The PurePRP® SP (Supra Physiologic) is the latest evolution of the PurePRP and the PurePRP II systems. It is a treatment that utilizes blood components from the patient for the healing and regeneration of injured and degenerated elements. The method is applicable to more serious damages or injuries that require more intensive treatment. It has a permanent effect by creating a new, healthy tissue and eliminates the need for surgery.
It is also known in the US as therapy with Autologous Growth Factors or PRP (Platelet-Rich Plasma) and treatment of the Regenerative Medicine. The Autologous Growth Factors are being used in the US for two decades in cardiac surgery, plastic surgery, orthopedic surgery and dentistry. Since 2006, application of PRP injections has began in the US initially in injuries and sports injuries, and later in degenerative lesions. The development of the method augmented by the use of musculoskeletal ultrasound enables us today to intervene with absolute accuracy at the location of the damage (contusion, rupture, degeneration) and rebuilt the area.
What is PurePRP® SupraPhysiologic
Platelet-rich plasma (PRP) is blood plasma that has undergone a suitable process in order to be rich in platelets. Although the average concentration of platelets in the blood is 250,000 platelets/dL, the minimum concentration of the PRP in order to be considered to have healing properties is 4 times more and equals to 1,000,000 platelets/dL which is considered as the baseline1. The significant concentration of the autologous platelets enables the PRP to contain an abundance of growth factors such as2: PDGF, TGF-β1, TGF-β2, PDEGF, PDAF, PF-4, GMP-140, IL-1, FGF, I-α, I-γ, ILGF.
Pure PRP SP is a variation of high density PRP. Hence, it displays high concentrations of growth factors, however, without the presence of red blood cells. The platelet and growth factor concentrations are 7 to 9 times greater compared to the PRP baseline. Furthermore, from the 6% of the platelets that exist in human blood, PurePRP® SP can reach concentrations up to 80 to 98%3. and is the only PRP variation that can be processed with or without neutrophil granulocytes.
How the healing process works
Platelets contain a vast number of proinflammatory bioactive factors such as critical proteins, growth factors, chemokines and cytokines. These are responsible both for the initiation and control of the inflammatory healing cascade. Furthermore, the increased platelet concentrations is been acknowledged to stimulate the proliferation, differentiation, and migration of cells to the site of damage.
Consequently, performing a PurePRP® SP injection at the point of damage stimulates the natural healing cascade of the organism 4 .That in turn, leads to regeneration of tissues, restores the damage, and stops pain.
In which cases we apply the treatment
This treatment is used by the Pain Management, Sports Medicine, and Plastic and Aesthetic Medicine. In all the aforementioned specialties, the common factor is the need for regeneration of tissues, although serving different objectives.
Specifically, in the Pain Clinic, this method is applied to a wide range of conditions, such as musculoskeletal conditions and nerve entrapment syndromes: neck pain, lower back pain, coccydynia, muscle strains, ligament sprains, tendinopathies, and bursities. Problems in the joints, osteoarthrosis of either traumatic or degenerative origin (shoulder, elbow, wrist, hip, knee, ankle, toes and fingers). Furthermore, it is applicable in hernia reconstruction, coccys cyst healing, scar tissue repair, skin ulser treatment, and other conditions.
Which medical equipment are used
The medical equipment that we utilize for the treatment is: the PurePRP® SP preparation KIT, the centrifuge, and the ultrasound imaging machine.
PurePRP® SP preparation kit
It is used for the collection, the centrifugation, and the final injection of the substance. It is consisted of disposable materials.
It is used to perform the separation of PurePRP® SP from the blood serum and the red blood cells. The centrifuge that we use is certified and exclusively designed for the production PurePRP® SP.
Ultrasound imaging scanner
Enhances our ability to identify the exact location of the lesion and to actively guide the needle for injecting PurePRP® SP with increased accuracy. The ultrasound that we use in the surgery is optimized, both by us and by qualified personnel of the manufacturer for the musculoskeletal system and provides us with the required accuracy needed for the injection.
How the treatment is performed
The treatment is performed by the pain clinic’s team in our surgery. The team includes the physician, a specially trained nurse, and the operator of the ultrasound.
The treatment procedure is comprised by the following four steps:
We begin in the surgery by our nurse collecting 60ml of blood from the patient. This quantity is needed for the production of the PurePRP® SP that we will use during the treatment.
PurePRP® SP production
The process of centrifugation is performed just after the blood collection and takes place in two stages. The whole process lasts for approximately 30 minutes.
Location of the damage
The location of the lesion is performed through clinical examination from our pain doctor and is enhanced under ultrasound analysis.
PurePRP® SP injection
The PurePRP® SP is accurately injected on the location of the damage under ultrasound guidance. Hence, we are able to stimulate the natural healing cascade of the organism that initiates the generation of new tissue, restores the damage, and stops pain.
Treatment success conditions
Correct patient selection
For the treatment to be successful, the patient should conform with a few prerequisites. This is necessary for us to ensure that the patient is in a suitable condition to absorb the enhanced healing power that is released. Hence, every patient is individually evaluated prior to the performance of the treatment.
Correct preparation of the patient
In order to ensure the maximum effectiveness of the treatment, every patient should undergo the proper preparation that is customized to fit the specific needs of every individual. As a baseline, a few prolotherapy treatments are performed in advance to raise the level of the organism at a suitable level that is needed to ensure that the body will absorb the PurePRP II injection and heal.
Modern equipment and PRP of excellent quality
The PurePRP® SP used is produced in the surgery under certified material, devices and procedures that guarantee it’s quality.
The combination of all the individual techniques that aggregate to the performance of the treatment, raise the level of expertize that the physician should obtain. Furthermore, the workload during the treatment is increased to a very demanding level. Both the experience and the training of our staff that is performed internationally, and our constant experimentation, guarantee the maximum effectiveness of the treatment.
Injection point accuracy
The amount of PurePRP® SP injected into the patient is in the order of a few ml. This means that to obtain the maximum effect from such a small quantity the substance should be placed exactly at the point of damage. Therefore, the use of directional techniques such as the ultrasound guidance is both necessary and imposed, while being the least harmful imaging method for the human body.
1. Alderman Donna, Alexander Robert, “Advances in Regenerative Medicine: High-density Platelet-rich Plasma and Stem Cell Prolotherapy For Musculoskeletal Pain,” Practical Pain Management Journal, October 2011:49-63, 90.
2. Marx R, Kevy SV, Jacobson MS, “Platelet rich plasma (PRP): A primer,” Practical Pain Management Journal, 2008; 8(2):46-47.
3. Emcyte Corporation, “PurePRP™,” http://www.emcyte.com.
4. Sampson Steven, Gerhardt Michael, Mandelbaum Bert, “Platelet rich plasma injection grafts for musculoskeletal injuries: a review,” Curr Rev Musculoskelet Med, December 2008, 1(3-4):165-174.