn?
@thanosfisherman
7 ай бұрын
How can you know the platelet count?
@karldavidson27
Жыл бұрын
Dr. Peng, I showed your video to my doctor. He is very excited. The only problem is his centrifuge will not handle 50cc. I have this wild idea. His vial is 15 cc's. Would it be possible to use 3 seperate vials and have a total of 45 cc's with the same results? One more question. He only spins the blood once rather than two spins. If my only option is one 15cc vial, would two spins be beneficial? Thanks for this unbelievably helpful information. Karl Davidson
@JeffreyPengMD
Жыл бұрын
Yes but the problem you'll run into is the final volume. Higher end kits allow you to adjust the final volume. If you combine the PRP from three smaller vials, you will have a larger final volume. For large joints like knees, it's probably fine since it can take a large volume injections. This would not work for smaller joints or for tendons. I can't comment on the spins because it really depends on the kit and centrifuge the doc is using.
@karldavidson27
Жыл бұрын
Thanks for taking the time to answer my. You're performing an service for many of us who can't get the California.
@ervinhalili1800
Жыл бұрын
Just had prp injection for hip labral tear and i aked the doctor how many platelet are in the prp. He told me 6 billions. Is that a good dose for hip labral tear?
@heythere6983
7 ай бұрын
How is your progress?
@blessall8856
Жыл бұрын
Dr. Peng you are right in that increasing the PRP to 10B or more, is where the pain relief starts to happen.
@JeffreyPengMD
Жыл бұрын
Just trying to spread the word!
@bobmontalvo7779
9 ай бұрын
DR. Peng. Is the PRP injection coming from our own blood or someone else? Are the injection platelets going through a ultraviolet process to prevent any issues? Thx
@maheshreddy6624
11 ай бұрын
Hello Doctor, this is very good informative video. Regarding Knee Osteoarthritis two Doctors whom I approached told me that Bone Marrow or Adipose stem cell therapy will last for atleast 9-10 years where as PRP may not last more than 1-2 years max. Could you please let me know your study/opinion on this. TIA.
@cbgardenmaryland
4 ай бұрын
I just had it done and gave no idea on the count . They took two large 1” syringe full and said they were happy because got 6 ml or whatever the measurements were. They took more blood than I thought
@heythere6983
7 ай бұрын
So how long does this resolve issues? Only a year?
@heythere6983
7 ай бұрын
I’m surprised you say prp doesn’t heal anything but just reduces pain. Iv always been convinced the growth factors are in fact healing destroyed tissues and repairing injuries to a certain degree and not just decreasing inflammation pains
@josephelphingstone491
Жыл бұрын
Are you aware if there are actually any meta-analyses evaluating platelet dose (1-3 vs 3-5 vs 5-10 billion...)? Feel like that would be interesting and worthwhile to pursue. Although it may not be statistically feasible to compare there aren't published trials evaluating different doses side-by-side to generate an effect size for data synthesis (among other study design variables).
@larrydew6960
11 ай бұрын
I had a right shoulder rotator cuff repair over a year ago and I still have some pain. Range of motion is good and the new MRI showed a partial tear, which was determined to be not worth going back into surgery for. Dr. recommended PRP, which I"m planning to do. What PRP counts are you getting?
@samaraiad25
Жыл бұрын
I took your advice about plasma injections and went to an orthopedic and spine surgeon in Texas. I had mild pain and the onset of a degenerative change in the knee. I felt slight pain when squatting. After the injection, I am now unable to walk or fully bend my knee with severe pain. And when I went to him again and told him he said I don't know. He prescribed me an anti-inflammatory drug, but it didn't help. Upon injection, I felt severe pain and cried out in pain. I felt something strange wrapped around my knee and then couldn't walk. Then he told me it's normal, and will get better after a few hours. I am 40 years old and my weight is perfect. Now my life has stopped after this injection and I don't know what the doctor did wrong and made me almost helpless. This happened a month ago
@JeffreyPengMD
Жыл бұрын
Thanks for sharing your experience. In my opinion, it's CRITICAL that PRP injections are done with imaging guidance (typically ultrasound) to ensure correct placement. Even the most experienced orthopedists can misplace an injection when done by palpation. PRP when injected erroneously into a surrounding fat pad can cause a severe inflammatory reaction. The pain can be so severe people end up in the emergency room. I don't know if this is what happened in your situation (you'll have to discuss with your healthcare provider about that). Good luck!
