September/October 2020 - 34

looked into PRP, people were asking questions about it. I
know with stem cells, when I see " stem cell " attached to
anything, there's always this apprehension. Do you still
hear questions when it comes to that? And what's the
difference between PRP and stem cell injections?
Dr. Mishra: The medical dictionary definition of a stem
cell has kind of changed. So I think when people use
that, the people who are promoting it sometimes are not
necessarily using it in an appropriate scientific mirror,
basically specialized human cells that can develop into
different cell types.
But I think one thing that's fair to say is that people who
are claiming to inject stem cell preparations are not always
doing that. I don't know all the regulatory parts of it, but (I
do know) the regulatory parts of it in the United States are
different than it is outside the United States. So, people
who truly want stem cell preparation, more often than
not, they're going to be going into Europe or some other
country. Because they are regulated in a very different way
than Platelet-Rich Plasma is.
Answering the other part of your question: from 2006 to
2020, the data is staggering better.
Another important component of the equation that's
important to understand is not all PRP is the same. I'll see
people for second opinions who've been somewhere else
and (I'll ask), 'What'd you have?' And they're like, 'Well, I
had PRP.' Well, what type of PRP? And the reason that's
important is the different types of PRP function differently.
When you talk about attracting stem cells.
CAD: At first, I looked at PRP and stem cell injections
as, 'Is it like Pepsi and Coke, " or something to that end.
Now it seems like PRP is on a totally different level.
Like you said, there are multiple different types of PRP
injections.
Dr. Mishra: They're actually radically different. Stem
cells are just a completely different animal than PRP.
Most PRP has a few stem cells in it. Within your bone
marrow are a variety of different types of stem cells. That
is within all of your tissues, including tendon tissues, there
are stem cells. They're just in small quantities. As we get
older, we have a diminished number of stem cells, and
that's one marker of aging.
If you're trying to collect or inject stem cells, you have
to have a way of harvesting them. That's much more
complicated than it is for PRP. You can get stem cells, for
instance, out of fat in some forms, you can get it out of
your bone marrow, you can get it out of different types of
tissues, but it's complicated.
Then the other side of the equation is PRP, which I'll
explain as if you were coming in to see me for tennis
elbow. You come in, you're an elite or a weekend warrior
kind of player. You've had this pain, and it can come from
playing tennis, golf, it can come from repetitive things
like too much time on the computer. You've tried a variety
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September/October 2020

Table of Contents for the Digital Edition of September/October 2020
