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Has anyone had Platelet Rich Plasma and Hyaluronic Acid Blend Injections?

 Poster: A snowHead
Poster: A snowHead
NickyJ wrote:
@skimottaret, great news, please keep us posted.
this
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 Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
going by the internet ...... the best blood treatment is an Adrenochrome infusion .
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5 weeks after first injection and definite improvement. Managing to do squats and back/front/lateral lunges (slowly) without pain. A few weeks ago got sharp pain when doing squats. Next injection in 3 weeks, delayed a bit but hopefully no big deal.
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@skimottaret, my injections were done 8 weeks apart. I don't think you reach maximum benefit for a year or more after you start so it won't matter.
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@Raceplate, yeah my guy seemed pretty relaxed in terms of the timings, the mfg recommendation was six weeks then the third six months after first but he was relaxed with doing em in 6-8 week increments. "No point waiting" I seem to recall. I just wanted to get all three in before ski season...

Interesting to hear that you felt most improvement a year later. There is hope !
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So, had my second injection today and was much easier than the first time. The first one was quite chaotic with lots of interruptions in an out patient room so they moved procedure to theatre. I had quite a bit of swelling after the first set so this time he gave each knee a local anaesthetic injection prior to the PRP/HA. My first time he mentioned a "double" sample of blood and I thought that may have caused the swelling but the double sample only referred to the fact that they needed enough blood for two knees, the amount in each knee was the standard dose. They drew about 50ml of blood total and injected approx 8ml of PRP into each knee. This second set of injections went in above the kneecaps, not sure if that is significant or not.

knees much less swollen compared to the first set and will do the 3rd set of injections in a few months.



Last edited by You'll need to Register first of course. on Sun 14-10-18 12:09; edited 1 time in total
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skimottaret wrote:
This second set of injections went in above the kneecaps, not sure if that is significant or not.

I didn't comment at the time but I thought the positioning of the injections you had first time was very odd. Miles away from where mine were. Only the plaster on your right knee second time matches where mine were done, the left doesn't.

My positioning was very consistent - from the lateral side into the middle of the joint space between the tibia and femur and behind the patella. That's the area of the knee with almost no natural circulation and so (I was told) is the area that benefits most from a high quality dose of blood. Effectively, it's the very centre of the joint and seems logical enough for an "even spread". I asked if my last injection could be biased towards the medial side because I have more problems on that side but it was not open to negotiation. I seem to recall that he said it could be done through the front of the joint (like your first ones) but it meant going through the patellar tendon which could be problematical for some people. You certainly had a lot more discomfort than I did so that bears that out.

I would think that that central space is also very difficult to reach from where the plaster is on your left knee second time unless it was a very long needle. But maybe your guy thinks you have a bigger problem area in a different place on that joint? Or maybe they're spreading it around because it's combined with HA?

I'm not sure how a local anaesthetic would make any difference to the swelling. My guy told me that the only benefit to a local was that you wouldn't feel the PRP needle going in. But you would still feel the LA needle going in so either way you feel a needle in your knee and it's pointless. Consequently, I just had the straight PRP injection each time. I have to say I considered it painless, the needle to withdraw the blood from my arm was more awkward than the one in my knee.

Putting all the procedural differences aside though, I'm still very positive that it will benefit you so all the best with it.
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@skimottaret, hope it works as those knees look a bit like mine wink
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O do a lot of injections including PRP.

The purpose of the injection is to deposit the PRP ( steroid etc) into the sac that the knee joint sits within. The route into the sac is irrelevant as long as you get the needle in correctly.

The injection can be placed from the lateral( outside), medial side ( inside) and adjacent to the patella tendon, via the same route that a telescope is placed in the knee.

The medial route can be the most in uncomfortable. The “ arthroscopy route” is most likely to not get the tip of the needle into the knee. Injecting 6 mls of PRP into the knee fat pad accidentally would be excruciating. So I use the lateral route.
Local anaesthetic stings quite a lot when it goes in and hurts as much, if not more, as an injection of PRP without local. I only use it if the patient insists. Occasionally we’ll use some “ man spray” which is a cooling spray- like the stuff sprayed by physios all over football players as they writhe around in the pitch clutching an ankle. I don’t think it makes any real difference though but it is a distraction.