@samaraiad25
Жыл бұрын
@@JeffreyPengMD Unfortunately, plasma was not injected with ultrasound guidance. I felt severe pain in this knee during and after the injection. When injecting the other knee, the injection site changed in the other direction, and I did not feel pain like the first knee. I went to the emergency room and the doctor said there was no swelling or redness. Is what you said about the possibility of injury to a specific area of the knee during the injection will heal? Or is there a risk to the knee or injection site. And what is the treatment . Thank you very much for your reply
@joshuaapple1322
Жыл бұрын
What’s the name of this place? And if that doctor really messed u up he needs to be held accountable and in Texas guns are rampant. U know what to do
@sba9450
Жыл бұрын
My brother had v bad pain in his knee, he took PRP Injection india at Manipal hospital. He was fine. After few months he took acupuncture treatment on the same knee for a week after he felt some pain again. It’s almost 7 years the pain has not returned
@sherrytucker016
Жыл бұрын
Dr. Peng, how do I approach this with my doctor for my upcoming appointment?
@wyngreece7
9 ай бұрын
Hello doc great video. But how you count platelets in you prp? Does a simple plt test do the job?
@johnwelch9539
Жыл бұрын
Greetings Dr.Peng. Your channel has been a life-changer for me! Thank you so much for your efforts. Is there a difference in PRP Kits regarding Leukocyte-Rich (LR) vs. Leukocyte-Poor (LP)? Is Monocyte concentration/quantity approximately equivalent to Platelet concentration/quantity? Is the Juventix Medical PRP Kit a good kit to use for knee Osteoarthritis? Thank you for your time and consideration, sir.
@JeffreyPengMD
Жыл бұрын
Yes -- there's a big difference between LR-PRP and LP-PRP. I hope to make a video on this in the future. Monocyte inclusion is critical to the success of PRP treatments. I've never heard of the Juventix system. A quick google search shows that it is a 12ml tube which means the blood draw is around 10cc. Unfortunately, this is nowhere near the 50-60cc blood draw that is necessary to reach the 10 billion platelet threshold.
@johnwelch9539
Жыл бұрын
@@JeffreyPengMD Thank you Dr. Peng. Your guidance is helping me a great deal, and I really appreciate it.
@gratiamedical
Жыл бұрын
@@johnwelch9539 Juventix also makes a 30ml Tube that if you used two would get you to 60. You can also remove PPP prior to injection to fine tune final volume.
@KMennen
Жыл бұрын
I talked to a Ortho clinic in South Dakota that uses LR-PRP for tendon injections with a 60cc blood draw, yield unspecified and LP-PRP for knee injections with 15cc blood draw with a 5cc injection yield. The LP-PRP injection PRP yield does not appear to be correct for a 15cc blood draw? The kit use was not specified on interview.
@JeffreyPengMD
Жыл бұрын
15 cc blood draw for knee injections are very low.
@ingrida.r.1533
Жыл бұрын
since we have to pay for the trearment it better work and last longer than 1 year. I will have it done but I expect to be healed
@karldavidson27
Жыл бұрын
Dr. Peng, my doctor is unable to locate a distributor for a 50cc kit. Please give me the name of your distributor. Thank you, Karl Davidson
@JeffreyPengMD
Жыл бұрын
I actually recommend 60 cc. There are lots of options. Some examples include GPS III PRP 60 cc kit by Zimmer Biomet or Emcyte Pure PRP 60cc kit.
@shoulderarmhealth
Жыл бұрын
Hi Dr Peng. I read the restore trial. I’m a bit confused since the description of their methods says their kit gets 1.6 to 5x the concentration of platelets. I read their table of supplemental information as well and it seems to suggest that the absolute platelet count was around 1.6 billion platelets per injection x 3 injections. Can you please comment on these numbers? They seem a bit different than the ones you presented. Please let me know if I made a math error. Thanks In advance.
