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Author Topic: Bursitis and PRP  (Read 3208 times)

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John C

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Bursitis and PRP
« on: March 25, 2014, 02:52:43 AM »
I am attaching the link (you will probably have to copy it and paste it in your browser) below because it is not that rare to have bouts of hip bursitis after resurfacing surgery. Many of us successfully treated this using the foam rollers on the IT band. However, when the bursitis persists, cortisone injections are often suggested by doctors. This study compares the success of these cortisone injections with PRP injections in treating hip bursitis.

http://www.healio.com/orthopedics/biologics/news/online/%7B810dc38b-164a-482e-bc1b-378e36ae3a94%7D/platelet-rich-plasma-more-effective-for-treatment-of-chronic-hip-bursitis-than-cortisone-study-finds
John/ Left uncemented Biomet/ Dr Gross/ 6-16-08
Right uncemented Biomet/Dr Gross/ 4/25/18

Canadian-Ice

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Re: Bursitis and PRP
« Reply #1 on: April 26, 2014, 01:24:28 PM »
Hi John,

As mentioned in a previous post I recently completed the third in a series of PRP injection for right shoulder supraspinatus tear. This was ultrasound guided, and at the last injection, bursitis was detected, and the doctor injected it. Now, maybe there were anti inflammatories in the injection I didn't know about, but as far as I know, only my own blood. Instantly the pain was gone, and while major soreness returned to the shoulder after about 5 days, the bursitis pain -- that sharp pain -- has definitely not returned.

Little doubt in my mind the PRP resolved the inflamed bursa. A follow up ultrasound 2 days ago showed no bursitis, as well.

Challenge with PRP, though, is it is there are many variables that seem to affect the result, and doctor experience and anecdotal knowledge of their own patient results may be what guides them.

John C

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Re: Bursitis and PRP
« Reply #2 on: April 27, 2014, 10:17:54 PM »
Hi Canadian-Ice,
You are right in that the one thing that all PRP studies end with is that not enough is yet known about dosage, number of injections, etc; so there is a lot of variety in how docs approach it. The two things that most of the studies agree on is that their does not appear to be any downside unlike cortisone, and that 60 to 80 % of patients show minor to major improvement.
You mentioned wondering whether any anti-inflammatories might have been included in your injection. This would be highly unlikely, since it would totally counteract the healing cascade affects of the PRP. Most docs will ask you to even stay off of oral anti-inflammatories for at least a couple of week after the injections. It is possible that your doc included a mild pain killer in the injection, as ours did with this last round, making the first day or so much more comfortable.
As for your knee, when I had my hip injected last fall, my wife decided to have her knee that suffers from occasional chondro-malacia injected, and she swears that she got through the ski season better than in previous years. Last week she decided that she was impressed enough to have both knees injected when I went in for another hip injection.
People have to remember that PRP injections are not intended to make you feel better right away; in fact the intent is to set up a healing response in the area, which may be uncomfortable at first. The biggest news is the recent MRI study out of HSS in New York, that in a blind study showed that there was no progression in arthritis out to at least one year after PRP, when they would have expected around a 5% cartilage loss in an arthritic joint during that time.
Someone mentioned Durolane which is a viscosupplement injection that I had pretty good success with a couple of years ago. It is interesting to note that some studies with PRP show that one of its many affects along with stimulating a healing response can be to stimulate the production of healthy joint lubrication, similar to the longer term affects of the viscosupplements. Since the PRP also offers the hope of overall healing and cartilage protection, I think that I would not go back to a viscosupplement again at this point.
Good luck with keeping all of our parts working ::)
John/ Left uncemented Biomet/ Dr Gross/ 6-16-08
Right uncemented Biomet/Dr Gross/ 4/25/18

Canadian-Ice

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Re: Bursitis and PRP
« Reply #3 on: April 29, 2014, 02:38:56 AM »
Hi John,

That's a very encouraging post, and I wish you and your wife continued good fortune. Consequently I'm in process of planning treatment in a similar vein for my knee and hip.

I wounder whether Durolane would interfere with PRP. Durolane is less expensive and best for me to try first, with PRP as second choice to use if the Durolane does not help or later in the year for its potential joint preservation properties.  Either way, I am going to start with my knee and, if that affects symptoms over time, move on to the hip.

Having looked at a secondary source on that HSS PRP study, it seems just one injection was used. Did you and your wife have one injection per joint, and done through a doctor outside ? I see a Dr. Galea in Toronto, who has a strong reputation for effective PRP. Certainly makes sense to stick with PRP.




John C

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Re: Bursitis and PRP
« Reply #4 on: April 29, 2014, 02:55:44 AM »
I would not think that Durlane would interfere with PRP. One thing to keep in mind with Durolane; most viscosupplements only remain in the joint for a few days, which is why they usually require multiple injections to get results. Durolane has a half life in the joint of around 28 days, which would seem preferable. This might mean that you would want to wait at least that long before having a PRP injection into the same joint.
Yes, we just did one PRP injection per joint. This was recommended by the orthopedist that did the injections, and some of the studies have shown that one injection is as good as multiple when it comes to PRP in  joints.
On a side note, Dr Gross used PRP quite a bit during the surgery when he resurfaced my hip 5 years ago. He coated the femoral head with it before putting the cementless cap on, and then sprayed the whole surgical field with PRP before closing up the wound.
John/ Left uncemented Biomet/ Dr Gross/ 6-16-08
Right uncemented Biomet/Dr Gross/ 4/25/18

Canadian-Ice

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Re: Bursitis and PRP
« Reply #5 on: April 29, 2014, 01:10:33 PM »

Thanks, John.

I wounder if other surgeons are using PRP with resurfacing. Was your recovery from Dr. Gross's surgery satisfactory?

Incidentally, you might be interested to know about the Trochlear Paste Graft option for knee arthritis under the knee cap. Not covered under most insurance plans, far as I know, but theoretically returns the knee to normal function for about ten years. This, according to the surgeon who invented it. Probably not needed if Viso or PRP injections already working, though.


John C

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Re: Bursitis and PRP
« Reply #6 on: April 29, 2014, 01:52:23 PM »
My recovery was definitely satisfactory, thought without a comparison, it would be tough to know if the PRP that Dr Gross used made a big difference. I am appreciative that he went to the extra effort to incorporate something that he believed would be beneficial.
Thanks for the info on the Trochlear Paste graft. My wife is not ready for that yet, but we will look into if the time comes.
John/ Left uncemented Biomet/ Dr Gross/ 6-16-08
Right uncemented Biomet/Dr Gross/ 4/25/18

Canadian-Ice

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Re: Bursitis and PRP
« Reply #7 on: April 30, 2014, 01:53:54 AM »

Yes, sometimes I think any method to speed healing is hard to prove, because with soft tissue issues there is always the chance it would have healed anyway! Not so with joints, mind you. 

 

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