When it comes to innovative treatments like PRP (Platelet-Rich Plasma) injections for osteoarthritis or tendon, ligament, or muscle injuries, there are a lot of questions surrounding the optimal conditions for success. One heavily debated topic among orthopedic surgeons is whether a patient should discontinue steroids and anti-inflammatory medications before undergoing PRP. Dr. David Guy, a triple board-certified orthopedic surgeon and expert in sports medicine and regenerative treatments, addresses this very question in his latest “Ask the Doctor” video series. Although there is no consensus or solid studies that dictate the necessity of pausing such medications, Dr. Guy shares his extensive experience and personal approach, offering insights into how to potentially maximize the effectiveness of these pioneering treatments. In this blog, we delve deeper into what he has to say, examine the nuances of PRP and autologous exosome therapies, and discuss the intricacies of managing pre-injection medication regimens.

Understanding PRP and Autologous Exosome Therapies

When it comes to undergoing PRP (Platelet-Rich Plasma) injections or similar regenerative treatments for musculoskeletal issues, patients and practitioners often ponder the impact of continuing steroid and anti-inflammatory medications. Dr. David Guy, an expert in orthopedic and regenerative medicine, provides valuable input on this subject based on his extensive experience.

The primary goal of PRP injections is to harness the body’s natural healing capabilities. By concentrating platelets and their growth factors from a person’s blood, PRP therapy aims to accelerate the healing of injured tendons, ligaments, muscles, and joints. A more advanced iteration, autologous exosome therapy, uses isolated and replicated exosomes, potentially providing even more profound regenerative benefits.

The Impact of Steroids and Anti-Inflammatories

However, the question arises: Do steroids and anti-inflammatory medications hinder these treatments? Dr. Guy points out that while there is no uniform answer, nor robust clinical studies to definitively support either side of the argument, common sense and experience often guide practice.

Steroids and anti-inflammatory drugs are commonly prescribed for their powerful anti-inflammatory effects, offering relief from pain and swelling. These medications work by suppressing certain immune responses in the body. Meanwhile, PRP therapy relies on triggering some of those very responses to promote healing. Consequently, one might intuit that continuing these medications could dampen the regenerative process.

Dr. Guy’s Recommendations

Dr. Guy suggests that, from his perspective, while there are no specific studies he is aware of showing poorer outcomes in patients who continue these drugs, it could make sense that they might interfere with the healing process. As such, he advises his patients, again emphasizing this is not medical advice but his personal approach, to discontinue these medications prior to treatment:

• Oral Steroids: A hiatus of about six weeks is ideal.
• Cortisone Shots: Similarly, a break of six weeks is recommended.
• Anti-Inflammatory Medications: Discontinuing these at least one week before the procedure is preferred.

Conclusion

This approach stems from Dr. Guy’s belief in maximizing every potential benefit from the treatment, given the time, effort, and financial investment involved. However, he acknowledges that not all practitioners share his views. Some orthopedic surgeons do not prioritize discontinuing these medications, proceeding with treatments regardless of ongoing use.

As regenerative medicine continues to evolve, the hope is that more definitive guidelines and insights will emerge, helping practitioners like Dr. Guy provide even better informed and effective care. Until then, personalized decision-making and ongoing patient education remain at the forefront of successful outcomes in this innovative field.