@JeffreyPengMD
Жыл бұрын
The RESTORE trial used RegenLab BCT kits. Manufactures ALWAYS over-estimate the amount of platelet retention they get. The study did not run platelet counts on their samples so we won't know the true numbers. But what we can safely assume that 1.6x is the absolute maximum retention they get. Other manufacturers have done their own analysis of RegenLab BCT kits and found that the absolute platelet count in much closer to 1 billion per injection. For argument sake, let's say it's in the 1-2 billion range. Even with this generous assumption, the BCT kits are still well under the 10 billion platelet range that is likely needed for clinical benefits.
@kennyy1492
Жыл бұрын
Hi Dr Peng, I’m thinking about having either prp or stem cell injection done on my knee. I’ve been diagnosed with ortho arthritis, bone spur and a tear in my meniscus. My question is how does one find a good clinic to go to? There are so many clinics that make so many claims, what questions should I be asking each clinic to find a good one? I currently reside in Colorado. I’ve talked to R3, Regenexx, Spruce Health group, I’m even considering going to Tijuana for stem cell injections? What are your thoughts do you have any recommendations? Thanks in advance! Also where are you located?
@JeffreyPengMD
Жыл бұрын
Best to ask the health care providers in your area. In general, you will likely find good advice if you visit an academic center. The University of Colorado system have excellent orthopedic and sports medicine physicians. Re: stem cells vs PRP. You may find this helpful: kzitem.info/news/bejne/ko9-uJh6rIGcaqw
@lauraboe1
Жыл бұрын
Dr. Peng, thank you for your videos. They’ve been very encouraging. I’ve had prp before and I’m sure they didn’t take 50cc of blood. I was pain free for about 8 weeks. I was wondering if you thought it would be better at this rate to get maybe 3 prps each a week apart? I no longer want knee replacement as my goal for I haven’t met a single person who has had a good outcome. 😕
@JeffreyPengMD
Жыл бұрын
Thanks for your comment. Unfortunately I cannot give medical advice over the internet. Please seek the advice of your trusted health care provider. Best of luck!
@marekopawliko1
Жыл бұрын
how do I know how many platelets are in my injectio? Don't the doctors know the more the better? Why would they inject less? How to make sure I have enough?
@JeffreyPengMD
Жыл бұрын
It all depends on the starting blood draw and how good the PRP kit is able to retain the platelets.
@Bigwillproductions
Жыл бұрын
If considering PRP for treatment. Should I worry about the risk of blood clots ?
@JeffreyPengMD
Жыл бұрын
Nope
@gugy68
Жыл бұрын
Hi Dr. Great info. One question, I’m doing PRP soon on both knees, so s it OK to ask to collect more blood than usual (60cc) so I have enough platelets for both knees? The clinic usually have a standard amount. My right knee has a bit more arthritis than the left. Thanks
@JeffreyPengMD
Жыл бұрын
It really depends on the PRP preparation kit that your physicians are using and how much blood that device can process. This is something that needs to be discussed with your treating team. Best of luck!
@rajeshboysie861
Жыл бұрын
Can PRP be effective or help with bulging disc at the L5 S1?
@JeffreyPengMD
Жыл бұрын
You may find this helpful: kzitem.info/news/bejne/wI-Qp45tj6ZjdKg
@barcellona777
Жыл бұрын
My knee and elbow tendons are trashed from Fluoroquinolones (Levaquin / Cipro). What treatment works best to resolve / treat this issue as the tendons never heal and are always weak?
@JeffreyPengMD
Жыл бұрын
Yes, fluoroquinolone toxicity is rather difficult and still an active area of research!
@davidellis1550
Жыл бұрын
Do you have an opinion on using Platelet Rich Fibrin vs PRP? Thank you so much for these videos. We need more people like you.
@JeffreyPengMD
Жыл бұрын
PRP is more extensively studied. Smaller studies suggest PRP is better than PRF, but we need more trials comparing the two.
@davidbijl2297
Жыл бұрын
Hai Dr peng. Amazing content. I have got a question. When i had the prp injection the doc wanted to show me the PRP, what has to be a white layer in between the red blood cells and the platelet poor plasma. But i just couldnt see it. Thats how thin the layer was. Does that mean that my platelets are very low?
@JeffreyPengMD
Жыл бұрын
Nope, that's called the buffy coat layer. It's hard to see unless your eyes are trained to seeing it.
