Dumb and Dumber: New PRP Ankle Sprain Research

By Chris Centeno, MD /

Receive a Regenexx® Patient Info Packet by email and learn why it's a superior regenerative solution.

prp ankle sprain

As you might be able to tell from reading these blogs, I love research. I read it voraciously, conduct studies, and publish it. But research, like all things can be smartly constructed or just plain dumb. I’d like to highlight a PRP ankle sprain study this morning that’s in the latter category.

PRP stands for platelet rich plasma, where platelets from whole blood are concentrated in serum. It should work by stimulating local stem cells and other cells to repair things faster or to prompt repair in an area that was unable to repair itself. Ankle sprains occur when the ankle ligaments are stretched, with most healing on their own. When they don’t heal, usually too much ligament damage has occurred for the body to be able to completely heal the micro and/or macro tears in the ligaments.

The new study looks great on the surface in that it’s randomized and double blinded, but it doesn’t take long to see how the authors doomed it to failure before ever injecting the first patient. The hypothesis seemed reasonable enough-a PRP shot in the emergency department for patients who look like they have a more severe ankle sprain will translate into faster healing of the ligament. Not a bad concept, although the first serious issue with the study is with it’s “control group”.

A control group in a study is one that isn’t treated or is treated with a treatment that we know won’t work so that the researchers can compare the treatment being tested to no treatment. However, what if your control group will also recover from the illness? This becomes a big issue when studying acute injuries that are expected to heal. This is why many researchers studying painful conditions chose chronic injuries, as they don’t usually recover on their own. Since acute ankle sprains tend to get better without care, choosing acute ankle injuries to study almost guarantees that the group without treatment will do pretty well. So in effect, if the study is a horse race between the control group and the PRP group, the control group began the race with a huge head start. If the authors would have waited a few weeks to only inject those patients that weren’t recovering, the horse race would have been more evenly matched and the study would have likely seen different results.

If you can chalk the first study flaw of treating acute ankle sprains up to hubris and a slip of common sense (or maybe that the study was conducted by ER doctors who only see the patient right after the injury), the second major study flaw was inexcusable in how it totally wasted the significant money spent on this study. We’ve known for some time that the anesthetic Marcaine (bupivicaine) kills stem cells as well as other cells quite dead. The authors of this study, for some unknown reason, chose to inject PRP plus lidocaine (which hurts stem cells) and Marcaine (which kills stem cells as well as tendon/ligament cells)! This last blunder likely insured that the cells the PRP were supposed to stimulate would be dead or dying by the time the PRP got there to do its job. Hence, more than any other thing they could have done, based on the research that exists, this decision virtually insured that the PRP group would do poorly. In essence, in our horse race, they set a stick of dynamite on the back of the PRP horse set to go off in the beginning of the race!

The upshot? The study of course concluded that PRP didn’t help ankle sprains heal more quickly than a saline shot control. At the end of the day, while all research is valuable in some respect, the study was a waste of money when looking at PRP effects. Because the authors chose to inject toxic anesthetics with PRP, we have no idea if the PRP would have helped these acute ankle sprains if used alone. More concerning for patients is that this study was actually approved by a major PRP machine manufacturer and went through many smart physicians who should have known better. How many patients are out there getting PRP shots with anesthetics we know are toxic to stem cells and other cells? The fact that this study exists, means to me that there are countless patients getting ineffective PRP shots from docs who haven’t gotten the memo that certain anesthetics kill cells.

Chris Centeno, MD

Regenexx Founder

Chris Centeno, MD is a specialist in regenerative medicine and the new field of Interventional Orthopedics. Centeno pioneered orthopedic stem cell procedures in 2005 and is responsible for a large amount of the published research on stem cell use for orthopedic applications.
View Profile

Get Blog Updates by Email

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Regenerative procedures are commonly used to treat musculoskelatal trauma, overuse injuries, and degenerative issues, including failed surgeries.
Select Your Problem Area
Shoulder

Shoulder

Many Shoulder and Rotator Cuff injuries are good candidates for regenerative treatments. Before considering shoulder arthroscopy or shoulder replacement, consider an evaluation of your condition with a regenerative treatment specialist.

