Cartilage damage: Helps a self-blood therapy?

In osteoarthritis, tennis elbow and muscle injuries some Orthop&auml syringes;the pläleaves-rich Plasma into the joint. To heal broken cartilage. However, the effectiveness of the procedure is controversial

Until now, hardly anything against geschädamaged joints do. Whether the self-blood therapy ächange is controversial

Blood erfüthe llt in the Köbody numerous functions, for example, as a Transport and communication system, für the distribution of the Wärme and the immune system. Who incurs a wound, can see the juice of life at work: He makes a schücorrosive barrier and stimulates the surrounding tissues to renew themselves. As it stands, the healing power of the blood also für inner Schäto want to use if, for example, cartilage, muscles or Tendons are attacked.

Especially the Blutpläleaves, platelets are called, contain substances that für the Regeneration of the tissue are important, for example, Wachstums­­hormones. "In this respect, the Blutpl&auml are;leaves well as a vehicle, these substances in the gewüyou want a place to transportieren", Professor Philipp Niemeyer, with the German company f&uuml says;r Orthopäthe and trauma surgery (DGOU) &quot the working group;Clinical Geweberegenera­tion" .

Blutpläleaves are supposed to heal injuries and osteoarthritis

Researchers ließthe blood en therefore, in a centrifuge, spin, so that its components separate and the Flüthe reliability of in several "Phasen" . The f&uuml can;r ­this type of therapy überflü- story elements such as the red Blutköthe body cells remove. Übrig pl&auml remains;leaves-rich Plasma (PRP), a yellowish Flüreliability. By syringe is injected where it needs to heal.

Increasingly more Orthopäthe method to apply. To your customers ge­­hören, among other things, Profifußshooting, the of a külower level of Genesungs­­time after injury promise. "Alone in MüMunich have üover 50 practices in the treatment with PRP an", Niemeyer, use the procedure in the case of his patient says. Even Non-athletes köthe method in Berücurrency.

Especially in the beginning Verschleißsymptoms of the joints make a lot of Ädoctors their patients hope that PRP can help relieve the discomfort. For example, in the case of frühen stages of osteoarthritis of the knee. Because it is not a cash performance ­is, numbers, many the treatment itself. "We charge per syringe into the joint in about 100 euros. The number of syringes depends on the indication; often two to three syringes are nötig", Niemeyer says.

Mode of action of the Plasma-spraying is still not geklärt

However, the effectiveness of the method in the case of osteoarthritis is questionable. Although the Orthop&auml experience;the successes in practice, as well as Niemeyer bestäneeded. The könne but a Placebo effect, Dr. Stefan Sauerland from the Institute für Qualität and efficiency in healthcare (IQWiG): "The more expensive a treatment, the größthe perceived effect is actually a ineffective sham therapy." This Phänoun had already been scientifically proven to be good, so the expert.

And nobody know exactly what happens after a PRP injection in the joint, says Sauerland: "PRP enthält a lot of substances, including factors that the Aktivität cells be­influences – even those that Entzü- making reactions. By the Entzümaking reaction to be the formation of new cartilage tissue is stimulated. How exactly k&ouml work;could be and which path is activated is largely unknown."

Research: studies provide widersprüfrail results

In addition, there have been in recent years, many studies, but most with only a few participants. Some studies showed a beneficial effect of PRPs in the case of knee complaints. Others found no significant differences in comparison to patients who received a sham treatment. A in the journal Arthroscopy , published Üreview work from the März 2017 evaluated the measurements of ten studies with üabout 1000 patients.

After six months, the results were still not significantly different from the comparison groups, which Kochsalz­lösung or Hyaluronsäure to the joint injected. Only after a year, the subjects reported with the PRP therapy, on average, less pain, and the function of their knee joints was graded somewhat better than in the other groups.

