FAQ - Stem Cell & PRP Treatment

FAQs - PLATELET RICH PLASMA TREATMENT

What is PRP (Platelet Rich Plasma)?

A small amount of a patient’s blood that has been centrifuged and processed to concentrate platelets, growth factors and anti-inflammatory cytokines from platelets

Uses

What are prp injections used for?

They are designed to help heal the TMJ and to reduce painful inflammation naturally

How many centers offer PRP injections for TMJ disorders

We are one of the only centers in the USA and the world offering PRP for TMJ disorders

Results

What are your success rates using PRP?

At least 80% of affected joint obtain substantial relief of symptoms. The success rate is less in joints that have no significant cartilage remaining

How many treatments are needed?

Often only one, sometimes two or three are usually sufficient to produce meaningful long lasting relief

How long does it take for treatment to work?

Relief may occur within a few days; in some it may take 3 – 4 weeks

How Long Does PRP Injection provide relief?

Usually for at least one year, often much longer

Can PRP injection be repeated?

Yes PRP is good for the health of the joint and can be repeated as often as necessary

Is PRP effective even if you are older?

Yes, in our studies age has not been a factor, even in patients in their ninth decade of life

Risks

Are there risks/complications from PRP injection?

No medical treatment is 100% safe, but we have had no adverse events

No complications have been reported in the literature to our knowledge

You cannot have a reaction to your own tissue, and no other drugs are used

There is a theoretical risk of injection after any injection but we have never seen one and none has ever been reported to our knowledge

Can I be treated with PRP if I am on blood thinners or other medicines?

Yes, patients should maintain all prior medications (except NSAIDs) for PRP or stem cell treatment. Coumadin or other blood thinners are not a problem

Mechanism Of Action

How Does PRP work?

Via growth factors that help your tissue heal (eg transforming growth factor beta, platelet derived growth factor)

Also via anti-inflammatory cytokines (eg interleukin 1 receptor anatagonist) that fight inflammation

A substance called Lubricin that is a natural lubricant for joints has also been recently discovered to be in PRP

Technique

Who does the actual injection in your clinic?

All injections are done by Dr. Prodromos or Dr. Hatz. Although they are certainly qualifieid to do so, we do not have nurses or physician’s assistants performing the injections as is the case at many clinics

Do you use sedation or medications?

None are used, none are needed

Is the injection painful?

There is some discomfort but it is minimal and usually far less than patients expect. Many patients are surprised that the injection has been completed so easily.

Can I come by myself and drive home?

Yes

How long do treatments take?

PRP preparation total treatment time is under one hour

Are Dr. Prodromos and Dr Hatz experienced in regenerative medicine?

Yes, Dr. Prodromos is one of the few board certified Orthopaedic Surgeons who is also board certified in Regenerative Medicine. Dr. Hatz is one of the few practicing Dentists who is also board certified in regenerative medicine

How Does PRP Injection Compare to Injection With Cortisone?

Cortisone has been shown to destroy cartilage cells. It has also been shown to sometimes cause infection. Even when it reduces pain the results usually are short lived.. For all of these reasons we never inject cortisone into the TMJ.

Cost

Is PRP Injection Covered by insurance?

PRP treatments are not covered by insurance. However, our charges are quite modest

FDA

Is PRP injection FDA approved?

Yes, and we perform all procedures in strict accordance with FDA guideline


FAQs - STEM CELL TREATMENT

Definitions

What Are Autologous Mesenchymal Stem Cells?

Partially differentiated stem cells from your body that are active in cartilage, tendon, ligament, and bone

They are NOT fetal or embryonic

Results

What are your success rates using stem cells?

In moderate arthrosis over 80% of patients respond well to these treatments. In bone on bone joints response is less

How many treatments are needed?

One successful treatment will usually last years

How long does it take for treatment to work?

Relief may occur in just a few days but, in some cases, can take several months to show benefit

Autologous Versus Allogeneic

What Do Autologous And Allogeneic Mean?

Autologous means the tissue – stem cells in this case -comes from the patient being treated

Allogeneic means the tissue comes from someone else, or is pooled from a number of other people about which generally nothing is known

Do You Use Autologous or Allogeneic Stem Cells?

We use autologous stem cells in all patients (unless they have active cancer) due to greater efficacy, safety, and lower cost

Are Autologous Mesenchymal Stem Cells More Effective Than Allogeneic?