@gerrygizzygarcia2572
Жыл бұрын
So how many shots do you think someone like myself would need I have her near to this in my lower back and what will be the price for every shot
@JeffreyPengMD
Жыл бұрын
This is something that should be discussed with your healthcare team, good luck!
@heritagephysiotherapyandre1536
Жыл бұрын
Hi DOC good info very much appreciated. do we need to do any specific blood screening test or FBC before procedure?
@JeffreyPengMD
Жыл бұрын
Thanks for your comment! Maybe one day when a "best" protocol is created, blood testing / counts will be part of it.
@Zergeometer
Жыл бұрын
I have a small meniscus injury that causes knee pain on my right knee for over a year now. I reached out to 2 providers in my area, they both only offer 1-2 billion platelet in one injection by taking 10-15 cc blood. Should I go for it?
@JeffreyPengMD
Жыл бұрын
Use this to help you decide: the RESTORE trial and the PEAK trial used volumes of 10-20 cc of blood. The results of those trials showed no difference in outcomes between "low dose PRP" and placebo. Many other studies using "high dose PRP" show significantly better outcomes than placebo.
@Zergeometer
Жыл бұрын
@@JeffreyPengMD Thank you!
@veritas9763
Жыл бұрын
Hello Dr. Peng, thank you so much for all the very informative videos. I just received my first PRP injection for my right knee medial meniscus tear and osteoarthritis. However, my provider could not provide me with the platelet dose of my injection. They only said they used the Arthrex Angel PRP system and take 15 cc of my blood and centrifuged it to 5 cc of PRP. Do you think it is a good PRP preparation ?
@JeffreyPengMD
Жыл бұрын
The Arthrex Angel PRP system gives you around 2-3 billion platelets in total.
@bilalahmad202
Жыл бұрын
Hi, I hope you are doing well. How are you feeling now? Did it work for you? I've Partial Meniscus tear and I'm thinking of PRP injection. Could you please share your experience? Much appreciated. Thanks
@mrdcwdcw
Жыл бұрын
Thanks for the excellent video, and for others of yours that I’ve watched on this subject. I am at the early stages of investigating what I suspect is osteoarthritis at the base of my thumb and am considering PRP as a treatment option. I started learning to to play the guitar about 16 months ago, and am keen to continue. You refer to the key factor as the total number of platelets ~ 10 billion. Is this for a knee treatment? If so, can I assume that fewer platelets would be required for the much smaller thumb CMC joint? One of the clinics here in Perth, Australia, refers to their kit as concentrating up to 11 times. I haven’t spoken to them yet about how much blood they would concentrate, but want to know what questions to ask. Thanks again.
@JeffreyPengMD
Жыл бұрын
Yes, 10 billion for large joints like the knee and hip. CMC joint would need MUCH less. How much? We don't know yet.
@mrdcwdcw
Жыл бұрын
@@JeffreyPengMD Thanks very much for getting back to me
@dugi3884
Жыл бұрын
Hey doctor, great videos. Do you have any information on PRP injection and if it can help nerve pain/ damage or nerve impingement? thank you
@JeffreyPengMD
Жыл бұрын
Not a lot of studies looking at the use of PRP for nerve entrapments. Anecdotally, yes it works. But need more data!
@joshuaapple1322
Жыл бұрын
Ya u definitely want to get that calcium gluconate with PRP
@JeffreyPengMD
Жыл бұрын
Still lots to learn!
@ryanknowledge
Жыл бұрын
what about prp with calcium gluconate?
@JeffreyPengMD
Жыл бұрын
There is a lot of debate within the orthobiologic community whether activating agents are necessary. Pros and cons to both sides of the argument
@greglemon7921
Жыл бұрын
Hello Dr. Peng. I have recently begun watching your videos regarding PRP injections and am considering this therapy for my knee and shoulder. I watched this video and took note of the specifics you provided for PRP concentration and platelet counts, ex. 10 billion platelets per injection. When I visited with a Sports Medicine physician just last week about PRP (he's been doing these injections for 10 yrs. now), he said that determining platelet count numbers in the spin down process isn't as simple as 1,3, 7 or even 10 billion. What he did say was that platelet counts are measured by factors; so a factor of 5x, or 6x, or 10x. He said these factors do not relate to counts in the billions, but more like in the millions, even hundreds of thousands. This confused me because it is significantly different than the numbers you indicate. I am reluctant to proceed with PRP therapy until I get some clarification this. BTW, this physician uses the Emcyte Pure PRP II kit.
