Athlete, heal thyself! Platelet therapy helps athletes and older folks

As an offensive lineman for the Purdue Boilermakers, Eric Hedstrom is used to getting up after being knocked down - but this is getting ridiculous.

Hedstrom lost most of the 2007 season to a knee injury. He missed most of last season due to a shoulder blowout. Last winter, he came down with viral encephalitis and nearly died.

And just when he had recovered and was ready to rejoin his teammates on opening day of practice this season, he felt it again: the stabbing pain in his shoulder that made it impossible to hold off charging 300-pound linemen.

But this time, Eric had a secret weapon on his side: his own blood.

While getting surgery to repair the labral tear in his shoulder, Hedstrom got treated with the latest development in sports medicine: PRP, or platelet-rich plasma.

It's a treatment which the Pittsburgh Steelers' Hines Ward used to recover in two weeks from a sprained knee ligament to play in this year's Super Bowl.

The common factor among Hedstrom, Ward and all PRP patients is that they have injuries to ligaments or tendons that are hard to heal.

It's an investigational treatment that hasn't been proven yet, but which some local specialists, including renowned orthopedic surgeon Tony Romeo, say shows great promise.

And it's being used for to help not only professional athletes, but high school athletes and elderly patients who haven't exercised in years.

The ultimate dream

Eric came out of Prospect High School in 2005 as a CBS Sportsline Prep Star All-American. At 6 feet 7 inches and 315 pounds and one of the top linemen in the country, he had dreams of going pro.

After all he'd been through, Hedstrom said not being able to play this season is "heartbreaking."

After consulting with Dr. Romeo, team doctor for the Chicago Bulls and White Sox, Eric decided to try PRP for his second shoulder surgery.

While he was under general anesthesia, a small amount of blood was drawn from him and spun in a centrifuge to separate out the platelet-rich plasma, which contains growth factors that help the body develop new blood vessels and tissue. The PRP was then injected directly into the injured area.

The difference was noticeable. While it took Eric three months to get out of a sling after his first surgery, after the PRP therapy, he was out of the sling in a month.

Initially, he could barely lift his arm to scratch his head, but is now seeing a trainer to improve on his range of motion.

"So far," he said, "it's healing a lot faster and a lot better."

He still calls the NFL "the ultimate dream." Eric continues his studies in leadership and pre-law, and is hoping to get permission from the National Collegiate Athletic Association to play a sixth year.

The NCAA promotes the therapy on its Web site. In contrast to the banned practice of blood doping, in which bicyclists and other athletes inject themselves with their own red blood cells for a boost in competition, PRP is used to heal injuries, not for overall performance.

Eric's father, former high school coach Richard Hedstrom, who played football at Indiana State, hopes his son's case can serve as an example for other injured student-athletes.

"It sends a signal to kids who've been injured and lost a season that people want you to heal up and compete."

Growing pains

PRP has been used in oral and facial and plastic surgery since the 1990s, but its use in the U.S. has taken off in just the past five years. Recent technological advances have allowed it to move out of hospitals and into doctors' offices for outpatients.

It's frequently used for tendinitis, such as tennis and golfer's elbow, jumper's knee, and problems with the Achilles tendon. Now, doctors are expanding its use in surgery.

For larger tears of the rotator cuff in the shoulder, for example, common in patients over 60, one-quarter to one-third of patients will reinjure the area.

Surgical anchors and sutures stay in place, but the tendons tear away. So doctors are using PRP to try to heal the tendon to the bone. It's also being tried for tendons around the knee and ankle.

Early anecdotal reports, Romeo said, suggest it does help. One of the main benefits, for reasons unknown, is the injury hurts a lot less.

The kits to perform the injection cost $150 to $300, and some doctors charge extra for the service. Some insurance policies pay for it, and some do not because it's experimental.

Besides athletes, the technique can also be used for older patients who have a hard time healing due to other factors, such as smoking or diabetes.

From lab to humans

Dr. Vishal Mehta, a sports medicine and orthopedic surgeon, has researched PRP in the lab, testing it on rabbits and showing it made tendons heal stronger.

Now he's applying the lab findings to his practice at Fox Valley Orthopedics in Elgin, Geneva and Naperville.

He used PRP on 16-year-old Olyvia Rand, a soccer and basketball player at Sycamore High School.

She cracked her lower thigh at the knee cap, breaking off a silver dollar-sized chunk of bone and tendon. Typically, such an injury would require multiple surgeries for a cartilage transplant.

Instead, Mehta screwed the chip back into place and bathed the area with an injection of platelets.

Six months after surgery, Rand is running and hopes to return to sports in the spring.

Her mother said they were very happy with the results so far, and Olyvia would recommend it to anyone who needs similar surgery.

"I would say definitely get it," she said, "because it's not going to hurt you, but there's always that possibility it could help you."

One of the attractions of PRP is that it uses the patient's own blood, so there's no danger of the immune system rejecting it and little chance of infection.

Mehta considers it the next frontier in healing medicine, but notes that it needs much more study in randomized trials to know the long-term results.

A new study in the journal of American Academy of Orthopaedic Surgeons concluded that PRP is more promising for healing soft tissue than bone and that it should be used cautiously until high-level clinical evidence is available.

"Caution needs to be taken, because we're very much in the infancy of this thing," Mehta said. "We've got a lot of mechanical ways to repair injuries, but this is one of the first ways we can turn on the body's own healing powers."