I had Adipose Stem cell treatment done twice to my right knee six months apart along whit a PRP injection. I have a tear on each side of my meniscus. After one year I had a follow up MRI I was expecting the MRI to read some positive changes but it read the same as Pre injections. However my keen fells much better. I am going to have umbilical and PRP mixture injected later this week. great channel!!
Thank you! Had torn ACL surgery last July and I have lost joint fluid (stage 3 of 4) after my steroid injection for meniscus strain 2 years prior. So my ACL surgeon said I needed a HA injection and to look into PRP and stem cells as most likely I’ll need a TKR down the road. This terrified me and now I wish I had filed a workers comp claim as I tore it at work but was afraid I’d be fired. I ended up quitting anyways as I can’t do the job after injuring my knee. The $$ cost of surgery and 6 months of PT with little improvement is disappointing. Now I am doing Blood flow restriction therapy and trying to decide if i should do Stem cells or PRP. Because of your video I have decided to do PRP now. Thank you!
I've been getting platelet rich fibrin (PRF) injections. From my knowledge, that's clearly better than PRP. And the procedure is the same. Latest thing I've heard is that an American company is developing a new centrifuge where the glasses change horizontal alignment during the centrifugation, which should make it even more effective.
Hello Dr. I recently saw a 3rd specialist and the 3rd dr. had recommended PRP. Because I am not at the level where I should get a knee replacement. So, I found your video and have a question on one thing. Should I consider getting Viscosupplementation before getting the PRP injection? Also, I have a few torn tendons in the R-ankle. The Podiatrist have suggested surgery, but is there an better option for this that I should be looking at? Thank you so much for your knowledge and info. you have shared.
The thing I've always thought about injecting PRP into the joint space is that how does it adhere long enough to the damaged tissue inside the joint space for any real healing to even take place? Aren't modern methods demonstrating that any significant clinical evidence of tissue healing occurs when some kind of hydrogen gel is combined with the cell solution, like a glue. I guess that can only be done athroscopically?
It's important to understand that PRP does not repair or heal anything. Rather it treats the microenvironment of the joint and converts it from an inflammatory environment to one that is more neutral. Therefore, a scaffolding is not necessary. Rather, you want the PRP to disperse as much as possible throughout the joint. I'll be making a few videos in the future trying to tackle this topic some more. Thanks for your comment.
Platlet rich storma which is a combined form concentrated platlets along with SVF is used for knee issues.... It is offering long year of relief... In one documted treatment there was regrowth of meniscus... Can you please check and do an video for us???
@@JeffreyPengMD wow. quite a powerful statement, so, there is no need for very expensive stem cells just PRP? maybe they can work also in similar way for neurogenerative diseases as well like Stroke, Parkinson’s etc. as well like for heart conditions, COPD? after all it is paracrine efficacy but not engraftment …
@@visitor762 To date, the head to head trials comparing MSC (adipose / BMAC) vs PRP has shown that PRP is just as good. Of course, this could change with more studies. My takeaway is that PRP should be the starting point when it comes to orthobiologics. No need to jump to expensive and invasive procedures. If PRP is no longer effective (and someone wants to avoid surgery), then yes, that person may want to explore adipose/BMAC.
@@JeffreyPengMD what is your opinion what is underlying mechanism of PRP efficacy then? Factors, exosomes.. do platelets need to be activated to demonstrate even higher efficacy?
Thank you for sharing your knowledge. I had PRP in my elbow for mild to severe tendonosis and marrow edema. I was in extreme pain but once I got the PRP things started to improve greatly. A year out I am almost completely symptom-free. Now having problems with my back basically bone on bone. What information do you have regarding PRP injections into spinal discs? I’ve seen a few videos that say they’re getting good results. Do you have any more knowledge that you can share regarding that? TIA
I had a PRP injection years ago for a hip labral tear. It worked wonders for 2 years. After 2 years, locking symptoms returned, my images then showed labral tear again along with early onset of osteoarthritis. It has now been recommended, and I am scheduled for adipose harvesting and injection. Are there any risks/complications associated with this? I have heard that fat embolism could be a risk, is that true at all?