@JeffreyPengMD
Жыл бұрын
It's all semantics at that point. The key is your starting blood draw volume and the platelet retention of the kit. The reason I talk in platelet counts and NOT factors is because you can start with a 1 cc blood draw and concentrate it down to 0.01 cc of blood and you have created a large factor concentration. BUT, your absolute platelet count is exceedingly low. This is why platelet factor is not as useful for conferring PRP dosing. Platelet COUNTS give you a much better idea of how many platelets you are introducing and the efficacy of the PRP. Emcyte Pure PRP starts with a 60 cc blood draw and is an excellent option.
@greglemon7921
Жыл бұрын
@@JeffreyPengMD Thank you for the clarification. That helps a lot. Glad to hear the kit my physician is using is well regarded. Keep up the good work with the videos. I have learned so much.
@ybd3326
Жыл бұрын
Hello, Dr. Peng, My utmost commendation to you for creating such excellent, informative and helpful videos. I'm not only impressed with your level of knowledge, but also with your eloquent speaking skills. Your genuine desire and sincerity in helping, educating and equipping your audience with unbiased, evidence based and factual information is highly appreciated. I have learnt and benefited tremendously from watching your videos. Thank you very much. I am seriously considering making a 6 hour drive to have you perform a PRP treatment for my chronic right knee osteoarthritis. This may be a redundant question, but please permit me to ask it anyway. Does your office centrifuge machine and PRP preparation kit consistently enable the harvesting of 10+ billion platelets in the final PRP aliquot? I have been doing a fair amount of research in this area and so far, the only machine I have come across is the Emcyte pure PRP double spin with a 60 cc blood draw which can achieve such level of platelets. Please comment on this. Another question relates to the knee injection site under ultrasound guidance. Based on the individual's osteoarthritis severity level and location(s) of the knee pain, does the PRP aliquot need to be divided and injected into more than one location? I can't seem to find any info on this. Thanks so much for all you do and I look forward to your response.
@JeffreyPengMD
Жыл бұрын
Thanks for your comment and support! Yes, we currently use the Emcyte system in our clinic. The PRP just needs to get in the joint and it will spread all around inside the knee. So multiple entry points are not necessary
@ybd3326
Жыл бұрын
Dr. Peng, Thanks for your prompt response. Based on the limited knowledge I have regarding the Emcyte centrifuge models and kits, I assume the one you're currently using is either the double spin Emcyte pure PRP or the Emcyte pure PRP Supra Physiologic double spin 1:36 , both requiring a 60 cc blood draw to harvest roughly 6 to 8 cc of leukocyte rich PRP. If this is so, then achieving a 10+ billion platelets in the aliquot will be the rule and not the exception. I feel assured knowing this. Any comment on the Emcyte absolute PRP with a 20 cc blood draw? I found a local medical office which uses this machine. (I don't believe there's the option to do a 60 cc blood draw). From what I know, this may only harvest 2.5 to 5 billion platelets and the final count is totally dependent on the blood draw volume. I'm a little hesitant about having my PRP injection performed there as this may mean multiple treatments over a course of time to achieve the 10+ billion platelets goal. I also like to hear your viewpoint about the difference between L poor PRP and L rich PRP. There seems to be a debate as to which product is superior for KOA treatment. Thanks again.
@ybd3326
Жыл бұрын
Sorry. The 1:36 is a typo.
@goodmood5346
Жыл бұрын
is PRP also effective on OCD (unstable) lesions on the knee? would be grateful if you could let me know. Thank you
@JeffreyPengMD
Жыл бұрын
PRP has not been studied for isolated OCD lesions in an otherwise healthy knee with no arthritis.
@goodmood5346
Жыл бұрын
@@JeffreyPengMD Thank you Doctor. What would you recommended as an alternative to a surgical procedure for OCD cases? ( if PRP it's not working for OCD)
@monbri9931
Жыл бұрын
Dr. Peng, any information on Peptide BPC 157? There is a lot of talk about this peptide being the next big thing replacing PRP.
@JeffreyPengMD
Жыл бұрын
There are a lot of claims about the "next best thing." A lot of things work in vitro, but not in vivo. There are currently no randomized controlled trials looking at peptide BPC 157 in humans (that I am aware of). Until that happens, PRP seems like the best treatment available.
