ORTHOBIOLOGIC INJECTION QUESTIONS

What conditions do they treat?


HA: The extent of evidence for HA is for mild-moderate osteoarthritis (OA) especially of the hip and knee joints. PRP: The majority of evidence also favours mild-moderate OA but it has also shown some improvements in pain and function for tendinopathies of the elbow (“tennis” elbow), patella, achilles, and rotator cuff. In elite athletes, who need to return to sport sooner, PRP has also improved muscle (hamstring tears) and ligament (ulnar collateral ligament of the elbow) function.




How do they work?


HA: Hyaluronic acid is a naturally occurring substance found in the body where it provides viscoelastic properties to synovial (joint) fluid. It acts as a shock absorber and lubricant to the joint. In arthritis, the joint has less viscous synovial fluid and more friction. Adding synthetically made HA further inhibits inflammation and prevents cartilage degradation, however, it will not reverse any structural damage already done to the joint. PRP: is made by autologous blood from the patient. A needle is injected intravenously in a patient’s arm and 30 ml of whole blood is removed. Then it is spun in a centrifuge (*Zimmer-Biomet GPS III) for 15 minutes. This separates the blood into its component parts: Plasma, red blood cells, white blood cells, and platelets. The platelets are concentrated and activated in this manner. Platelets contain the growth factors necessary for healing. A small volume (3 ml) of this rich platelet matrix is then injected into the injured tissue. The whole process takes about 45 minutes.




What are the costs?


Physician assessments are covered by OHIP but the injections are not covered. HA: May be covered by your health benefit insurance. The typical cost depending on the product is from $500-580. PRP: Is not yet covered by any insurance benefits package. The cost is $550.