Understanding the Use of Growth Factors in Regenerative Medicine

What are Growth Factors and How do Growth Factors Work?

Growth Factors (GFs) or Platelet Rich Plasma (PRP) Injections1 are used in Regenerative Medicine to stimulate healing.

GFs can be obtained from amniotic fluid, placental tissue, or your own blood. Amniotic products contain anywhere from 4-8x more GFs then your own PRP. The amnion-derived GFs can be injected directly into the injured site (e.g, joints) using an ultrasound guided technique to ensure proper placement. These proteins then stimulate repair and regeneration at the site, offering the patient pain relief and quicker healing rates.

It also promotes angiogenesis (new capillary formation) to make it easier for cells to get to the damaged area. In most cases, 1-3 injections are required.

Examples of GFs found in amniotic products include:

• bFGF (Basic fibroblast growth factor): a signaling protein that assists in cell growth and maturation, morphogenesis and tissue repair
• EGF (Epidermal Growth Factor): a protein that stimulates cell growth and differentiation into various tissues, proliferation, and cell survival
• KGF (Keratinocyte Growth Factor): involved in the skin repair; it recruits special cells to form the epithelial layer that heals wounds
• PDGF (Platelet Derived Growth Factors): a group of growth factors that are implicated in tissue remodeling and is necessary for cellular division of special cells called fibroblasts that aid in wound healing
• TGF (Transforming Growth Factor): aids in the proliferation and differentiation of cells and activates immune cells essential for healing and maintaining healthy tissue

What Conditions are Treated with Growth Factors?

Growth Factors can treat a number of conditions involving the hip, knee, arm, shoulder, lower leg, and feet. It is best to consult with your physician for a complete listing. However, below is an abbreviated list of conditions that can be treated with GFs.

• Acute muscle tears and strains
• Chronic Tendinopathies (tennis elbow, Achille’s tendon injuries, patellar tendonitis and partial rotator cuff tears)
• Ligament injuries (e.g., medial or lateral collateral ligament—MCL/LCL) or Plantar fasciitis

Why Use Growth Factor Injections?

Growth Factor injections are an alternative to surgery. Ideal candidates would be those who prefer a less invasive, natural alternative to surgery or those who are unable to undergo surgery. GF injections also allows for a much quicker recovery period and is much less painful than a surgery. GFs can also be used in conjunction with various medications (although see below regarding the use of NSAIDS after injection) and with other Regenerative Medicine treatments.

How do Growth Factors Work?

A large amount of growth factors are released at the site of injury upon injection. These proteins induce an inflammatory response to initiate healing and recruit stem cells. The stem cells are able to restore tendons and ligamentous proteins as well as strengthen cartilage allowing it to become firmer and more resilient.

Are Growth Factor Injections Painful?

Patients usually tolerate the injection well. However, there can be soreness after the injection due to the GF-induced inflammatory response. You can expect swelling and soreness during the first 48 hours post injection and may need pain medication to help alleviate the discomfort.

How Quickly Do Growth Factor Injections Work?

Most patients see some improvement within 2-6 weeks. The pain becomes less and less as the weeks pass with most clinical trials reporting improvement up to 6-9 months post injection.

Are Growth Factor Injections Safe?

These injections are safe. Since the amniotic fluid and placenta do not contain HLA antigens that trigger dangerous immune responses, the injections are considered safe.

However, there is some minimal risk involved. During research studies and clinical trials, the only risk noted was that the injection could cause an infection to develop. This is not unique to GF injections, however. Anytime a person undergoes an injection there is this risk.

Using one’s own body as a healing mechanism is a relatively new concept in the world of medicine, and an exciting one at that. As therapies such as these begin to prove they are beneficial and effective, you will likely see similar therapies develop in other areas of medicine. It is important that patients considering this therapy find a doctor with experience administering these types of ultrasound guided injections. Favorable outcomes are more likely if the doctor or PA administering the injections is experienced and skilled.

Is There Any Patient Who Would Not Be a Good Candidate for Growth Factors?

Patients with severe anemia, low platelet count, abnormal platelet function, active systemic infection, or those with an active cancer are not recommended to be administered Growth Factors. NSAIDs, anti-inflammatories such as Motrin, Advil, or Aspirin should not be used 3 days before the procedure and for 4 weeks after the procedure. Tylenol or Tramadol can be used for pain.

What is the Future of Growth Factors?

As people seek out alternative options to surgery for injuries and other conditions, demand for therapies such as Growth Factors will increase. Not only are patients excited about the treatment outcomes but physicians are as well, as it gives them more options to offer their patients.

Stimulating the patients with their own stem cells is revolutionary and more than likely represents just the beginning of these forms of treatment. Further research is ongoing and the use of these treatments will continue as long as they prove to be effective.

About StemX Group

Founded in 2017, StemX Clinic is located at 124 Lomas Santa Fe Dr., #206, Solana Beach, CA and can be reached at 858-228-4189. We provide stem cells as regenerative medicine services for orthopedic, joint, muscle, and tendon injuries.

References

1. https://orthoinfo.aaos.org/en/treatment/platelet-rich-plasma-prp/