@monbri9931
Жыл бұрын
@@JeffreyPengMD I agree. I had microfracture surgery in August 2021, and have been supplementing PRP. No complaints. Love your videos. I learn so much so thanks.
@terriestes5255
Жыл бұрын
You mentioned to ask what Kit the provider uses. What are the different ones and the difference between them? What are the newer methods to prepare the PRP? Thank you.
@JeffreyPengMD
Жыл бұрын
There are a LOT of different PRP kits out there. The main difference is how much volume blood they can process (which seems to be extremely important) and their platelet / growth factor retention.
@gerrygizzygarcia2572
Жыл бұрын
I have heirnated discs in lower back I meant both sides of the back
@JeffreyPengMD
Жыл бұрын
You may find this useful: kzitem.info/news/bejne/wI-Qp45tj6ZjdKg
@bilalahmad202
Жыл бұрын
Great video and valuable information. Can PRP heal a partial Meniscus tear? Thank you in anticipation.
@JeffreyPengMD
Жыл бұрын
PRP cannot "heal" a meniscus tear. Rather it treats the environment of the knee to flush it out of the inflammatory markers that are often caused by the meniscus tear, replacing it with "healthy" growth factors and a more neutral environment. This leads to pain and symptom relief.
@bilalahmad202
Жыл бұрын
@@JeffreyPengMD thanks for your reply
@bilalahmad202
Жыл бұрын
So, surgery is the only option for 100% treatment of Partial Meniscus Tear? Right?
@beeoracle8254
Жыл бұрын
Hi Doctor, What are your thoughts on making vascular channels in the meniscus? And cleaning up minor/medium tears like mold from the meniscus?
@JeffreyPengMD
Жыл бұрын
I've never heard of mold growing on meniscus!!
@beeoracle8254
Жыл бұрын
@@JeffreyPengMD I was not saying that there was mold, it was figurative language
@dc9291
Жыл бұрын
THANK YOU
@fioncruz3536
Жыл бұрын
Does Tropocells PRP 22 ml reach the target 5 to 10 billion of platelets ?
@JeffreyPengMD
Жыл бұрын
Typically you'll need at least 30 cc of blood to get 5 billion and 60 cc to get 10 billion platelets. It doesn't matter how well the system concentrates and retains the platelet if your starting amount won't even get you to the minimum threshold of 5-10 billion.
@jtkoons
Жыл бұрын
@@JeffreyPengMD Dr Peng, I love your videos and look forward to more. Question, if I had a 30ml blood draw with a system that yields approximately 15cc of 1.8x concentration, and I removed 10cc of PPP before resuspending the platelets what might the new concentration look like on the remaining 5cc? 5.4x ? What if I took out 12cc PPP and had a remaining 3cc? Would that be 9xconcentration remaining theoretically before resuspending platelets? and whatever that value you might estimate is, do you think it would be clinically beneficial? thanks so much.
@amit32131
Жыл бұрын
Does age matter to get right amount of Platelet concentrations?
@JeffreyPengMD
Жыл бұрын
Age and PRP is an active area of research!
@thetambay684
Жыл бұрын
Can prp heal focal cartilage injury, medial undersurface of the knee
@JeffreyPengMD
Жыл бұрын
PRP does not regenerate or "heal" anything. Rather, we think it changes the inflammatory environment of an arthritic knee and by doing so reduces symptoms and disability.
@thetambay684
Жыл бұрын
@@JeffreyPengMD what's your take on hyalofast for focal cartilage injury?
@stef3565
Жыл бұрын
50-60 cc's is a lot of blood! I hope I don't pass out on that draw!
@JeffreyPengMD
Жыл бұрын
Yes it is! But it is still significantly less than blood donations which can take up to 1 pint (450cc)
@stef3565
Жыл бұрын
So I ended up having 17 billion platelets for my knee injection! I did everything you recommended. @@JeffreyPengMD
@kafatiak
Жыл бұрын
Great content Dr. Peng. What are your thoughts on Alpha-2-macroglobulin in conjunction with prp? I know it gets concentrated within the prp itself, but could it be worth it to additionally incorporate its own concentrated form in a separate injection?
