A recent New York Times article questioned various treatments injured athletes may undergo to become healthy. According to the article, treatment options include steroid injections, taping, Platelet-rich Plasma (PRP) and surgery. The article questioned these methods due to their widespread use and lack of positive outcomes in clinical studies. The article made the case that PRP use is currently outpacing research-backed evidence, which is dangerous medical practice. This contention is very legitimate and needs further investigation from a clinical perspective. It is important to understand when PRP should be considered and may be beneficial. The offering of PRP by orthopedists to patients who have failed conventional treatment methods and are facing surgery, is medical practice that should be supported.
“Everyone wants to get into sports medicine,” said Dr. James Andrews in the Times article. Dr. Andrews is a sports medicine orthopedist in Gulf Breeze, Fla., and president-elect of the American Orthopaedic Society for Sports Medicine. As the article cites, oftentimes the sports medicine specialty requires less training than other specialties. This works to make sports medicine a desirable specialty for doctors following an extensive education and residency program. Beyond that, because PRP requires an injection, a fairly simple medical function, doctors from a variety of specialties are attempting to capitalize on the therapy’s popularity. This sets a dangerous precedent for future regenerative therapies and since the treatment may be considered for an injury where no clinical research supports its use, contributes to negative outcomes.
Orthopaedic specialists and orthopaedic surgeons are the researchers conducting the studies on PRP and the experts who specialize in soft-tissue repair where PRP has shown clinical effectiveness. Orthopaedic specialists have the most training and experience in these areas of the body and are most qualified to decide when PRP is an option for an injured patient. PRP should not be used recklessly just because it is popular among athletes and simple to use. Like all medical therapies, it should be carefully considered only after conventional, less costly and proven therapies have been applied.
The widespread use of PRP is partially due to professional sports. “Patients see a high-profile athlete and say, ‘I want you to do it exactly the same way their doctor did it,’ ” said Dr. Edward McDevitt in the New York Times article, an orthopedist in Arnold, Md., who specializes in sports medicine. Unquestionably, this is the wrong way to go about offering new regenerative therapies. The medical community should be attempting to obtain proper treatment applications before offering regenerative therapies such as PRP. Most often, a professional athlete uses a variety of conventional and experimental treatments simultaneously in hopes of returning to their job faster. Without treatment specifics, offering PRP because a certain professional athlete used it is irresponsible medical practice.
However, just like the professional athlete who requires an expedited return to their job, active people and workers need the same quick turnaround. Livelihoods are at stake. Most people cannot afford to take months off to recover from surgery. Therefore, to offer PRP as a last resort to surgery when conventional treatments have failed is responsible use. In these instances, orthopedists should offer PRP for injuries and conditions that have had encouraging clinical results. Cautious patients and orthopedists who recognize the importance of responsible practice should be commended. Not only does the responsible offering of PRP in specific cases “do no harm,” it may improve lives.