Well, I have to partially disagree, doc. There are differences. AMSCs with TGF-b (1x10 power of 6 cells/ml) might, just might restore articular cartilage, there have been different studies showing different result in vitro and in vivo. PRP just can't rejuvenate articular cartilage. HOWEVER! I had some high intensity parts on my anterior meniscus in my right knee before ~8 months. After an year on 1500mg glucosamine, MSM and boswellia, plus 2 PRP injections 2 months apart, now my meniscal cartilage is having no-intensity, and has a good density. My chondromalacia did not recover, so I'll try a therapy of a high dosage ADMSCs with growth factors in a month. Periostium-derived stem cells, bone marrow stem cells and adipose ones just might be the future of cartilage recovery. Kartogenin as well. There's this company called Trialspark - they're now in 2nd stage development of their product called Sprifermin - which should help people with KOA - at least that's what the results so far are showing.
Oh believe me, I'm hopeful one day we can develop MSCs to help regenerate cartilage. We're just not there yet. There is nothing to date that has been shown in large randomized placebo controlled trials that shows anything we inject can regenerate anything. Again, hopefully one day!!
Is it okay to get guided injections of adipose/bone marrow stem cells directly on a ligament/tendon? I have heard of stem cells turning into other things like bone instead of the desired tissue, is this true? Or must the injection just be intraarticular right inside the joint space? Thank you for all the helpful information.
Depends on the indication. If you have a torn tendon or tendinopathy, then yes, you WANT the injection guided into the affected area. Similarly, if the problem is arthritis, then you want the injection guided into the joint space. Thanks for your question.
Hey there. Just came across this video. Are you aware of any studies involving ankles? I have osteoarthritis and have been suggested 3 treatments (first one adipose, second and third PRP) but am wondering if I should just start with PRP.
Mesenchymal stem/stromal cells do not run out! In the future, the hope is we can culture the cells and expand them. This is done in many countries, but not currently approved by the FDA. Many studies have shown culture expanded MSC injections are superior.
I'm not here to argue with the study. But at the sports medicine doctor office I work at, I myself have seen people have better outcomes with Mfat injection.
According to a study PRF injections doesn't increase the cartilage thickness. ADSC MSC stem cells does increase the cartilage thickness. It creates fibrocartilage. It's good to use it with BMP-2! One friend of mine did 2 ADSC MSC with BMP-2 and 1 PRF afterwards. 7 years later still no pain in knees! Synovial Stem Cell are able to form real cartilage! That is not yet available widely as far as I know! It binds better to the surface! That's the main difference!
Can you provide a link to the study you are referencing? I'm not aware of any randomized controlled trials that show adipose derived MSC injections increase cartilage thickness in osteoarthritis.
Are those comparative studies of PRP versus stem cells just extracted stem cells and not lab expanded stem cells? I can't see how prp could compete with stem cells that have been expanded in the lab and then reinjected
Every comparative study so far has looked at non expanded cells. PRP seems to hold it's ground. Culture expanded cells is only currently allowed in clinical trials, otherwise it is illegal in the United States. But this is why the studies need to be done. Many providers argue PRP cannot compete with non expanded cells, but it looks like it really can. Thanks for commenting.
I had Adipose Stem cell treatment done twice to my right knee six months apart along whit a PRP injection. I have a tear on each side of my meniscus. After one year I had a follow up MRI I was expecting the MRI to read some positive changes but it read the same as Pre injections. However my keen fells much better. I am going to have umbilical and PRP mixture injected later this week. great channel!!
Good luck!
How was the umbilical and prp mix
@@abe7553 not great. Just do PRP with ultrasound injection. Ultrasound is the key.
Hi did it worked for you ? Any positive feedback?
@@zursvlogs4729 just do PRP with ultrasound guidance. The ultrasound is the key.
Thank you! Had torn ACL surgery last July and I have lost joint fluid (stage 3 of 4) after my steroid injection for meniscus strain 2 years prior. So my ACL surgeon said I needed a HA injection and to look into PRP and stem cells as most likely I’ll need a TKR down the road. This terrified me and now I wish I had filed a workers comp claim as I tore it at work but was afraid I’d be fired. I ended up quitting anyways as I can’t do the job after injuring my knee. The $$ cost of surgery and 6 months of PT with little improvement is disappointing. Now I am doing Blood flow restriction therapy and trying to decide if i should do Stem cells or PRP. Because of your video I have decided to do PRP now. Thank you!