The most effective way of doing the injections is to get on with it as most of the discomfort is in the build up. The additional steps of drawing up local etc just increase anxiety levels.

I’ve been doing PRP for 3 years and am doing some work on the health economics. Picking the right degree of wear in the knee is important as there is little published on which knees it will works best on. Some systems of preparation of the PRP seem to be more effective than others
Jonathan Bell
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@Raceplate, To clarify a few things for future readers. My first injection was done in a seated position and the second lying down on a bed as @Jonathan Bell, mentions I don't think the entry point is a problem as long as injection goes into the sac.

Prior to putting in the second set of injections he asked me how I was getting on and I said the injections had definitely helped but the first set was quite painful which I recon he took as code for me being afraid of needles so he injected me with a local prior to my second injections. After the anaesthetic injection I talked further about the swelling and he did mention that it could have been due to getting some in the fat pad.

In hind site I think the initial swelling and pain was him incorrectly injecting a portion of the shot into my fat pad. He withdrew the needle after I winced more than a bit on the first attempt ! I had two separate blood spots / holes in the right knee afterwards so he must have had to adjust. Perhaps I moved during the first set of injections, the room was too busy or he just got it wrong and went into the fat pad.... Hard to say..

The good bit is the second injections went in very easy and no swelling afterwards, knees feel good after skiing yesterday!

Due to delays in the first two sets of injections he decided to hold on the third set until the springtime as the recommended interval is 6 weeks then 6 months post the first set. Fingers crossed for the ski season.

I would say that before treatment I self scored myself as mild to moderate arthritis (29) on this scale http://www.orthopaedicscore.com/scorepages/oxford_knee_score.html my right knee is worse than left.
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@Raceplate, I know you are sceptical on HA but have at the following links

Mixing HA to PRP improves levels of growth factors
https://www.sciencedirect.com/science/article/pii/S2214687316000029

Treatment of knee osteoarthritis with platelet-rich plasma plus hyaluronic acid in comparison with platelet-rich plasma only
http://www.ijcem.com/files/ijcem0023424.pdf
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And love to help out and answer questions and of course, read each other's snow reports.
Jonathan Bell wrote:

I’ve been doing PRP for 3 years and am doing some work on the health economics. Picking the right degree of wear in the knee is important as there is little published on which knees it will works best on. Some systems of preparation of the PRP seem to be more effective than others
Jonathan Bell


Thank you for commenting, always grateful for you taking the time to reply to these type of discussions.

My guy did say he thought it would be 50/50 to see benefit in my case but so far has definitely made an improvement. I do think that it would be great to have clearer subjective published information to review as to the level of arthritis that this treatment is most effective with. I had insurance and saw little downside so went for it...
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@Raceplate, Could you say roughly how much these cost if done privately without insurance? A friend of mine is interested but without private medical insurance and my insurers won't tell me... rolling eyes
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You know it makes sense.
I really wish you well.

I went through similar issues, except with lower back. First of all, skiing used to loosen it out. Then the back would start giving bother during the holiday, requiring treatment. Then became just too sore to ski. I went through various injections/oblation, into discs and facet joints. None of which worked. It was finally a fusion of L3/L4 that gave me 70% of my life back.

It is miserable when your old bones let you down. My advice, though you already know it, is not to push too hard, too soon, if the pain is eased. Easier said than done, though.

I have had to take 6 months off, to allow my back to recover, from pushing a little harder than was advisable in the gym. Now I'm back to square one, regarding fitness...certainly not worth it. Much better to lower the sights a bit.

Take care...and good luck with it all.
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@Old Fartbag, Sad I do hope you will be OK to ski in the upcoming season. Good luck.
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Double post


Last edited by Poster: A snowHead on Sun 14-10-18 15:13; edited 1 time in total
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Hurtle wrote:
@Old Fartbag, Sad I do hope you will be OK to ski in the upcoming season. Good luck.

