Synergies of Platelet Rich Plasma (PRP) and TECAR Therapy Treatments

Over the past few decades, there has been a significant rise in amateur sports. Around 20 years ago, the number of people running marathons or completing IronMan events was limited. Today, many individuals participate in these endurance sports at a high level without being professional athletes. This increase in activity among amateur athletes has led to a rise in pathologies that were previously exclusive to age-related deterioration or professional athletes. Now, these conditions are becoming more common among amateur athletes as well.

Preliminary results from an ongoing study show success in combining Platelet Rich Plasma (PRP) injections with radiofrequency/TECAR Therapy treatments, specifically targeting cartilage degeneration in knee osteoarthritis. Regardless of whether this condition affects a young athlete or an elderly person, it can be debilitating.

Why Osteoarthritis is so Prevalent

• Main cause of pain and functional weakness in first-world countries
• Leading cause of disability in aging adults

What is Osteoarthritis?

• Progressive erosion of cartilage
• Generates osteophytes, synovitis, myxoid degeneration of the meniscus, and degradation of capsular-ligamentous tissue

Importance of Exercise in Combating Osteoarthritis

Exercise is crucial in maintaining joint flexibility, strengthening muscles around the joint, and reducing pain. However, acute pain and discomfort, often combined with kinesiophobia, can make it difficult for patients to adhere to exercise plans. Practitioners must utilize various resources to manage pain and enable active therapy for long-term results. One resource is PRP, which, along with therapeutic exercise, can effectively manage the symptoms of osteoarthritis.

Myths and Realities of PRP

What PRP Doesn’t Do:

• Regenerate the joint
• Regenerate cartilage
• Achieve greater healing of the meniscus
• PRP is not stem cells

What PRP Does:

• Acts as a potent and natural anti-inflammatory
• Has very few contraindications (e.g., infections, certain oncological processes, vascular precedents)
• Minimal side effects and adverse effects

Managing Patient Expectations for PRP Injections

• Cost: PRP injections can be expensive and are not always covered by insurance.
• Pain: PRP injections can be painful, especially when administered to tendons. Patients should expect discomfort regardless of the injection site.
• Post-Injection: Patients may experience increased pain and other symptoms in the first few days following a PRP injection.
• Recovery: Younger athletic patients typically have quicker recovery times and manage post-injection pain better. However, pain relief is not guaranteed.

How PRP is Obtained and Applied

PRP is obtained through a mechanical centrifugation process of a blood sample (autologous) from the patient. The sample is placed in a high-speed centrifuge for 20-30 minutes, after which the PRP is extracted. Prior to treatment, a stimulant is applied to enhance the effects of the plasma.

For pain management, ice is applied to the affected area for approximately 10 minutes before the PRP injection, which is guided by ultrasound for precision. After the injection, TECAR therapy treatment with an INDIBA device is used to treat the affected area.

PRP and TECAR Therapy Case Study

Study Details:

• Participants: 153 adults
• Inclusion Criteria: Symptomatic for at least 6 months, previous clinical and radiological diagnosis of knee or meniscus osteoarthritis (according to the American College of Rheumatology Criteria)
• Exclusion Criteria: Contraindications for PRP or radiofrequency/TECAR therapy, pregnancy, active cancer, active tuberculosis, metallic implants in the affected knee, pacemaker or other sensitive implants, neurological impairment, active skin lesions in the affected area, hypersensitivity to heat, and recent surgical procedures in the affected area.

Materials and Methods:

• PRP application followed the protocol published by ZimmerBiomet
• CRMRF at 448 kHz was performed using an INDIBA CT8 device
• Subthermal application level used
• 5 minutes of the Capacitive (CAP) electrode and 10 minutes of the Resistive (RES) electrode after PRP infiltration on the entire knee
• Return plate placed on the popliteal side halfway between the fibular head and lateral malleolus
• Placebo Intervention: Same procedure but with sound turned off. Patients were unable to see the device in the treatment and placebo groups.

Results:

Using the SPSS software for statistical analysis (IBM SPSS Statistics, 20.0 version, North Castle, New York, https://www.ibm.com/) p values <0.05 were considered statistically significant.

In the first 24 hours, patients who received the subthermal dose experienced a significant reduction in post-infiltration pain compared to those who received the placebo. While natural pain reduction occurred in the placebo group, it was slower and less impactful.

Conclusion

Based on preliminary data, the following conclusions can be drawn:

• PRP injections improve symptoms of osteoarthritis pain
• A side effect of PRP can be increased pain, which may lead to treatment refusal by some patients
• Post-infiltration radiofrequency/TECAR therapy significantly improves post-infiltration pain

As the study progresses and more patients participate, these findings will be further validated and refined.