If you're still searching for relief, look into Lipogems.
Thanks Dr Peng, where can I find more information on prp for the spine
I've been getting platelet rich fibrin (PRF) injections. From my knowledge, that's clearly better than PRP. And the procedure is the same. Latest thing I've heard is that an American company is developing a new centrifuge where the glasses change horizontal alignment during the centrifugation, which should make it even more effective.
I’ve never heard this, thanks for sharing!
@@hrc6408 in Denmark I hardly think you can get PRP any longer. They started with PRF in 2016.
Technology is always improving!
@@Knud451 how much is prf and stem cell in Denmark?
@@batman-sr2px PRF is 2k DKK, ~265 EUR. Stem cell I'm not 100% sure, its much more expensive. I think its a factor 10 to PRF.
Hello Dr. I recently saw a 3rd specialist and the 3rd dr. had recommended PRP. Because I am not at the level where I should get a knee replacement. So, I found your video and have a question on one thing. Should I consider getting Viscosupplementation before getting the PRP injection? Also, I have a few torn tendons in the R-ankle. The Podiatrist have suggested surgery, but is there an better option for this that I should be looking at? Thank you so much for your knowledge and info. you have shared.
Can you explain what PRF is, please.
Great share!!
I see that PRF is mentioned in the comments. It would be great if you could do a video on PRP vs PRF orthobiologics
There is not a lot of data on PRF. Definitely not as much as PRP
The thing I've always thought about injecting PRP into the joint space is that how does it adhere long enough to the damaged tissue inside the joint space for any real healing to even take place? Aren't modern methods demonstrating that any significant clinical evidence of tissue healing occurs when some kind of hydrogen gel is combined with the cell solution, like a glue. I guess that can only be done athroscopically?
It's important to understand that PRP does not repair or heal anything. Rather it treats the microenvironment of the joint and converts it from an inflammatory environment to one that is more neutral. Therefore, a scaffolding is not necessary. Rather, you want the PRP to disperse as much as possible throughout the joint. I'll be making a few videos in the future trying to tackle this topic some more. Thanks for your comment.
Where can we get this done? I live in Northern CA.
When you say there is an improvement or positive outcome of any sort do you mean the cartilage actually comes back?
So I am bone on bone I. Both my knees. Is there any of these things that would help me, but is it only for just some arthritis manifesting?
Platlet rich storma which is a combined form concentrated platlets along with SVF is used for knee issues.... It is offering long year of relief... In one documted treatment there was regrowth of meniscus... Can you please check and do an video for us???
With all the mounting evidence, I hope it's only a matter of time before PRP (probably not stem cells yet) get approved by insurance.
I'm with you on that! The more people who can get access to PRP the better!
Great video! it would be great if you could provide references for those comparative studies.Thanks in advance!
You may find this helpful! th-cam.com/video/JjkQvbM6rsw/w-d-xo.html
@@JeffreyPengMD wow. quite a powerful statement, so, there is no need for very expensive stem cells just PRP? maybe they can work also in similar way for neurogenerative diseases as well like Stroke, Parkinson’s etc. as well like for heart conditions, COPD? after all it is paracrine efficacy but not engraftment …
@@visitor762 To date, the head to head trials comparing MSC (adipose / BMAC) vs PRP has shown that PRP is just as good. Of course, this could change with more studies. My takeaway is that PRP should be the starting point when it comes to orthobiologics. No need to jump to expensive and invasive procedures. If PRP is no longer effective (and someone wants to avoid surgery), then yes, that person may want to explore adipose/BMAC.
@@JeffreyPengMD what is your opinion what is underlying mechanism of PRP efficacy then? Factors, exosomes.. do platelets need to be activated to demonstrate even higher efficacy?
Whatt about IPRF?
Do you have any idea how long before the FDA allows the use of expanded stem cell therapy in the USA? Thanks
Your guess is as good as the rest of ours!
Thank you for sharing your knowledge. I had PRP in my elbow for mild to severe tendonosis and marrow edema. I was in extreme pain but once I got the PRP things started to improve greatly. A year out I am almost completely symptom-free. Now having problems with my back basically bone on bone. What information do you have regarding PRP injections into spinal discs? I’ve seen a few videos that say they’re getting good results. Do you have any more knowledge that you can share regarding that? TIA
Check this out! th-cam.com/video/_YZAZ7Vt2As/w-d-xo.html
Thanks!