@JeffreyPengMD
Жыл бұрын
There's not a lot of data on a2m injections. Once more data (specifically randomized controlled trials) comes out, I'll definitely cover it!
@kafatiak
Жыл бұрын
@@JeffreyPengMD Thank you
@johnbrennan9778
Жыл бұрын
I just looked up my platelet counts from my blood tests over the last 8 yrs and they are always at the low end of the acceptable range. I am on blood thinners because of a Saddle PE 2 yrs ago. Is a 10 billion platelet number be achievable?
@JeffreyPengMD
Жыл бұрын
Yes, just might require a larger blood draw. This is something you'll want to discuss with your healthcare provider. Best of luck!
@johnbrennan9778
Жыл бұрын
@@JeffreyPengMD I just received a message from my orthopedic dr who has on his resume that he does PRP Injections. He said to save my money, that studies don't give proof that it works. I even said that 10 billion platelets per injection gives better results. He doesn't seem to believe this. Do you have any papers that I could show him? I have access to ProQuest. The other option is do you have recommendations of who to go to in upstate NY who follow the same protocols you do?
@JeffreyPengMD
Жыл бұрын
@@johnbrennan9778 Lots of references in the description in the video!
@johnbrennan9778
Жыл бұрын
@@JeffreyPengMD Found it. I was looking in the NIH papers. Thanks so much! I assume that if I can't find anyone in the east, I could come out to see you for the proper injections?
@JeffreyPengMD
Жыл бұрын
@@johnbrennan9778 LOTS (!) of docs can do this for you on the East coast. Most major academic medical centers have experts in PRP that can help you out.
@jenniferp7749
Жыл бұрын
Interesting 😮
@JeffreyPengMD
Жыл бұрын
Indeed! Platelet numbers really matter!
@marwanalhussain8502
Жыл бұрын
Great video
@JeffreyPengMD
Жыл бұрын
Thank you!
@darian5428
Жыл бұрын
nice haircut
@JeffreyPengMD
Жыл бұрын
Ha! Thanks
@ramuchilakamarri2109
Жыл бұрын
I like your valuable videos related prp.But l would like to know about oats surgery regarding cartilage development.please explain about it sir...TQ sir
@michaelcolarusso7545
Жыл бұрын
Hello, Dr. Peng - excellent video (like all of your videos). I'm currently undergoing PRP treatment for stage 3 knee osteoarthritis with an Arthrex ACP kit, which on my first shot yielded 4.5mm of ACP (PRP) with an estimated platelet count of 3-4.5 billion platelets. I'm planning to do a 3-shot series because studies/meta-analyses suggest they can yield greater VAS/WOMAC improvements for longer-term (which you've of course reported on as well). One of the things I've noticed in the literature is the importance not just of platelet count but also DEPA score - platelet DOSE injected, but also capture EFFICIENCY, PURITY of PRP (with respect to WBC+RBC), and ACTIVATION method. DEPA matters because the ratio of anabolic to catabolic content appears to be important in a PRP preparation for knee osteoarthritis (with low catabolic content being preferred). For example, my provider could have used the Arthrex Angel system to provide a much higher number of platelets per 5ml, but the anabolic-to-catabolic ratio would have been poorer. So, two questions: 1. Do you think my current treatment approach - 3 shots of a leukocyte-poor, high anabolic ratio PRP preparation, without an activation agent, but with a lower overall platelet count - will be sufficiently therapeutic? 2. The treatment protocol my provider uses is injections at two-to-four-week intervals. Do you think a one-week interval would be better given the lower overall platelet count in each injection? Thanks for your time and informative channel - it's truly terrific!
@JeffreyPengMD
Жыл бұрын
Injection frequency doesn't seem to matter as much. Anywhere between 1-4 weeks has been shown to be beneficial. Activation is also a hot area of research with multiple studies supporting both sides. By far the most important number is platelet count which has to do with 1) starting volume and 2) capture efficiency of the kit.
@Wrathofgod220
Жыл бұрын
Hi Dr Peng. I recently got a PRP injection for a complete tear of my TFCC tear in my wrist that is 5 years old and I've been beginning to notice its benefits. Can you please do a video on any information you can find on PRP for TFCC tears?
