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Melanie Cole (Host): During the past several years, much has been written about a preparation called platelet rich plasma and its potential effectiveness in the treatment of injuries. My guest today is Dr. Justin Sherfey. He’s an orthopedic surgeon and a member of the medical staff at Palmdale Regional Medical Center. Dr. Sherfey, tell us a little bit about platelet rich plasma or PRP. What is it and what is the evolution of it?

Dr. Justin Sherfey (Guest): Sure. Well it is a process where we actually take the patient’s own blood, we draw out some blood just like you would get any blood draw when you go to the lab or have some testing done. And we then take that blood and we process it where we separate it into its different factors and out of that separation, we take out some of the growth factors that are normally found in your blood as well as the actual platelets that are found in your blood. And we take that part of that sample and then that is injected into different areas of the body; whether that is into a joint or into a tendon or into an area of injury. And the whole process, the goal of it is to take some of these natural healing factors that you have in your body and concentrate them into kind of a very high level and then by injecting that into an area we want it to have some actions and hopefully can stimulate healing and encourage your body’s own natural healing process, but in a much more kind of intense way.

Melanie: So, which conditions would benefit most from platelet rich plasma?

Dr. Sherfey: Well, the process was first studied in tendon problems, particularly into Achilles tendon as well as into the lilial elbow, what we call elbow, tennis elbow or tendonitis. That is where this was first kind of trialed and studied and it had the most success. Up to today, it still probably does the best in these areas, but it is being expanded to multiple other things such as joints including hips, knees, elbows, ankles where we hope to have some effect on the arthritic process as well.

Melanie: So, then tell us about the benefits for the patient and a little bit about the science behind it, what you tell your patients when they say okay, so you know how does this even work?

Dr. Sherfey: Sure, well the first thing we tell the patient is it’s your own natural body’s product. We are not adding any artificial medicine, we are not adding something synthetic. We are basically taking what you already have in your body, your blood, and we are just concentrating it. Normally, when you have an injury, your body naturally starts a healing response to try to deal with that. Well we are taking those factors that are found in your blood and we are super concentrating them so that instead of a normal response to that we are giving you a 10 to 100 times the response for your body to deal with that. So, the science is really just taking your normal factors which are called growth factors and these hormones that are in your body and are found in your blood as well as taking the platelets which have some anti-inflammatory and healing properties and when we take that and put it in another area of the body at a super concentrated level; it just kind of starts that normal cascade of healing, really triggers it to occur. So, that’s the whole process. We are trying to get some healing. We are trying to have your body heal itself naturally. We are just encouraging it.

Melanie: Tell us about the procedure itself. What’s it like?

Dr. Sherfey: Well, the procedure takes anywhere from about fifteen to twenty-five minutes. Basically, you and most of the time this is just done in the office. It can be done in other settings as well, but you come in, you have your blood drawn just again like I said anytime you would get a lab test. That blood is then taken to what’s called a centrifuge where it separates it by spinning it rapidly into its different factors. That takes about ten to fifteen minutes. After that, we draw out the parts of the blood that we want which I said was the growth factors and platelets and then those are injected, just like you would receive an injection anytime in a normal office visit if you have got like a cortisone shot or something like that in the past. There is nothing really fancy about the procedure. It’s just that we are using parts of your own body in regard to the blood products.

Melanie: Is this an image guided injection? Or does it not really need to be?

Dr. Sherfey: It depends on the area. In some areas of tendons, there are some things that are very superficial or a large joint you may not need to use image guidance. In fact, I would say probably 70% of the injections I do of PRP are just office based non-image guided. Now you can use image, you can use ultrasound in the office to help ensure you are getting it to the exact area. When I do it into a hip joint or a shoulder joint, something I want to ensure I actually get into the joint into the deeper structure, I usually do this as a small outpatient procedure in the surgical center or hospital and we do it under x-ray guidance in that case. So, it can be done either way.

Melanie: And how often does it need to be done?

Dr. Sherfey: So, once – the whole process, once it’s done, it takes about six weeks to really see if your body is going to respond. Your body has some initial anti-inflammatory effect, so you get a little relief early, but then this is kind of – I tell my patients it is kind of like planting grass seed. You kind of put it in there and you have got to let the process occur and that body healing response takes about six weeks. It can be done as frequently as needed. I mean there is no side effects, there is no downside. It is your own natural body healing, its own factors; however, most of the time, a person only needs a single injection. In some more chronic issues depending on the response, they may need to go two or three injections.

Melanie: Can it help somebody avoid surgery Dr. Sherfey?

Dr. Sherfey: Absolutely. That’s the goal and in fact, a lot of times, in this last five years of my practice, this has become more mainstream, that’s kind of what I talk to the patients about. I say heh, I have an alternative. This gives your body some healing potential and this may help either delay or avoid a surgery all together depending on what we are treating. Now it’s not going to reverse very advanced arthritis. It’s not going to make you 18 years old again. But it can definitely help some of these problems heal themselves. And I have seen it myself, multiple patients with issues of rotator cuff partial tears or some small meniscal tears or some chronic tendonitis; they are healed, and they avoid surgery after a simple as one maybe up to two of these treatments.

Melanie: Wow, that’s really cool and what a neat advanced kind of procedure that isn’t invasive for the patient. So, wrap it up for us. Give us your takeaway. Tell patients what you want them to know about this type of stem cell treatment, platelet rich plasma that can help them maybe avoid surgery and heal their injuries.

Dr. Sherfey: Well sure, there are a couple of things I always want the patients to know and I think this is the best way to wrap it up. Number one, this isn’t a magic potion, so you hear a lot about this, it is becoming a very popular thing, you hear professional athletes doing it, it’s on TV, you hear it in the newspaper articles, online, you can find out all about it. But you have to remember there are appropriate things that this can be used for and this isn’t magic. It’s not going to be used for everything. I see people promoting it for things that it’s not meant to do. But it is a very good option and it is something that can really work. The science is very young on it and we don’t really have a lot of research out there, it’s just starting. And so, it’s new and we are still learning about it and I am sure over the next five years, we are going to have this process down to even a more exact science. We are going to know what the dose should be. We are going to know which places it’s really going to work and what it’s probably not going to work for. So, I would tell the patients just know it is out there. Know it’s an option. Talk to your doctor about it and it may be a very good option for you to avoid some surgery.

Melanie: Thank you so much for explaining that to us Dr. Sherfey. What a fascinating topic we discussed today. Thank you again for joining us. You’re listening to Palmdale Regional Radio with Palmdale Regional Medical Center. For more information, please visit www.palmdaleregional.com. Physicians are independent practitioners who are not employees or agents of Palmdale Regional Medical Center. The hospital shall not be liable for actions or treatments provided by physicians. This is Melanie Cole. Thanks so much for listening.