For more detailed information on regenerative medicine or if you have specific questions, please contact us at 716-247-5320.
Dr. Geraci has trained with a Sports Medicine physician in Los Angeles who specializes in using both Platelet Rich Plasma (PRP) Cell Therapies on patients including professional athletes from three teams in the Los Angeles area and now offers cutting edge regenerative medicine in Buffalo, NY. Dr. Geraci uses the most advanced centrifuge systems available that can not only concentrate the platelets to the ideal level for healing but can also exclude the harmful red blood cells, reduce neutrophils or the white blood cells yet keep the healing properties of the other white blood cells. Dr. Geraci, as the principle investigator, just completed an Internal Review Board (IRB) approved Cell Therapy and PRP Study for shoulder, hip and knee osteoarthritis.
Dr. Geraci also is the co-chair of the North American Spine Society’s (NASS) mid-year meeting where he organized and moderated a session on the use of Cell Therapies and PRP in the lumbar discs. This session was so well received at the 2015 meeting that it was selected for the 2016 program agenda. This is the largest spine society world-wide and this will be the first time a NASS meeting will have an entire session dedicated on this subject. Dr. Geraci was the only physician from the Buffalo area in attendance at this very important meeting where the most current researchers from around the world presented their studies.
For the past 20 years in animals and for approximately 10 years in humans, Platelet Rich Plasma (PRP) injections have been done. To help you understand this very exciting part of medicine, called regenerative medicine, some questions need to be asked, followed by some answers from what current research tell us.
PRP is a volume of plasma having a platelet concentration above normative baseline values. It is taken from the patient’s own blood and concentrated in a centrifuge.
Currently in NYS only Worker’s Compensation Carriers with prior approval routinely pay for PRP but not stem cells. No-fault insurances carriers may cover PRP but no prior approval process is in place and payment can be retroactively denied and then you are responsible for the payment. Private insurance companies do not currently cover Stem Cells nor PRP injections.
With the older systems a series of 3 injections each costing $400 is not uncommon. With the newer systems a single injection costing between $795 -$1000 is typical. The majority of the patients will receive one injection with the centrifuge system that Dr. Geraci uses, however if the tear is large, a second injection may be indicated.
YES! Annual review of the list of banned substances put out by WADA (World Anti-Doping Agency) includes substances that:
Yes, they are safe and effective. Adverse reactions are similar to other injections.
Post-Injection pain is common for a 2-3 days. Local anesthetic used in the skin, but not into the injured tissues as local anesthetics decrease the function of platelets. Relative rest for 3 weeks post-injection is recommended.
Double blinded randomized study showed PRP is better than steroid at 26 and 52 weeks.Others studies have shown PRP at the 2 year follow up, works better to control pain and increase function when compared to steroids and viscosupplements. PRP given for anular tears in lumbar discs can heal these types of tears. A few studies have demonstrated that Stem Cells and PRP in the lumbar discs have increased disc height.
Ultrasound or fluoroscopic (x-ray) guidance with contrast should be used for accurate placement. Discuss with the physician performing the procedure whether any medications you are currently taking need to be stopped before you have your PRP injection. Be aware that currently in Buffalo, a number of university as well as private physicians are providing PRP injections. Generally, one PRP injection is needed but in a MINORITY of cases where a tear is large, then 2 PRP injections may be required. If a series of injections is recommended and the payment is expected for all injections up front, this practice is not routine and is strongly discouraged by international experts from this year’s world conference on regenerative medicine.
Cell Therapy is relatively new. Select cells are unspecialized (undifferentiated) cells that are characteristically of the same family type (lineage). They retain the ability to divide throughout life and give rise to cells that can become highly specialized and take the place of cells that die or are lost. These cells can both renew themselves and create new cells of whatever tissue they belong to. Cell Therapy is capable of regeneration, repairing, replacing and maintaining or enhancing organ function that has been lost due to:
These cells used for cell therapy in humans most commonly come from bone marrow or adipose (fat) tissue. Some studies are showing fat cells are better than bone marrow cells in regenerating damaged cartilage such as seen in osteoarthritis of joints and degenerative discs. Cells from your own fat have been shown in recent studies to facilitate cartilage growth in knee joints better that bone marrow derived cells (Bean AC, et al: Chondrogenesis using MSC from bone marrow and fat. TERMIS, 2011).
The newest use of cells from the patient’s own fat is a unique procedure using Lipogems, which is a fat harvest and then a fat transfer to the involved joint. This allows blood vessels to be maintained in the fat that have Pericytes on them which are the precursors to all cells. When injected in a joint, the Pericytes are released from the blood vessels and produce cells which are then activated into regenerative cells that can call on cells from around the patient’s body to bring the healing cells necessary to stimulate the healing process.
These cells have two main functions—immunologic and regenerative. Currently if you go to ClinicalTrials.gov, there are at least 426 studies underway for all types of diseases.
If you are considering Cell Therapy, remember that larger studies need to be done to determine if the outcomes justify the cost. Dr. Geraci completed a pilot study as the principal investigator looking at the efficacy and safety of Cell Therapy in peripheral joints for osteoarthritis. This study was completed in October, 2015 and showed that it was both safe and efficacious in regenerating cartilage growth in the knee at 6 months on an MRI compared to the MRI done before treatment. MRI scans will be done at 1 and 2 years post treatment.
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