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Institute of Advanced Orthopedics, MOSC Hospital and Medical College, Kolenchery, Ernakulam, Kerala

Autologous Conditioned Plasma (ACP)

Autologous Conditioned Plasma or ACP is defined as a volume of plasma with a platelet concentration higher than the average in peripheral blood. Many basic, preclinical and even clinical case studies and trials report ACP’s ability to improve musculoskeletal conditions including osteoarthritis.

Platelets, also known as thrombocytes, are small cytoplasmic fragments derived from bone marrow megakaryocytes. Most platelet functions are directly connected with platelet activation, a process that occurs naturally after an injury in the wall of a blood vessel. Platelets are then exposed to collagen and other extracellular matrix proteins that stimulate their activation, resulting in the release of the content of their cytoplasmic granules1. Overall, platelets contain over 800 proteins and molecules, comprising cytokines, chemokines, membrane proteins, metabolites, messenger molecules, growth factors (GFs) and numerous soluble proteins2. As a result, besides their role in coagulation and hemostasis, platelets are also involved in vasoconstriction, inflammation, immune response, angiogenesis and tissue regeneration and consequently, they participate in numerous physiologic signaling mechanisms and are related to multiple pathologies3.

How does it work?

The platelets in your blood contain growth factors. It is found that injecting PRP growth factors from your own blood into an injured area will help tissues repair themselves by causing new cells to form. In this way, PRP could help reverse existing tissue damage.

It is a newer treatment and more studies are being done world wide for studying the molecular level effects of Platelet Rich Plasma or Autologous Conditioned Plasma in Osteoarthritis.

Who can benefit from Injection ACP?

Autologous conditioned Plasma or Platelet rich plasma works in early osteoarthritis and in musculoskeletal conditions like tendinitis (eg: Achilles tendinitis, Tennis Elbow etc where conservative treatment has not given effect. The effects are still under evaluation and there are mixed results about it use. This treatment aims at producing a healing response in the degenerating body tissues, like the cartilage of the knee, shoulder or hip joints and inflamed tendons which move different joints.

Safety of use

PRP uses your own blood, so experts say it is safe from any adverse effect.

However, an injection into the knee joint can entail some risks, including – local infection, pain at the site of injection, nerve damage, most likely at the site of injection. Other minor adverse effects include pain and stiffness, a rapid heartbeat, fainting and dizziness, nausea and upset stomach, sweating, headache. But these are very rare and are temporary.

What happens during the procedure?

First a small amount of blood will be drawn from your arm.

Then, they’ll put the blood sample into a centrifuge to separate the components and obtain a concentrated suspension of platelets in plasma. At this point, variations in procedure may lead to different concentrations of the various components. (ACP gives a higher concentration of regenerative elements compared to most other techniques to make Platelet Rich Plasma)

Next, the doctor will numb your knee or shoulder joint and inject the PRP into the joint space in the knee. They may use ultrasound to guide the injection (Esp for shoulder joint)

After resting a while, you will be able to go home. You should arrange for someone to drive you home, as there may be pain and stiffness after the injection.

What happens during recovery?

After the procedure, your doctor may advise you to:

ice your knee for 20 minutes every two to three hours for the first two days

take Paracetamol (Acetaminophen) to help manage any discomfort

avoid NSAIDs, like ibuprofen, since they may block the effect of PRP

get plenty of rest and avoid activities that put excess weight on your knee

Follow your physician’s advice about follow-up appointments.

Useful Links:

Understand More about ACP >>

References:

1. Dovlatova N. Current status and future prospects for platelet function testing in the diagnosis of inherited bleeding disorders. Br J Haematol 2015; 170: 150–161.

2. Di Michele M, Van Geet C, Freson K. Recent advances in platelet proteomics. Expert Rev Proteomics 2012; 9: 451–466.

3. Speth C, Rambach G, Wuerzner R, et al. Complement and platelets: mutual interference in the immune network. Mol Immunol 2015; 67: 108–118

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