I had a PRP injection years ago for a hip labral tear. It worked wonders for 2 years. After 2 years, locking symptoms returned, my images then showed labral tear again along with early onset of osteoarthritis. It has now been recommended, and I am scheduled for adipose harvesting and injection. Are there any risks/complications associated with this? I have heard that fat embolism could be a risk, is that true at all?
Great video .. you feel PRP Is good for hip too? Thank you
Yes!
th-cam.com/video/DrDrMSh-Y5Y/w-d-xo.html
th-cam.com/video/0sZEvvPWq88/w-d-xo.html
Well, I have to partially disagree, doc. There are differences. AMSCs with TGF-b (1x10 power of 6 cells/ml) might, just might restore articular cartilage, there have been different studies showing different result in vitro and in vivo. PRP just can't rejuvenate articular cartilage.
HOWEVER!
I had some high intensity parts on my anterior meniscus in my right knee before ~8 months. After an year on 1500mg glucosamine, MSM and boswellia, plus 2 PRP injections 2 months apart, now my meniscal cartilage is having no-intensity, and has a good density.
My chondromalacia did not recover, so I'll try a therapy of a high dosage ADMSCs with growth factors in a month.
Periostium-derived stem cells, bone marrow stem cells and adipose ones just might be the future of cartilage recovery. Kartogenin as well.
There's this company called Trialspark - they're now in 2nd stage development of their product called Sprifermin - which should help people with KOA - at least that's what the results so far are showing.
Oh believe me, I'm hopeful one day we can develop MSCs to help regenerate cartilage. We're just not there yet. There is nothing to date that has been shown in large randomized placebo controlled trials that shows anything we inject can regenerate anything. Again, hopefully one day!!
Is it okay to get guided injections of adipose/bone marrow stem cells directly on a ligament/tendon? I have heard of stem cells turning into other things like bone instead of the desired tissue, is this true? Or must the injection just be intraarticular right inside the joint space? Thank you for all the helpful information.
Depends on the indication. If you have a torn tendon or tendinopathy, then yes, you WANT the injection guided into the affected area. Similarly, if the problem is arthritis, then you want the injection guided into the joint space. Thanks for your question.
Hey there. Just came across this video. Are you aware of any studies involving ankles? I have osteoarthritis and have been suggested 3 treatments (first one adipose, second and third PRP) but am wondering if I should just start with PRP.
Do stem cells ever run out especially for older or repetitive injury people. Especially when they are taking your own stem cell.
Mesenchymal stem/stromal cells do not run out! In the future, the hope is we can culture the cells and expand them. This is done in many countries, but not currently approved by the FDA. Many studies have shown culture expanded MSC injections are superior.
@@JeffreyPengMD thank you
I'm not here to argue with the study. But at the sports medicine doctor office I work at, I myself have seen people have better outcomes with Mfat injection.
According to a study PRF injections doesn't increase the cartilage thickness. ADSC MSC stem cells does increase the cartilage thickness. It creates fibrocartilage. It's good to use it with
BMP-2! One friend of mine did 2 ADSC MSC with BMP-2 and 1 PRF afterwards. 7 years later still no pain in knees! Synovial Stem Cell are able to form real cartilage! That is not yet available widely as far as I know! It binds better to the surface! That's the main difference!
Can you provide a link to the study you are referencing? I'm not aware of any randomized controlled trials that show adipose derived MSC injections increase cartilage thickness in osteoarthritis.
Who's doing these?
Bro could you ask your friend for the name of the doctor who does this? I'd really appreciate it.
Are those comparative studies of PRP versus stem cells just extracted stem cells and not lab expanded stem cells?
I can't see how prp could compete with stem cells that have been expanded in the lab and then reinjected
Every comparative study so far has looked at non expanded cells. PRP seems to hold it's ground. Culture expanded cells is only currently allowed in clinical trials, otherwise it is illegal in the United States. But this is why the studies need to be done. Many providers argue PRP cannot compete with non expanded cells, but it looks like it really can. Thanks for commenting.