Caring Medical - Where the world comes for ProlotherapyOsteoarthritic bone repair


Ross Hauser, MD

In this article we will examine the medical research concerning the effectiveness of stem cell therapy, Prolotherapy, and platelet rich plasma therapy on stimulating bone growth and repair.

In examining this research it is easy to see why doctors around the world have focused their attentions on the challenges of repairing and regenerating osteochondral defects (the bone on bone phenomena and accompanying bone destruction in osteoarthritic joints) by controlling the body’s inflammatory response to healing. This is a remarkable transformation away from joint replacement.

The one thing that all this research suggests but never spells out clearly is that for this transformation to occur you need doctors to transform themselves from expert surgeons to expert inflammationists.


Inflammation is regenerative medicine

This paragraph from a new research study accurately describes the current line of orthopedic thinking and the patient experience in the doctor’s office when examining the non-surgical options.

Injections to include corticosteroids, hyaluronic acid, blood-derived products such as Platelet Rich Plasma Therapy, mesenchymal stem cells; are considered the final option for conservative therapy, if pharmacological treatments are unsuccessful.

In contrast to systemic pharmaceutical interventions newer intra-articular therapies exert their effect by more directly targeting the underlying processes of knee osteoarthritis in combination – loss of cartilage in the joint.1

Amazingly, treatments such as Platelet Rich Plasma, Stem Cell Therapy, and Prolotherapy are thought of, if thought of at all, after the use of anti-inflammatories and painkillers derail and impede the natural healing process of the body. We damage the healing process – the inflammatory response to healing – when inflammation is needed the most.

In new research on fracture healing a team of American and doctors from the United Kingdom suggest that:

The problems pointed out above is that any treatment that relies on the inflammatory process needs an expert in inflammation to monitor healing – an expert inflammationist.

Independent of this research comes findings from Iranian doctors who tested the effectiveness of Platelet Rich Plasma on the repair of large bone defects.

The researchers here are calling for new treatments  to increase the quality and accelerate bone healing. They conclude that Platelet concentrates (PRP) in different forms can be considered an attractive option for such purpose because Platelets are a natural source of growth factors, and cytokines (the cells that comprise the healing signalling communication system), and other healing factors.

Here is their opinion:

Variability based on levels of expertise and doctor experience. In research we often cite a recent article in Orthopedics Today that warns against the high degree in variability among practitioners who use Platelet Rich Plasma (PRP). The main concerns are lack of standardization in treatment regimes and formula concentration.4

Here again, the problems pointed out above is that any treatment that relies on the inflammatory process needs an expert inflammationist.

Doctors in China have recognized this. Here is their research:

Here again, the problems pointed out above is that any treatment that relies on the inflammatory process needs an expert inflammationist.

Research updates to this article

New research continues to support the use of biological growth factors for healing bone defects.

If you would like to continue your research on our webiste please see the companion article – Can stem cell therapy reawaken the inflammation that makes regenerating joint tissue possible?

Prolotherapy doctors

1 Wehling P, Moser C, Maixner W. How does surgery compare with advanced intra-articular therapies in knee osteoarthritis: current thoughts. Therapeutic Advances in Musculoskeletal Disease. 2016;8(3):72-85. doi:10.1177/1759720X16642405.

2.Giannoudis PV, Hak D, Sanders D, Donohoe E, Tosounidis T, Bahney C. Inflammation, Bone Healing, and Anti-Inflammatory Drugs: An Update. J Periodontol. 2015 Sep 14:1-14. [Epub ahead of print]

3. Oryan A, Alidadi S, Moshiri A. Platelet-rich plasma for bone healing and regeneration. Expert Opin Biol Ther. 2015 Nov 11. [Epub ahead of print]

4.  “Platelet-rich plasma promises pain relief and healing, but remains controversialOrthopedics Today. Web. April 2013. Accessed April 29 2013.

5. Liu C, Zhang H. Advances in the research of promoting healing of chronic wound with platelet-rich plasma 2014 Oct;30(5):433-6.

6. Castillo-Cardiel G, López-Echaury AC, Saucedo-Ortiz JA, Fuentes-Orozco C, Michel-Espinoza LR, Irusteta-Jiménez L, Salazar-Parra M, González-Ojeda A. Bone regeneration in mandibular fractures after the application of autologous mesenchymal stem cells, a randomized clinical trial. Dent Traumatol. 2016 Aug 11. doi: 10.1111/edt.12303.

7. Sinclair KL, Mafi R, Mafi P, Khan W. Mesenchymal stem cells and growth factors used for bone formation, fracture healing and non-unions- A systematic review. Curr Stem Cell Res Ther. 2016 Jun 13.

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