Thank you.....I hope so too - but you never quite know until you try....and I intend to try, provided I can dig up somebody to go with. My usual suspects aren't going this coming season. I do however have a Baldrick cunning plan, though.... Toofy Grin
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skimottaret wrote:
@Raceplate, Could you say roughly how much these cost if done privately without insurance? A friend of mine is interested but without private medical insurance and my insurers won't tell me... rolling eyes

My insurers told me that the going rate acceptable worldwide was $1,000 US per injection. Mine were done in Qatar and were the equivalent of $1,400 (everything's expensive in Qatar) so I had to pay the difference.

However, as is often the case as treatments become more commonplace, costs seem to be coming down. I'm sure I've posted this before but the cheapest I've seen in the UK is http://www.blackberryclinic.co.uk/injection-therapy-costs at £250/350 a pop (for pure PRP).

Interestingly, their HA cost is £450! I guess that's the difference between having to pay a pharmaceutical company's profits (HA) vs the labour cost and amortisation of someone just putting your own blood in a centrifuge! wink I could buy HA over the counter in Qatar for about £185 and the hospital consultant would inject it for free as part of a normal visit. Laughing

IIRC, when I looked up Harley St clinics they seemed to be around £6-800/injection for PRP. We should probably ask Jonathan Bell if he would do a Snowheads special. How do you start a petition... snowHead
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@Raceplate, thanks for that , sorry I missed the link to costs in a previous post, will pass onto my friend. snowHead
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Friend of mine is due to have stem cell (prp) on the NHS at Southampton U H it is several options on offer - they are not offering replacement as he is so young at 59....
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@boredsurfin, good to know, my friend works in the NHS and is somewhat against paying for treatment...
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@skimottaret, I don't believe its generally available my friends consultant is putting up a case for him to have it - Southampton does a fair amount of medical research and it maybe linked to that.
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@boredsurfin, no worries but will pass on. can you mention who the consultant is?
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Old Fartbag wrote:
Hurtle wrote:
@Old Fartbag, Sad I do hope you will be OK to ski in the upcoming season. Good luck.

Thank you.....I hope so too - but you never quite know until you try....and I intend to try, provided I can dig up somebody to go with. My usual suspects aren't going this coming season. I do however have a Baldrick cunning plan, though.... Toofy Grin
Some gentle skiing on a Dolomites Bash, perhaps? There are plenty of other old farts on the lists.
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Hurtle wrote:
Old Fartbag wrote:
Hurtle wrote:
@Old Fartbag, Sad I do hope you will be OK to ski in the upcoming season. Good luck.

Thank you.....I hope so too - but you never quite know until you try....and I intend to try, provided I can dig up somebody to go with. My usual suspects aren't going this coming season. I do however have a Baldrick cunning plan, though.... Toofy Grin
Some gentle skiing on a Dolomites Bash, perhaps? There are plenty of other old farts on the lists.

I'll keep it in mind...Again...Thank you.
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@Raceplate,
We are £995 for a course of three PRP injections. I think that makes us less than the prices you’ve found 😉 Part of the problem is that each syringe we use is over £100! I’m not yet happy that the adipose stem cell products are there yet I can’t see enough data to satisfy me that they are better or equivalent.
Jonathan Bell
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How does someone get assessed and then recommended for PRP Treatment? Do you go through your GP and ask for it? I have private Health insurance with Vitailty so not sure if they cover, but figure that is moot if its not recommended.
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@FrediKanoute, Think it depends on your insurers, with mine I had to see GP and I asked/suggested during my GP visit that I needed to see a consultant. My GP gave me a referral and I contacted insurers to see if the knee consultant I had in mind and was on their list and he was and they agreed on the phone for an initial consult. The Consultant prescribed an MRI and then PRP after reviewing all other options with me.

Top tip, a physio friend who works privately said to make sure to tell your GP that it was an injury, not a chronic existing condition Wink
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Sweet. I'd delay operations as long as possible. There is funky stem cell stuff in the pipeline.
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@FrediKanoute,
To trigger insurance you may need to see a GP or speak to their own triage team. Other wise you can self refer by contacting direct .
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