What do you tell your son or daughter after they have suffered an injury that keeps them away from the sport they love? They may already be asking how long they have to wait to get back in the game. Maybe they’ve jumped online to see how their favorite athlete was treated for a similar injury and now want to see if they can use stem cells or platelet rich plasma (PRP) to heal their injury quicker.
As sports medicine physicians, we are increasingly being asked these questions by parents, coaches and young injured athletes. Over the last several years, we have seen a dramatic increase in interest in regenerative medicine, especially the use of PRP and mesenchymal stem cells to help athletes return to their sport after injury. Yet many patients and caregivers struggle to make an informed decision about the use of PRP and stem cells in injury recovery as these are newer, and thus less understood, treatments.
What is PRP?
Blood is composed of plasma, red cells, white blood cells and platelets. Normally when you have an injury, your platelets help form a clot so the wound can heal. This involves a cascade of events where platelets signal other proteins called growth factors to the injured site. PRP is a concentration of these platelets that are created in a lab.
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The early thought was that if PRP was injected near an injured bone, cartilage, muscle, tendon or ligament it might help accelerate the recovery process since more of these growth factors would be near the site of injury. Early evidence shows that PRP helps to decrease pain and increase function safely in injuries like tennis elbow, hamstring muscle tears and even osteoarthritis. This treatment option has gained widespread attention after reports that elite athletes like Kobe Bryant, Tiger Woods and Rafael Nadal used cell therapies for their injuries.
While promising, the use of PRP has not been studied extensively in the pediatric population and it is important that young athletes and their families meet with their sports medicine physician before consenting to this treatment.
What are MSCs?
Similarly, mesenchymal stem cells (MSCs) are thought to accelerate the healing process for musculoskeletal injuries. They are seen as the body’s master cells, and studies have shown these cells have the capacity to differentiate into bone, cartilage, muscle and ligament tissues. MSC cells are usually harvested from bone marrow or fat cells. Evidence from laboratory and veterinary research suggests that MSC may provide an alternative treatment option for conditions that affect muscle, tendons, ligaments and cartilage.
This evidence, however, is limited and based on a few small, randomized clinical trials in adults. Benefits have been reported in patients with osteoarthritis, especially after specific knee surgeries. However, it remains unknown whether these results would be similar in children with athletic injuries.
Why caution is needed
Recently there has been an increase in the number of unregulated clinics advertising rapid recovery with the use of stem cell therapies. The American College of Sports Medicine urges patients and their families to exercise caution when considering these treatments. The use of PRP and stem cells remains an exciting treatment option for many sports injuries. However, young athletes and their caregivers should be cautious in pursuing this as a first option for treatment. Despite the enormous potential of these cell-based therapies, more studies are needed to determine their effectiveness and long-term safety in children.
Everyone wants a young athlete to get back to sports as quickly as possible, but it is important to look first at treatments that have been shown to be effective before considering unproven options. To achieve this, take your child to an expert who is board certified specifically in sports medicine. If regenerative medicine therapies, such as PRP or MSCs, are suggested, make sure to ask about the physician’s experience with these treatments, and about the side effects and possible long-term risks. Unless advised otherwise for a specific reason, consider traditional sports medicine treatments and therapies for your child’s injury.
If your child has suffered an athletic injury and needs treatment, call the University of Miami Sports Medicine Institute at 305-243-4000.
Stephen Henry, M.D., is a primary sports medicine fellow, Clifton Page, M.D., is a primary care sports medicine specialist, and Thomas Best, M.D., Ph.D., FACSM, is a primary care sports medicine specialist at the University of Miami Sports Medicine Institute. For more information, visit UHealthSprotsMedicine.com or UHealthSystem.com/patients/pediatrics.