  • Rotator Cuff Tears and Tendinitis
  • Shoulder Instability
  • SLAP Tear / Labral Tears
  • Shoulder Arthritis
  • Other Degenerative Conditions & Overuse Injuries
Learn More
Cervical Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Knee

Knees

Knees are the target of many common sports injuries. Sadly, they are also the target of a number of surgeries that research has frequently shown to be ineffective or minimally effective. Knee arthritis can also be a common cause for aging athletes to abandon the sports and activities they love. Regenerative procedures can be used to treat a wide range of knee injuries and conditions. They can even be used to reduce pain and delay knee replacement for more severe arthritis.

  • Knee Meniscus Tears
  • Knee ACL Tears
  • Knee Instability
  • Knee Osteoarthritis
  • Other Knee Ligaments / Tendons & Overuse Injuries
  • And more
Learn More
Lower Spine

Spine

Many spine injuries and degenerative conditions are good candidates for regenerative treatments and there are a number of studies showing promising results in treating a wide range of spine problems. Spine surgery should be a last resort for anyone, due to the cascade of negative effects it can have on the areas surrounding the surgery. And epidural steroid injections are problematic due to their long-term negative impact on bone density.

  • Herniated, Bulging, Protruding Discs
  • Degenerative Disc Disease
  • SI Joint Syndrome
  • Sciatica
  • Pinched Nerves and General Back Pain
  • And more
Learn More
Hand & Wrist

Hand & Wrist

Hand and wrist injuries and arthritis, carpal tunnel syndrome, and conditions relating to overuse of the thumb, are good candidates for regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Hand and Wrist Arthritis
  • Carpal Tunnel Syndrome
  • Trigger Finger
  • Thumb Arthritis (Basal Joint, CMC, Gamer’s Thumb, Texting Thumb)
  • Other conditions that cause pain
Learn More
Elbow

Elbow

Most injuries of the elbow’s tendons and ligaments, as well as arthritis, can be treated non-surgically with regenerative procedures.

  • Golfer’s elbow & Tennis elbow
  • Arthritis
  • Ulnar collateral ligament wear (common in baseball pitchers)
  • And more
Learn More
Hip

Hip

Hip injuries and degenerative conditions become more common with age. Do to the nature of the joint, it’s not quite as easy to injure as a knee, but it can take a beating and pain often develops over time. Whether a hip condition is acute or degenerative, regenerative procedures can help reduce pain and may help heal injured tissue, without the complications of invasive surgical hip procedures.

  • Labral Tear
  • Hip Arthritis
  • Hip Bursitis
  • Hip Sprain, Tendonitis or Inflammation
  • Hip Instability
Learn More
Foot & Ankle

Foot & Ankle

Foot and ankle injuries are common in athletes. These injuries can often benefit from non-surgical regenerative treatments. Before considering surgery, consider an evaluation of your condition with a regenerative treatment specialist.
  • Ankle Arthritis
  • Plantar fasciitis
  • Ligament sprains or tears
  • Other conditions that cause pain
Learn More

Is Regenexx Right For You?

Request a free Regenexx Info Packet

REGENEXX WEBINARS

Learn about the #1 Stem Cell & Platelet Procedures for treating arthritis, common joint injuries & spine pain.

Join a Webinar

RECEIVE BLOG ARTICLES BY EMAIL

Get fresh updates and insights from Regenexx delivered straight to your inbox.

Subscribe to the Blog

FOLLOW US

Copyright © Regenexx 2019. All rights reserved. | Privacy Policy

*DISCLAIMER: Like all medical procedures, Regenexx® Procedures have a success and failure rate. Patient reviews and testimonials on this site should not be interpreted as a statement on the effectiveness of our treatments for anyone else.

Providers listed on the Regenexx website are for informational purposes only and are not a recommendation from Regenexx for a specific provider or a guarantee of the outcome of any treatment you receive.