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Dr. Gerard DeGregoris III, MD is a pain medicine specialist in New York, NY and has been practicing for 11 years. He graduated from Univ Of Mi Med Sch in 2007 and specializes in pain medicine and anesthesiology.Read his story
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Dr. DeGregoris III' bio
This content was provided by Dr. DeGregoris III " Platelet rich plasma (PRP) is an increasingly commonly performed treatment for a variety of musculoskeletal problems. PRP has been used for over 20 years in a variety of medical fields including orthopedics, sports, medicine, dentistry, ENT, neurosurgery, ophthalmology, urology, wond healing, cosmetic surgery, cardiothoracic surgery, and maxillofacial surgery. PRP uses the body's own cells and growth factors to facilitate tissue healing, and offers an alternative to surgery for many patients. To perform the procedure, the physician starts by drawing approximately 20-50cc of blood from the patient, usually from veins in the hands or arms, under sterile conditions. The skin of the patient is sterilized using antiseptic solution. A variety of sterile equipment including gloves, a disposable needle, tubing and syringe is also used. Once the whole blood is collected, it is then separated in a centrifuge into its constituent parts. Whole blood contains plasma, red blood cells, white blood cells, and platelets. The plasma is the liquid component of blood, and is made up of water and a variety of proteins. Red blood cells carry the majority of oxygen from our lungs to the various tissues where it is needed. They then pick up carbon dioxide (a waste product of cellular respiration) and deliver that to the lungs, where it can be exhaled. White blood cells serve many functions, including fighting infections and removing other dead blood cells. Platelets play an important role in injury. They are typically among the first cells that act to staunch bleeding, and they start a cascade of events involved in tissue repair and the development of new blood vessels. Though variable from patient to patient, a typical blood specimen is made up of 93% red blood cells, 6% platelets, and 1% white blood cells. Because platelets are believed to be among the most important components for tissue repair, it is theorized that a concentrated treatment using these cells can facilitate healing when applied to damaged tissue. Platelet rich plasma is defined as a sample of a patient's own plasma that has a platelet concentration that is higher than normal. Usually the concentration is enriched by separating whole blood in a centrifuge and isolating the portion of the plasma that is richer in platelets. This relies on the principle that, when spun in a centrifuge, the heavier components of blood (ex: white blood cells and red blood cells, will be drawn by centrifugal force to the bottom of the container. Lighter components (such as platelets) are more likely found in the center and on the top of the container. The platelet enriched portion of plasma can then be drawn off either automatically or manually (depending on the physician's preference).One reason that platelets are thought to help with healing tissue is that they are a source of growth factors. These factors are stored within platelets in vesicles known as alpha granules. The main growth factors include transforming growth factor beta (TGF-Beta), vascular endothelial growht factor (VEGF), platelet derived growth factor (PDGF), and epithelial growth factor (EGF). TGFbeta influences cell proliferation and replication. VEGF is a stimulator for the growth of new blood vessels (which may be especially important when the injury is in places with low blood supply [such as cartilage and tendons]). PDGF helps stimulate the production of other growth factors and promotes stem cell and endothelial cell replication. PDGF also promotes collagen synthesis (collagen forms the building blocks of tendons and ligaments). Physicians are applying newfound understanding of the utility of platelet rich plasma to various body sites. Studies have shown possible benefit from PRP injection in Elbow pain, Knee pain, Shoulder pain, spine pain, and other sites."