Yes, your own tissue is always more effective in you than someone else’s

Beware of advertised stem cell treatments, such as amniotic fluid, that are not from you, and do not have real living stem cells in them. In fact, if they did have living cells they would be classified as a “351” tissue which the FDA prohibits

Are There Greater Risks From Allogeneic Tissue?

Yes, there are always greater risks from tissue from others. Improper processing can result in a higher risk of infection and even death

Are Allogeneic Treatments More Expensive Than Autologous?

Yes, allogeneic treatments usually come from pharmaceutical or other companies who will always impose additional costs from preparation and from taking their profit as middlemen. Autologous tissue is prepared directly by us from you with no intermediary to drive up costs.

Are Your Own Autologous Stem Cells Effective Even If You Are Older?

Yes, in our studies age has not been a factor, even in patients in their ninth decade of life

If Autologous Is More Effective, Safer And Less Expensive, Why Are Allogeneic Used By Some?

There are huge potential profits to companies that can produce an “off the shelf” allogeneic product. Therefore companies that distribute them market them heavily to doctors

It is much easier for any doctor to use allogeneic tissue; whereas using your own autologous tissue takes significant technical expertise and an investment of time by the doctor to become experienced in these techniques.

Risks

Are There Any Risks Or Complications From Autologous Mesenchymal Stem Cell Injection?

We have had no complications or adverse events from mesenchymal stem cell injection

Can I be treated with Stem Cell if I am on blood thinners or other medicines?

Yes, patients should maintain all prior medications (except NSAIDs) for stem cell treatment. Coumadin or other blood thinners are not a problem

Mechanism Of Action

How Do Autologous Mesenchymal Stem Cells Work?

Via Growth Factors That Help Your Tissue Heal (E.G. Transforming Growth Factor Beta, Platelet Derived Growth Factor)

Also Via Anti-Inflammatory Cytokines (Eg Interleukin 1 Receptor Antagonist) That Fight Inflammation

A Substance Called Lubricin That Is A Natural Lubricant For Joints Has Also Been Recently Discovered To Be In Stem Cells

There Is New Evidence That Mesenchymal Stem Cells Take Root and Live After They Are Injected, and Keep Working Long After the Injection

Stem Cells Do NOT Impair Healing as Cortisone and NSAIDs Do. Rather They Stimulate Healing Directly and By Inducing Your Own Stem Cells to Work

Note That While Stem Cells Do Help the Joint to Heal No Stem Cell Treatment Has Been Shown To Generate New Tissue, Despite Some Misleading Claims to the contrary.

Technique

Who Does the Actual Injection In Your Clinic?

All injections are done by Dr. Prodromos or by Dr. Hatz. Although they are certainly qualified to do so, we do not have nurses or physician’s assistants performing the injections as the case at many clinics

Do You Use Sedation Or Medications?

None are used, none are needed

Are the injections painful?

The injections have some discomfort but it is usually far less than patients expect.

Can I Come by Myself And Drive Home?

You could, but it is preferable to have someone drive you

How Long Do Treatments Take?

Stem cell treatment takes about 1 hour and 45 minutes

Where Do You Harvest Mesenchymal Stem Cells From?

The back of the iliac bone, (this is not the hip or spine, but rather a non-weight bearing readily accessible pelvic bone at waist level)

A small lipo-aspiration of fat (fat contains stem cells and is used for its cushioning effect) from the love handle area

Very little pain is involved, only a light local anesthetic is used,

Are Dr. Prodromos And Dr. Hatz Knowledgeable and Experienced In Regenerative Medicine?

Yes, Dr. Prodromos is one of the few board certified Orthopaedic Surgeons who is also board certified in Regenerative Medicine. Dr. Hatz is one of the only dentists who is also board certified in regenerative medicine

Cost

Are Stem Cell Injections covered by insurance?

No, However, our charges are lower than most comparable centers for stem cell treatments.

When do you use Stem Cells versus PRP?

Stem cell treatments have lasted far longer in our study, but treatment is more expensive

Are these procedures FDA approved?

Yes, we perform all procedures in strict accordance with FDA guidelines

  • American Academy Regenerative Medicine
  • American Academy and Board of Regenerative Medicine
  • American Orthopaedic Society for Sports Medicine
  • isakos
  • Rush University Medical Center
  • American Association of Nurse Anesthetists
  • American Academy of Orthopaedic Surgeons
  • European Society of Sports Traumatology, Knee Surgery Academy
  • International Cartilage Repair Society