If left untreated, avascular necrosis can lead to serious complications and severely impact your quality of life, and most of the treatments for this condition can be extremely aggressive and taxing to the body. This is especially true if the condition has already progressed to the later stages. However, more options have been explored for less intense yet equally effective treatments, like platelet-rich plasma injections to address avascular necrosis, specifically of the hip.
So how effective is platelet-rich plasma therapy for avascular necrosis of the hip? While the regenerative capabilities of this treatment certainly make it a promising avenue to explore, it’s still too early to say that it’s a definitive way to help patients who are suffering from avascular necrosis. However, the treatment has somewhat proven itself for medical conditions and is overall safe to use, so it can still be a viable option for you to try with the clearance of your doctor.
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Platelet-rich plasma treatment is a fairly straightforward process: by injecting a solution of platelet-rich plasma directly on the affected area, your body can regenerate cells, repair damage, and otherwise boost the wound healing response. Normally, this response is only reserved for instances where your body receives damage from an injury, which activates your blood clotting. In general, your platelets aren’t used much for regenerative purposes except in treatments like this.
PRP therapy can inject an almost pure sample of platelets directly into your body by extracting a sample of your blood and isolating all other factors like red blood cells, white blood cells, and other compounds. This kick-starts the repair, regeneration, and regrowth response of your cells. PRP therapy can also be combined with proteins and growth factor treatments to maximize its effects on the body.
Platelet-rich plasma treatment has already seen plenty of success in the field of sports medicine, where the wear and tear of intense physical activity can affect the performance of athletes and make their bodies more prone to injury over time. By using PRP injections on injuries, they’re able to get back to their peak physical condition without having to worry about surgery or other invasive methods.
Regenerative medicine may also have a positive effect on the overall health of the body long-term: by keeping your body relatively resilient against day-to-day injuries, you’re less likely to be drastically affected by degenerative disorders or other conditions that develop as you age. However, keep in mind that applications of PRP therapy with this goal are less understood, and will require more evidence from providers and studies alike before it can be implemented on a larger scale.
Avascular necrosis is a condition where your bones weaken and collapse from a lack of blood supply. It’s easy to think that the bone doesn’t require that much blood compared to your other organs, but a healthy blood supply is essential for healthy and growing bones. With a prolonged interruption in blood supply, the specific bones in a certain part of the body become more brittle and prone to serious injuries, and the bone tissues may even die eventually.
Avascular necrosis is generally caused by any condition that can affect the normal blood supply to the bones, from serious injury to alcohol consumption. Several pre-existing conditions can also put you at risk for developing this disease, including but not limited to:
However, the biggest cause of avascular necrosis by far is injury, especially traumatic events that can cut off normal blood supply to the bone. Because avascular necrosis can happen to any bone in the body, patients who’ve recently gotten themselves into accidents should always be on the lookout for potentially developing complications related to this disease.
One of the characteristics of avascular necrosis that can make it difficult to treat is that oftentimes there are no symptoms at all until the condition has progressed to the later stages. Even if symptoms do show up, patients may confuse them with regular instances of pain, or other similar and less serious degenerative diseases.
There’s also the issue that each patient can experience different symptoms depending on where they were injured, as well as their overall health condition. One of the most common symptoms reported by patients is joint pain, which can be easily mistaken for other conditions entirely and can aggravate the disease and cause it to progress faster.
Given that avascular necrosis can happen to any bone in your body, how is the hip of special interest? Because the joints of bones contain the majority of the blood vessels responsible for keeping it healthy, long bones like the hip are far more likely to trigger the right conditions for developing avascular necrosis compared to most areas of the body.
Considering that the hip is also particularly vulnerable to plenty of degenerative conditions like osteoarthritis, it’s an area of special concern for doctors who are looking for potential early signs of avascular necrosis. Any injury that you’ll get around the bottom half of your body will most likely affect your hip in some way, which can put you at the risk of developing avascular necrosis.
