Frequently Asked Questions

Platelet-Rich-Plasma FAQ

What is Platelet Rich Plasma (PRP)?

PRP is a concentration of platelets, growth factors and cellular signaling factors that play a significant role in the biology of healing. It also contains plasma proteins and proteases that work in a variety of ways to promote healing and prevent tissue degeneration. A therapeutic dose delivers over 1 billion platelets per mL of treatment, which is a 4-6 fold increase in platelet concentration compared to whole blood.

How is PRP Therapy performed?

A blood sample from the patient is put into a centrifuge, which separates the blood into its many components, including platelet rich plasma, which is then collected and delivered via injection to the injured area. Ultrasound guidance can be used to ensure precise placement. The procedure is usually complete in 20-30 minutes, and most people return to normal activity within a few days after the injection. 

Does PRP Therapy hurt?

A local anesthetic is used during the injection, however patients can have some tightness or discomfort for a short time following the injection. Occasionally, patients can experience soreness at the site of the injection for a few days after the procedure.

Is PRP Therapy safe?

Yes. Because PRP is prepared from your own blood there is no risk of rejection or disease transmission and virtually no risk for infection.

How well does PRP Therapy work?

Numerous clinical studies have shown significant healing and long-lasting reduction in pain for a variety of injuries, such as tendon and ligament damage, sports injuries, joint pain and arthritis. Clinical results are proving PRP to be an effective, natural alternative to steroid injections, which temporarily relieve pain but do not help heal the cause. PRP may eliminate the need for more aggressive treatments such as long-term medication or surgery.

Are all PRP concentrating devices and PRP treatments created equally?

No. There are multiple PRP concentrating devices available, with varying processes and performance that lead to variability in clinical outcomes. 
A good quality PRP treatment must provide:

– A dose of over 1 billion platelets/mL (therapeutic dose)
– A high dose of growth factors released at injury site
– A high platelet yield (recovers over 80% of platelets in blood)
– Removal of most red and white blood cells for a pure treatment

Delo Sports Medicine & Interventional Orthopedics uses the EmCyte PRP system, which delivers all of the above characteristics for a clinically significant outcome. 

How often should I repeat Platelet Rich Plasma procedures?

Considerable to complete relief and healing is often achieved from the first PRP injection. In some cases, especially chronic conditions, additional PRP injections may be necessary. Dr. Delo waits at least 6-8 weeks to evaluate healing prior to determining if another treatment could be advantageous.

What are the expected results of PRP Therapy?

Both ultrasound and MRI images have shown definitive tissue repair after PRP therapy, confirming the healing process. This can greatly reduce the need for surgery as it can treat the tissue before damage progresses and becomes irreversible. PRP therapy doesn’t provide immediate relief; instead, it sets in motion a repair mechanism that heals the tissue. A study in the American Journal of Sports Medicine shared the following results in patients with elbow tendonitis:

– 46% pain relief by week 4
– 60% pain relief by week 8
– 81% pain relief by 6 months

At the completion of the study, 93% of the patients were completely satisfied with the results of the PRP treatment and avoided surgery.

If a patient’s own blood cells are not healthy or proliferative enough to trigger a healing response, amniotic injections can provide an alternative. Amniotic injections don’t contain stem cells. Instead, they are a concentrated injection comprised of purified growth factors and cytokines (signaling molecules) from a healthy newborn’s amniotic membrane. These amniotic injections can be injected into an injured site in the same manner as PRP.

Stem Cell FAQ

What are Mesenchymal Stem Cells?

Stem cells are the only cells in the body able to morph into other types of cells. When your own stem cells are injected into damaged tissue, they appear to amplify the body’s natural repair efforts by reducing inflammation, accelerating healing, and preventing scarring and loss of function. They provide a powerful approach to treating arthritis but can also treat ligament, tendon, cartilage, and even bone problems.

How is Stem Cell Therapy performed?

Through a simple office procedure, your stem cells are obtained from either your pelvic (hip) bone or your fat. An FDA approved device manipulates them to optimize the healing cells. Then they are injected into the injury or joint using image guidance. You will be able to leave the office at the conclusion of the procedure.

Does the treatment hurt?

A local anesthetic is used, which results in minimal discomfort from acquiring the cells.  There can be some discomfort following the injection of the cells for 1-2 days.

When can I expect to feel better after treatment?

Some patients experience rapid improvement, but the healing process takes between 4-8 weeks, so improvement is often gradual over this time period.

What is recovery like after a stem cell procedure?

There may be some soreness in the joint for a few days after the injection. Heavy exertion and anti-inflammatory products, such as aspirin, Motrin, Advil and Aleve should be avoided for the first two weeks after the procedure. Taking Tylenol is acceptable. Dr. Delo will guide return to activity while you are healing, and will provide rehabilitation exercise to optimize your response.

Will my body reject stem cells? Are they safe?

No, they won’t be rejected as they are your own cells. Also, because immune cells are present, there is virtually no risk of infection.

Is stem cell therapy an alternative to knee replacement?

Stem cells can be highly effective in reducing pain and improving function in patients with arthritis. Plus, bone marrow and fat contain many powerful growth hormones and anti-inflammatory proteins that will greatly reduce inflammation and promote healthier tissue. However, patients with severe arthritis do get less of a response to stem cell injections than those with mild-moderate disease. While regenerative medicine may slow the degenerative process, there is no evidence that it reverses the process.

Can stem cells grow cartilage?

Stem cells have been shown in many studies to have the power to grow cartilage in certain types of procedures, micro fractures and tibial osteotomies. However, the ability for cartilage to form after an injection is still an active area of academic research.

Can stem cells help optimize my results from a surgical procedure?

This depends on what type of procedure is done. Ask a member of our team to learn more. In the case of micro fracture surgery to restore knee surface cartilage, there are numerous scientific articles that detail a far more robust cartilage healing response when an orthobiologic injection is given post-operatively.

Shockwave FAQs

 How is the treatment performed?
The areas to be treated are marked. A coupling gel is applied to the specific treatment area to transmit the waves, then the Extracorporeal Pulse Activation Technology (EPAT) pressure waves are released via the activator as it is moved over the region.
How long is the treatment and how many will I need?
Treatment sessions last approximately 15 minutes, and generally 3 treatment sessions are recommended at weekly intervals.
What are the expected results?
The benefits are often experienced within 3 treatments, although it may take up to 4 weeks for pain relief to begin. The procedure may eliminate pain and restore full mobility. Over 80% of patients treated with EPAT report being pain free and/or have a signigicant reduction in pain. 
 Is Shockwave Therapy Safe?
Yes. The FDA considers EPAT safe for use. It was developed in Europe decades ago, and has been in constant use there and around the globe since. Extensive clinical studies and tests have confirmed its safety and efficacy. 
The only contraindications are use of blood thinners, an active cancer, or pregnancy.

How do I schedule Shockwave Therapy?

In order to undergo treatment, you do need a diagnosis from a healthcare provide. Your provider can refer you for treatment, or you could undergo a brief evaluation by Dr. Delo prior to your first treatment.