Dr. Peter Jüni, the centre für ­clinical research at St. Michael’s Hospital at the Universität Toronto (Canada) directs, schätzt however, the significance of this Üsummary of work than the low-a after he looked at the studies in more detail: "The Work, the PRP with saline injections to compare, all have a low number of participants für serious conclusions."

Own blood therapy is as effective as Hyaluronsäure – or a Placebo

In the Compare with Hyaluronsäure’s only two of something größEUA studies. In the first place, although in a Parameter bezüthe question of the acceptance of pain is an advantage für PRP. Other Messgrößen do not reflect this advantage. And in the second study, the PRP is on a par with the Hyaluronsäure. "However, because the effectiveness of Hyaluronsäure a Placebo – so a dummy treatment – is different, as is the PRP."

Sauerland looks at the study location is also critical: "In the case of an efficient method and a well-defined area of application müthe results of the individual Stu&shy clearing up;dien much more äto resemble." That they are so different, könne ­meh­rere Gründe: "Möcompensated for errors made, for example, in the distribution of subjects to treatment and control groups were in the study design."

Recommendation for the preparation of PRP-PräPat is missing

Maybe it was the fact that the different effective PRP-Präspecimens were presumed to be in the Sauerland. Meanwhile, there is worldwide ungefähr 30 different systems, in order to generate the Plasma. Therefore, it may differ in composition, for example, whether it is still weiße Blutköbody cells enthält or not. "The studies suggest but so far no final darüber to which PRP preparation the most benefits bietet", Sauerland says.

In the guideline of the German society für Orthopäthe and accident surgery for the treatment of osteoarthritis of the knee, which appeared at the end of 2017, is the short sentence: "A statement to the PRP can still be made." The authors bemäthe small number of high-quality clinical studies, the defects also. Further, they note: "A recommendation für a specific process for the preparation of PRP can currently not be given." 

Treatments müshot for sure, but not to be successful

How is it that, nevertheless, many Ädoctors offer the treatment? "Für as a method, it needs only the approval of the zustäcomplete Landesbehörde", erklärt Sauerland. "There prüit is not ft but if the treatment is effective." Rather, it is a question of whether certain Hygiene­­standards are adhered to, and whether it is a safe procedure, so the risk of serious side effects is low.

Because it is the blood of a patient, köcan üon the Plasma, no HI – and Hepatitis viruses, other persons übe transferred – at least, as long as no Präparate reversed and no syringes are used several times. However, grunds&auml is;in addition, the danger that the puncture bacteria are introduced and the joint entzünd. The risk is one in 1000. "A high level of care in the application and compliance with strict Hygienemaßopinions here are of großhe Bedeutung", Orthopäde Niemeyer says.

Own blood therapy is not a health insurance performance

But such a method as the Fund performance m&uuml is approved, ;to suggest, for example, the kassenämedical Association submit a claim, and the Federal Joint Committee and the IQWiG to write an opinion on the effectiveness of wüauthorities. "But in the case of the current data wäit re a sky travel command to beantragen&quot the health insurance reimbursement;, Sauerland says.

He kögrunds&auml could though;addition to imagine, in the case of the knee the method pain to try as a Patient. "But only in the context of a well-planned study. Because we need further studies to understand whether the method is something to it." Also Jüni &quot notes: ;Unfortunately, we have still not found a miracle cure for osteoarthritis." So only &uuml stay;brig, the life-style around the joints m&ouml adapt;to get as possible long: move and possibly lose weight.

Self-blood therapy in dermatology: vampire Lifting 

Also in the äaesthetic medicine is used for PRP: When "Vampire Lifting", sometimes "Dracula-Therapie" called, injections to tighten the skin and refresh as well as acne scars, großpore, skin, eyes, rings, Knitterhä, wrinkled neck, and Bindegewebsschwäche help. 

However, there is little research on how the success of the treatment länger-term ausfällt. The decisive factor is the individual response of the K&ouml is probably;body, which is why the effect is difficult abschäappreciate lässt. Üview d&uuml way;are likely to regelmäßige refreshing, nötig.

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