So how can PRP therapy help with avascular necrosis? While the studies we have on the exact benefits of the treatment still need to be replicated on a larger scale, the benefits of using this approach are threefold:
The most significant benefit that studies have found with PRP therapy on avascular necrosis is the increased angiogenesis and osteogenesis after treatment or the formation and repair of blood vessels and bones. Given that a large part of the complications caused by avascular necrosis of the hip is caused by the weakening of bones and the reduced performance of blood vessels, this effect is one of the strongest reasons why PRP therapy is being considered as a treatment for the disease.
Especially in the case of blood clots, platelets excel at getting your cells to stick together. This characteristic can also be transferred to your body’s normally dormant wound healing response. This way, your body can repair itself without having to rely on procedures that would otherwise strain it more, like surgery.
Given that PRP treatments are extracted and processed from your own blood, this also ensures that your treatment has a low risk of being rejected by your body. This has normally been one of the issues that have held back chemical treatments of avascular necrosis since certain chemicals can be too harsh or incompatible with a patient’s body. But using the body’s own cells for regenerative treatment, it’s more likely to give you the outcome that you’re looking for.
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Apoptosis is the mechanism where your body intentionally kills cells that could potentially be harmful to your body. The apoptotic response is a crucial function of your immune system, which helps it guard against cells that have developed incorrectly or have the risk of becoming malignant, like cancer.
However, excessive apoptosis can also occur with conditions like avascular necrosis where healthy or otherwise still-living cells are targeted and killed before they have a chance to heal by glucocorticoids. These are compounds that help your immune system in plenty of ways from reducing inflammation to controlling how they use fat and sugar, but one of their primary purposes is looking for cells that your body thinks should be removed.
PRP injections can help reduce apoptosis by repairing the cells in the hip to the point where your body no longer considers them a threat to be removed. This allows for damaged bone to regrow and repair itself over time, which reduces bone loss and directly supports the growth formation of other bones caused by the osteogenesis of your PRP treatments. There’s also some limited information that suggests that they can also help strengthen the regrown bones, but these claims need further study.
PRP injections can also lower inflammation in the hip, which is crucial to limiting or reducing the amount of pain avascular necrosis patients experience every day. Excessive amounts of joint pain are one of the most common symptoms of the disease and are normally treated with painkillers or other similar procedures. But with PRP therapy, providers can repair the area to the point where inflammation isn’t that much of an issue anymore.
Inflammation by itself isn’t an inherently bad response from the body – it’s one of the best indicators that something’s wrong and it needs to be fixed. However, given that the majority of avascular necrosis patients develop their conditions via injury, it’s also a sign that the blood vessels in the area have been blocked or damaged in some way, which can further aggravate the symptoms and progression of the disease.
By reducing the inflammation, the strain on your body is lowered significantly and leaves it free to focus on its wound healing response to make sure that your bones and blood vessels are working right again. Combined with the other two benefits discussed earlier, this ensures that your hip can heal in reasonable time and comfort, without having to strain your body during the process.
So given all of these effects, why isn’t PRP therapy being pushed as a more common treatment for avascular necrosis cases? While the earliest trials and studies that have been done on the process have given promising results, the procedure itself still needs a lot more study before medical professionals can recommend it as a solution for avascular necrosis.
One reason why more study is required is that the PRP preparation process can vary from provider to provider, so there’s no set standard on what type of PRP therapy works the best. Given that each person’s response to PRP therapy can also differ, it’s difficult to give an exact guarantee of how well the process will work, especially for patients who have advanced avascular necrosis.
However, given the relative safety of the PRP process, it can be considered as an exploratory treatment for patients who have caught their avascular necrosis of the hip early, since the body’s wound healing response doesn’t have to work as hard to repair the cells. However, it’s important to remember that this should always be done with the advice and oversight of a medical professional.
Platelet-rich plasma injections can be a possible cure for avascular necrosis of the hip, but you need to keep in mind that regenerative therapies have a very small window in which they can be effective. If you’re thinking of getting a PRP injection to help with avascular necrosis, it’s far better to get it done alongside another treatment option for your condition, especially if it’s progressed to a later stage.
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