Platelet-Rich Plasma Centrifugation Changes Leukocyte RatiosTheodore E. Harrison, Jannice Bowler, Todd N. Levins, K. Dean Reeves, An-Lin Cheng

Published: April 13, 2021 (see history)
DOI: 10.7759/cureus.14470
In this study, we looked at what happens to the white blood cells during centrifugation. In our first study we observed that there seemed to be a swing from the "heavier" denser white blood cells to the "lighter" white blood cells. While we don't know what effect this has for your PRP results, we do know that some of these "lighter" cells act as scavengers cleaning up debris and removing the more inflammatory white cells, as well as stimulating the "rest and repair" aspect of the immune system. This may explain some of the healing mechanisms that happen after your initial PRP inflammation has settled down. 

Prolotherapy is such a wonderful treatment. It can make a big difference to pain reduction and to correcting instability in the body. It is a privilege to be on the teaching team heading to Calgary in September, Covid-precautions permitting, to train 20 physicians from across Canada. We hope this will lead to easier access to prolotherapy for more people, as more physicians become proficient in the treatment :-)

Please see our updated handout answering many of your commonly asked questions, under the FAQ page, and then the PRP page. Note that this can also be used following prolotherapy for optimal recovery. There are detailed instructions on what exercises should be done when, along with other tips and instructions. Thanks to Dr Annette Zaharoff for a lot of the information included in the handout. She is a colleague in Texas, who also used to be a professional tennis player, so she knows a thing or two! She has an avid interest in "prehab", ie. getting you prepared for PRP, as well as optimal "rehab" afterwards, and is very knowledgeable in these areas. Please spend time reading this handout before your PRP appointment for best results! A copy is attached here. 

A study has been published, showing a significant rise in your platelet count (and thus also the number of platelets you will have when we draw your blood) in response to exercise. Specifically this was after 4 minutes of high intensity training (HIT), tested on a stationary bike. We can probably assume if you do this within 30 mins or less of your blood draw, ie. stop for a quick sprint/jog/aerobic activity (raising your heart rate) to the best of your ability, we will get better platelet counts. If you don't have a heart condition, consider doing this at the Interurban Rail Trail (on the Prospect Lake Rd side of the West Saanich/Prospect Lake intersection) or at the Whitehead park which is minutes from our clinic. Make sure you tell the receptionist as soon as you arrive, so that we can take your blood sample as quickly as possible, for the best result!

It's that time again, when we are renewing our Advanced Cardiac Life Support. This is a standardized and well-taught training which needs refreshing from time to time!
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 Hot off the press is the article I co-wrote with colleagues Drs. Harrison and Levins, on comparing platelet yields using 6 different preparation methods. While this is more of a basic science and technical paper, the bottom line is there is a lot one can do to produce high quality, effective platelet-rich plasma (PRP) to facilitate healing from many chronic musculoskeletal pain conditions. This paper can be found on our research page, under the PRP section. We have already started work on a second paper! 

The blog has been quiet for a while as this season I am President of the Canadian Association of Orthopaedic Medicine. Basically this means a lot of conference planning and organising, and dealing with any day-to-day issues that arise. We are hosting a conference on platelet-rich plasma in Sidney, BC in May, and then the main CAOM conference is set for October in Victoria. Go regenerative medicine! The way of the future...

Our colleague from Kelowna, Dr. Francois Louw, has just published a well put-together study on prolotherapy for TMJ (jaw) pain. It is yet another excellent randomised controlled trial (the best kind of study) showing how effective this simple treatment can be. Well done, Dr. Louw! (You can see the details under our Research tab, in the prolotherapy section).

CBC news has a story entitled "Every bit of exercise counts in reducing risk of early death". You can find a link to here. The study authors compared bouts of exercise to regular (eg. taking the stairs instead of the elevator) as well as total moderate to vigourous daily activity. The more the better, but any exercise counts!

David and I have recently returned from a prolotherapy medical mission to Honduras. We were based in the small town of Tela, and had a great time learning and teaching, sharing prolotherapy with each other and with many Hondurans who made the trip to the town from outlying villages. It was the 49th year the HHPF organisation has run the mission! Here are some pictures of the week there :-)