@JeffreyPengMD
Жыл бұрын
Unfortunately PRP has not been studied for the treatment of TFCC tears. There is anecdotal evidence that it works, but no larger randomized controlled trials (to my knowledge).
@samaraiad25
Жыл бұрын
@@JeffreyPengMD I took your advice about plasma injections and went to an orthopedic and spine surgeon in Texas. I had mild pain and the onset of a degenerative change in the knee. I felt slight pain when squatting. After the injection, I am now unable to walk or fully bend my knee with severe pain. And when I went to him again and told him he said I don't know. He prescribed me an anti-inflammatory drug, but it didn't help. Upon injection, I felt severe pain and cried out in pain. I felt something strange wrapped around my knee and then couldn't walk. Then he told me it's normal, and will get better after a few hours. I am 40 years old and my weight is perfect. Now my life has stopped after this injection and I don't know what the doctor did wrong and made me almost helpless. This happened a month ago
@1shanshan76
Жыл бұрын
Research the WristWidget created by Wendy Medeiros. This device was invented only for TFCC tears. She has a weight bearing test and protocol. I've healed my old TFCC tear this way.
@heythere6983
7 ай бұрын
@samaraid25 I’m assuming it’s resolved but I’m always shocked when people say they feel normal a few days after prp . Everytime Iv ever done prp it takes Atleast 6 weeks for the injection pain to go away , about 3 months to feel back to somewhat normal for daily easy activities and 8 months in I can feel I can push and pull on the area in a gym setting with heavier weight. I wouldn’t exercise within a month and a half’s time is just let the area heal. Maybe certain body parts don’t fee as bad but for the spots I had it it was never quick but it does heal . Prp I noticed doesn’t last forever either so I start to question the point of it because maybe surgery is inevitable and for me prp seems to take aslong to heal as a surgery would anyways. But yeah initially prp always feels like it set me back, but it always gets better
@jaimerivas5612
Жыл бұрын
I am still not quite convenced on the theory "the more the better". Firstly, it is not acurate to talk about absolute numbers as phisiological level of platelets vary from person to person from 150.000 to 450.000 platelets/ul. And secondly and probably more important, cell biology studies tell us that concentration of platelets above 4-5 fold of basal level, make the cells stop to proliferate and migrate. And it makes sense, there is an optimal pharmacological level on everything. We need to take 4g of paracetamol daily, why dont we take 20g daily then? The same might apply to platelets, more is not better, there is always an optimal concentration
@JeffreyPengMD
Жыл бұрын
Thanks for your comment. I agree with your comments. PRP is still in the "dose discovery" phase. The RESTORE trial showed us too few platelets and you don't get a response because you are subtherapeutic. We are still trying to find the upper bound range if there is potential toxicity. One of the studies I provided used 21 billion platelets with no adverse effects (small sample size). But PLENTY of other studies use PRP in the 7-10 billion platelet range, all with no adverse effects (large sample size) and all showing long term sustained benefits. Hopefully more research will allow us to find the "best" dose response curve for PRP.
@jaimerivas5612
Жыл бұрын
@@JeffreyPengMD Thanks a lot Dr Peng, to take your time to answer :) Yes, RESTORE trial used a kit with trixotropic separating gel in the blood collection tubes. These systems are not efficient, the more stringent spin regime drops all cells including the platelets. The platelet count on these PRP are sometimes below 1x..., even below 0,5x if you don´t dismiss the PPP. 7-10 billion sounds more reasonable and reachable. Also important is the activation, to guarantee a strong fibrin scaffold that provide a substained release of GF over several days. If I had to choose between 10mill platelets and non-activated and 5-7mill platelets activated, I´d go for the second :)
@jaimerivas5612
Жыл бұрын
And you are right! Only data collection and big data on PROMs will help us understand
@billwhite8117
Жыл бұрын
Dr Peng - thanks for your videos - really appreciate the information. Do you have a list of questions / guidelines that you could share or post to help identify if my ortho dr is the best choice for getting PRP injections? In addition - I have torn meniscus and arthritis in both knees - right knee is worse than left, but both have pain. Do you focus on one knee at a time or both for injections at the same time ? I had the partial tear surgery on the left knee about 5 years ago - and it was better for a few years, but back to pain (lesser though). Right knee is keeping me up at night and looking to avoid surgery if possible.
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