"Pitching" PRP: Repairing athlete's elbows without surgery

Tiger Woods, Kobe Bryant, and Alex Rodriguez are just a few of the superstar athletes who've used it to help their banged-up knees, shoulders, and Achilles’ tendons.

Now the somewhat controversial treatment is being used to repair a serious, sometimes career-ending injury in a fraction of the time it would take with surgery.

Eduardo De La Riva throws heat, so fast the talented pitcher who accepted a college baseball scholarship right after his sophomore year in high school tore up his elbow.

"Probably the worst pain I've ever had," explains Eduardo De La Riva a high school pitcher.

He considered Tommy John Surgery; were bone is drilled and a tendon graft helps reconstruct the elbow. It's very effective, but recovery can take a year or longer.

Eduardo De La Riva
"It was scary, says De La Riva. “Very scary."

"I'm seeing an astounding number of young baseball pitchers who have this injury," says Preston Wolin, MD Director Spetsmedicine Weiss Memorial Hospital.

Doctor Preston Wolin offered Eduardo a surgery-free 30-minute alternative called platelet rich plasma therapy.

"The idea behind PRP is to use the body's own natural healing mechanism," explains Dr. Wolin.

Growth factor cells in the patient's own blood are extracted and injected back into the patient's elbow to supercharge healing. Just three and a half months after his injection, Eduardo's elbow is fixed.

"It's been feeling really good," says De La Riva.

Now he's winding up for his first college season and hoping to strike it big in the majors someday.

Some call PRP performance-enhancing. Doctor Wolin says it does not make healthy parts perform better, it helps injured parts heal without surgery.

He says it's showing good results for athletes who have partial ligament tears in their elbows. He believes Tommy John Surgery is probably better for those with complete tears.

The procedure is not covered by insurance. The injection can range from a few hundred dollars to more than $1,000.


TOPIC: "Pitching" PRP: Repairing athlete's elbows without surgery
REPORT: MB # 3517

BACKGROUND: Ulnar collateral ligament injury of the elbow is a sprain (tear) of one of the ligaments on the inner side of the elbow. The ulnar collateral ligament (UCL) is a structure that helps keep the normal relationship of the humerus (arm bone) and the ulna (one of the forearm bones). This ligament is injured in throwing types of sports or after elbow dislocation or surgery. It may occur as a sudden tear or may gradually stretch out over time with repetitive injury. This ligament is rarely stressed in daily activities. It prevents the elbow from gapping apart on the inner side. When torn, this ligament usually does not heal or may heal in a lengthened position (loose). Sprains are classified into three grades. In a first-degree sprain, the ligament is not lengthened but is painful. With a second-degree sprain, the ligament is stretched but still functions. With a third-degree sprain, the ligament is torn and does not function. (Source: Washington Orthopaedics & Sports Medicine)
SIGNS: Symptoms include pain and tenderness on the inner side of the elbow, especially when trying to throw; a pop, tearing or pulling sensation noted at the time of injury; swelling and bruising (after 24 hours) at the site of injury at the inner elbow and upper forearm if there is an acute tear; inability to throw at full speed; loss of ball control; elbow stiffness; inability to straighten the elbow; numbness or tingling in the ring and little fingers and hand; clumsiness and weakness of hand grip. (Source: Washington Orthopaedics & Sports Medicine)

TREATMENT: For those who have an acute rupture of the ligament or those who have failed therapy and wish to continue throwing competitively, surgical reconstruction (rebuilding the ligament using other tissue) is usually recommended. This procedure is known as the "Tommy John" procedure, named for the player whose career was saved when the ligament was reconstructed by Dr. Frank Jobe. The ligament reconstruction can be performed using a variety of soft tissue grafts obtained from the patient, but is most commonly carried out using the palmaris longus tendon from the forearm. Because this tendon provides biomechanical characteristics that are similar to those of the native ligament, and because there are no consequences from its absence, it makes an ideal ligament substitute. Some patients do not have a palmaris longus tendon and therefore require an alternative graft for reconstruction, such as one of the toe extensors. (Source: Washington Orthopaedics & Sports Medicine

NEW TECHNOLOGY: PRP therapy offers a promising solution to accelerate healing of tendon injuries and osteoarthritis naturally without subjecting the patient to significant risk. Blood is made of RBC (Red Blood Cells), WBC (White Blood Cells), Plasma, and Platelets. When in their resting state, platelets look like sea sponges and when activated form branches. Platelets were initially known to be responsible for blood clotting. For the treatment, doctors take a small vial of a patient's blood, about 30 milliliters, and spin it in a centrifuge to separate the platelet-rich plasma from the other components. Then they inject the concentrated platelets at the site of the patient's injury. (Source: Orthohealing.com)


Preston Wolin, MD
Weiss Memorial Hospital
(773) 248-4150

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