Traditionally, the medical community has offered a scenario of rest, medication and, for the most severe injuries, surgery as a way to keep America’s weekend warriors active well into the golden years. Thanks to modern medicine, the advent of joint replacement surgery and ligament reconstruction procedures have also provided relief for individuals who were faced with the specter of giving up their active existence for a more sedentary lifestyle.

    On the golf course, conversations about knee and hip replacements, ACL reconstruction, and bone fusion procedures are as prevalent as the three-putt bogey. Statistics support the fact that Americans are using these surgical procedures more than ever, with documented success. But the results are not 100 percent successful. In a recent study patients who had undergone recent total joint replacement had over 90 percent surgical success without serious complications, but patient satisfaction with their clinical outcomes was only 70 percent. 

    Because the public understands this realization, the tide is changing as both professional and amateur athletes seek less invasive options to soothe their aching bodies.

    Enter Platelet-Rich Plasma (PRP) and its close relative stem cell therapy as viable alternatives to the harsh-reality of major surgery. Quite simply, the more-common PRP process begins with collection of the patient’s blood. The blood sample is then placed in a centrifuge to separate the platelet-rich plasma from the other components of whole blood. Doctors then inject the concentrated platelets into the site of the injury often using ultrasound guidance for accuracy. The treatment process generally takes 20 to 30 minutes.

    Stem cell therapy introduces new adult stem cells, usually harvested from the patient’s iliac bone, processed and concentrated, similar to a PRP treatment and then is accurately injected using guidance into a damaged joint or tissue. 

    Indeed, this cutting-edge technology is steadily gaining mainstream support, one success story after another. With the refinement in stem cell therapy and the ability to harvest a patient’s own stem cells – without the controversial use of embryonic cells – and the advancements in PRP procedures, surgery has become an option and not the sole solution.

    “Any tendon or muscle strain, ligament strain, cartilage injury and arthritic joint can be treated (using PRP),” explained Dr. Brian J.  Shiple, D.O., owner of The Center for Sports Medicine and Wellness in Springfield, Pennsylvania, and one of the region’s most respected experts in stem cell and PRP treatments. Regarding the difference between stem cell therapy and PRP, “PRP works for mild to moderate injuries as well as arthritis and stem cells are reserved for more severe injuries and more severe arthritis,” Dr. Shiple added.

    After graduating from Western Connecticut State University, Dr. Shiple graduated from the New York College of Osteopathic Medicine with his D.O. degree, completed his residency training at The Medical Center of Delaware and finished his fellowship in sports medicine at Pennsylvania State University’s Hershey Medical Center. He developed one of the area’s first sports medicine fellowship programs in sports medicine for the Crozer-Keystone Health System and ran it for 13 years before going into private practice over the last six-plus years. Twenty-two years in sports medicine have allowed him to see the benefits of both traditional and new era medical technology. 

    “After my own chronic injury needed treatment, I simultaneously found the answers for both my patients and myself,” Dr. Shiple said. “As new treatments became available for sports medicine specialists, PRP and stem cell treatments became a natural extension of our earlier work.”

    Today, Dr. Shiple serves as a consultant to the University of Delaware, helping injured star athletes through PRP therapy while avoiding surgery. When he directed the sports medicine fellowship program in Delaware County mentioned above, he was in charge of sports medicine care for five school districts. He is also an authorized RegenexxTM specialist, licensed to utilize the company’s patented process in both stem cell and PRP therapies. Through these connections, he has built up quite a following of satisfied patients.

    According to Dr. Shiple, he has handled more than 2,000 PRP cases and 200 stem cell cases. Innovations in technology have also allowed Dr. Shiple to treat injured nerves in the arms and legs as well as the spine and the vertebral disc.

 

HELP FOR GOLFERS

    Dr. Shiple has treated many patients with golf-related injuries with approximately 90 percent showing marked improvement.

    “Golfers experience many of the same injuries as other athletes, such a sprains and strains of ligaments, tendons and muscles,” he said. “Many also have cartilage injuries, cartilage tears and arthritis. I also treat many patients with back strains, sprains, pinched nerves and herniated or degenerated disc problems.”

    For those golfers who face the reality of joint replacement surgery, Dr. Shiple said PRP or stem cell therapy is certainly a viable alternative. “Yes, absolutely, if the joint is not too far gone. Generally bone-on-bone arthritis has about a 50-to-60 percent chance of getting better enough to return to pain free or nearly pain free golf. Moderate and milder forms of arthritis have an 80-90 percent chance of feeling great and doing well for a long period of time.”

    According to Dr. Shiple, for most patients it generally takes three to eight weeks to help get enough healing for the pain to resolve and then rehabilitation must be done to get ready to return to golf. “Muscle injuries heal the quickest,” Dr. Shiple said. “Arthritic joint pain, ligament and tendon injuries and cartilage injuries take a bit longer to heal.”

    While traditionalists argue that stem cell and PRP processes are still too new to fully endorse, Dr. Shiple has witnessed almost miraculous results through non-surgical treatment. However, he offers this caveat.

    “Treatments have no guarantee that they will work in each and every patient. The severity of the injury or condition and the patient’s ability to heal and follow directions to recovery will have a huge impact on a patient’s success or failure to a given treatment regimen,” he said. “It also is not a cure, yet, for chronic degenerative conditions such as severe arthritis. We do see evidence of healing smaller cartilage lesions but severe bone-on-bone arthritis where the cartilage has been gone for years is a much harder problem to solve. In many cases we can give a patient pain relief for many months to a year or more but the disease is still there. 

    “Studies show that these treatments can stop the progression or slow it down and in some can even reverse the arthritic process, but not for all patients and all comers,” he added. “So for the over 65 who is bone-on-bone they may be as good or even a better candidate for a joint replacement surgery than for PRP or even stem cells to make a long term change that patients would consider worth it. But, for the younger patient with less severe disease or those that cannot get surgery, PRP and stem cells are a definite option to help manage their disease.”

 

PRP versus Surgery

By the Numbers

 

   Of course, the financial impact when comparing PRP to surgery is a driving force for many individuals. 

   “In my practice, it takes two to three treatments to heal an injury, and the cost is about $1,700 to $2,500 for these treatments. Out-of-pocket versus the co-pays and deductibles for a typical patient that has insurance for their covered surgeries should be compared to that cost.

    “Comparing the medical cost of healing an injury with PRP versus surgery; again the cost is about $2,500 for three PRP treatments and $15,000 to $20,000 for the surgical cost of a treatment.”  n

 

Editor’s Note: Dr. Shiple recently finished a book called “Regenerative Healing for Life,” Joc Doc Press, 2013, which is written as a patient’s handbook that highlights the differences between the surgical paradigm and this new minimally invasive cellular medicine paradigm of treating acute and chronic injuries as well a chronic degenerative conditions such as osteoarthritis. It’s available on his web site at drshiple.com and on amazon.com.