Cellular Matrix Injections
In our previous blogs we highlighted the beneficial effects of Hyaluronic Acid (HA) and Platelet Rich Plasma (PRP) in the treatment of joint and soft tissue injuries. The world of sports medicine recognised long ago the potential deleterious effects of cortisone – particularly in the patient population they were treating – and were among the first to adopt HA and, more recently, PRP injections as an effective alternative. The use of HA & PRP in the wider population represents a significant leap forwards in the non-surgical management of conditions like joint pain, sports injuries and chronic tendon injuries.
A cellular matrix injection is simply a combination of these two therapies – HA and PRP – and is a move away from using drugs like cortisone to fight disease – rather harnessing the body’s natural ability to heal and repair. Read on to find out why cellular matrix injections are now our ‘go-to’ therapy for joint pain and arthritis.
A reminder about PRP and HA
PRP injections is an area of regenerative medicine that seeks to harness our bodies’ natural mechanism to repair injured tissues – our platelets. If you think about a cut on your skin – blood rushes to the area to quickly stop the bleeding by causing a clot, deals with any dirt or infection (using our immune response via white blood cells) and continues to provide exactly what is needed to heal that cut (the inflammatory cascade). It’s pretty amazing when you think about it? Once the immediate safety actions are taken (stopping the bleeding and protecting the body from infection) the healing process begins. This is mediated predominantly through platelets which in-turn release thousands of bioactive proteins responsible for healing. Platelet Rich Plasma is the portion of the blood that contains these important blood cells and their proteins. You can find out lots more about the benefits of PRP here.
Hyaluronic acid is found all over the body – most notably in synovial joints like the knee. HA has a number of essential properties that help to provide normal function of the joint like elasticity (helps to absorb loading), viscosity (helps to lubricate the joint surfaces) as well as providing a barrier to inflammatory mediators that can harm the joint. The scientists might not like the analogy but you could consider HA doing a similar job as hydraulic fluid – lubricating joints but also helping to accept pressure and load.
Cellular matrix injections | why combine PRP with HA?
As well as the benefit of combining the viscoelastic properties of HA with the healing potential of PRP, there are some other important biological reasons to do so:
1/ PRP injections have been shown to increase the production of natural HA suggesting an additive effect when combined together 1
2/ Combining PRP and HA can enhance the production of the cells that make up articular cartilage (chondrocytes) 2
3/ Combining PRP and HA encourages stem cells to form chondrocytes 3
4/ Combining PRP and HA has the potential to break the inflammatory cycle 4
5/ The anti-inflammatory effects of PRP are enhanced when combined with HA 5
Essentially, research centred primarily around knee arthritis, shows better outcomes when PRP is combined with HA when compared to using PRP or HA alone 6 which provides the basis for our recommendation to use cellular matrix injections for knee OA and other arthritic conditions.
What is involved in a cellular matrix injections?
The process is very similar to our PRP injections – a small amount of blood is taken from a vein in your arm (in the same way as you give blood or have a blood test). This is then taken to a centrifuge which produces the platelet rich plasma from your blood sample. This is then mixed in a closed system with hyaluronic acid to ensure sterility is maintained throughout before being injected into the arthritic joint.
The scientific protocol for cellular matrix injections requires a series of 3 injections at 2-4 week intervals. We go into a few more of the geeky details about this here but in short – articular cartilage has a poor blood supply and therefore a poor capacity to heal. If we consider again a cut on your skin, it heals quickly because of its constant supply of platelets and bio-active proteins due to its plentiful blood supply. The scientific research shows that repeated PRP injections produce a sustained anti-inflammatory effect7 with reduced pain and improved function8.