Tissue Graft Repair of the Plantar Fascia

“Platelet-rich plasma is significantly more effective than cortisone
both in the short-term and the long-term treatment of these difficult patients.”
Raymond R. Monto, MD, American Academy of Orthopaedic Surgeons 2012 Annual Meeting.

We use tissue graft repair for plantar fasciitis and damage to the flexor digitorum brevis muscle at the heel. This technology utilizes our patient’s own blood platelets. The terms APC+, Autologus Platelet Concentrate and enriched with growth factors; and PRP, Platelet-rich plasma, are used interchangeably in this page.  The blood is treated by a two-stage centrifuge (spin down), which allows for a high concentration of the platelets and growth factor. This tissue can be used as graft repair material, which is then percutaneously placed in the damaged area.

In other words, we use a patients blood to concentrate bio-active proteins and growth factors that are used for the repair of cells. When tissue is injured, platelets travel to the area to contribute to the healing process naturally. This treatment amplifies the healing process that the human body performs naturally. The common causes of heel pain are a result of connective tissue damage. Connective tissue has no direct arterial supply, as a result has a very limited supply of the nutrients and oxygen used in the healing process. This procedure directly amplifies the resources available for healing.

For example, using ultrasound guidance, the concentrated tissue graft material is percutaneously injected directly into the damage plantar fascia and flexor digitorum brevis muscle at the heel. This can be done instead of surgery for chronic plantar fasciitis. It is also used for damaged tendons. In this way, the bodies own healing ability is utilized to repair damaged tissue. The best part of this procedure is that it is minimally invasive compared to other procedures. And, it utilizes your own blood or tissue and not another donor. This has been used by oral surgeons and plastic surgeons for over a decade. The tissue graft material is derived from a small amount of your own blood that is drawn at the time of the repair procedure.

Individuals undergo surgery for a variety of different reasons. For some, the decision is prompted by the need to repair damage caused by trauma, birth defects, and/or the aging process. For others, the decision is to improve their personal appearance and well-being. In either situation, Autologus Platelet Concentrate enriched with growth factors (APC+) is one tool used by surgeons to help improve surgical outcomes.

APC+ is made from a small sample of your own blood (approximately 1 oz.). The process concentrates the platelets found in the blood sample. These concentrated platelets contain huge reservoirs of growth and wound healing factors. Growth and would healing factors are natural components of your body. Clinical data has shown that growth and wound healing factors may enhance and accelerate your body’s normal healing process.

The use of APC+ is now readily accessible in our office. Potential benefits of APC+ include the reduction of bleeding and bruising, decreased inflammation and swelling, enhanced would closure, accelerated bone growth, and reduction of overall healing times.

HOW LONG HAS APC+ BEEN USED?

APC+ has been used clinically for over a decade. Leading clinicians in specialties such as dental, ENT, Facial Plastic & Reconstructive Surgery. Orthopedics, Cardiovascular, Plastic Surgery and Wound Healing routinely use APC+ to deliver a cocktail of natural, bioactive growth factors.

HOW COULD APC+ BE USED FOR ME

The use of APC+ varies from procedure to procedure. Common podiatric use of APC+ are, plantar fascitis, non-union or delay union of bone, post-op or intra operative foot and ankle surgery tendon injuries.

WHY IS APC+ (ENRICHED WITH GROWTH FACTORS) PREFERRED OVER OTHER PRODUCTS OR METHODS?

APC+ is the only available product that contains elevated levels of all your naturally occurring growth factors. These growth factors are maintained in precisely the same ratios found circulating in your body. Although recombinant products are available, these products are usually synthetic derivatives of a single growth factor. Fibrin glues are another product readily available to the physician. However, the fibrin glues currently marketed do not contain any growth factors and are virally inactivated derivatives of blood components drawn from other donors.

IS APC+ SAFE?

APC+ is derived from a small quantity of your own blood. The APC+ is made point-of-care under physician’s control. Also, since the APC+ is made from your own blood, it is insulated against the risk of disease transmission.

WHO MAKES APC+?

Historically, the production of APC+ at the time of surgery was complex, time consuming, expensive, and required large blood volumes. The process often involved outside personnel and a transfusion of blood products. The recent introduction of small automated, office based APC+ systems makes the benefits of APC+ practical in the office and outpatient setting. Now, our doctors and staff prepare APC+ in parallel with the surgical procedure.

HOW IS APC+ MADE?

20cc of your blood is placed in a specialized centrifuge that spins and automatically separates the red blood cells from the plasma. The plasma is then further centrifuged to concentrate the autologous platelets and hence your natural growth factors. The APC+ is then available for our doctors use as needed. The entire process takes less then 15 minutes.

WHAT IS AUTOLOGOUS PLATELET CONCENTRATE (APC+)?

Autologous Platelet Concentrate (APC+) is composed of platelets and plasma. Platelets are tiny cells that are partially responsible for causing blood to clot. Platelets also contain large reservoirs of natural growth factors. While a normal concentration of platelet circulating in your blood is 200,000 per micro liter, the platelet count in PRP can exceed 2 million platelets per micro liter.

WHAT ARE GROWTH FACTORS?

Platelets contain potent growth factors necessary to begin tissue repair and regeneration at the wound site. Growth factors derived from platelets initiate connective tissue healing, bone regeneration and repair, promote development of new blood vessels, and stimulate the wound healing process.

IS AUTOLOGOUS PLATELET CONCENTRATE ENRICHED WITH GROWTH FACTORS (APC+) FOR YOU?

The use of APC+ is considered by many to be a “new frontier” of clinical therapy. Since APC+ can be used in so many types of procedures and for so many types of patients, you should discuss your specific surgery with your doctor.

APC+, another treatment option for heel pain and plantar fasciitis.