The PRP Wars and the Planet Academia
Sometimes I read media stories written about PRP and I say to myself, “What planet are these guys from?” I have now answered that question, they are from the planet Academia. It’s an interesting place at odds with itself, so let’s dig into what we know.
The Dichotomous Media Stories that Inspired this Blog
This fall there were two stories that were diametrically opposed that featured PRP:
- US stem cell clinics boomed while FDA paused crackdown
- Could Platelet-Rich Plasma Injections Help Avoid Knee Surgery?
Both of these were published by the Washington Post. The first article was supposed to be about stem cell clinics but instead devolved into a bizarre discussion of Platelet-Rich Plasma. It turned out to be a hit piece that talked about a very rare poor outcome of a single patient who had shoulder pain. It then used the silly “research” published by Pew, which instead of any kind of actual research into the complication rates of biologic therapies, is instead just a collection of random bad outcomes without any sense of how many patients were treated to get those complications. Meaning, NOT scientific in any way. The academics here, hand-picked for this story, were very negative about PRP.
The second article, published by the same news outlet, couldn’t be more different. It actually quotes an academic physician expert on PRP who uses this therapy and is largely encouraging. This makes sense, given the many randomized controlled trials published showing the efficacy of PRP when used to treat various orthopedic conditions. The academics quoted in this piece represent a much larger contingent of academics at American university medical schools who now use PRP in their daily practices.
After reading the first piece, I thought to myself, what planet are these guys from? Through a little sci-fi parody this morning, let’s learn about which planet that is, the planet Academia.
Sci-Fi as Social Commentary
Before we dive into the planet Academia, let me explain where I’m coming from this morning. Back in the 60s, Gene Roddenberry showed us that a good Sci-Fi plot could help jettison our usual way of thinking and make us question what we usually believe. His quintessential episode of Star Trek that exposed the racial injustices of the 60s was built around a planet where half the population was black on the right side and white on the left and the other half was the opposite. These two species were at war with each other, which didn’t make any sense to the viewer or the crew of the Enterprise. This served as critical social commentary in the middle of the upheaval that was the 60s. Let’s borrow from Gene today as I help you understand why you see what you see in the media about PRP.
The Planet Academia
This newly discovered planet has two large and powerful waring continents. The first is called “Labatria”. This is populated by bench scientists and other academics who don’t really know much about the clinical use of PRP. The economy of Labatria is run off government grants and licensing patents fueled by the discoveries of the scientists who occupy the region. They have formed a country called the “ISSCR” which seeks to protect the interests of the population of Labatria. This country is at war with the other continent.
The other half of the planet has a continent called “Medatria”. This region is populated by medical doctors who care for patients. The Populus here knows quite a bit about PRP and the economy is run by the revenues generated by treating happy patients. Meaning if patients are helped, Medatria prospers. They have formed several countries that seek to protect the interests of the population.
The PRP Wars
Why would the lab scientists living in Labtria care about the use of Platelet-Rich Plasma by the doctors in Medatria? Like most wars here on our planet, the reason makes no common sense. Let’s dig in.
The lab scientists are focused on the scientific method above all else, in fact, you could say that scientific evidence is their religion. However, the doctors have copious scientific evidence that PRP helps patients. For example, they can site dozens of randomized controlled trials that show that PRP injections can safely help things like knee arthritis, which is more research than supports more invasive therapies like knee replacement. Hence, why in the world would the lab scientists in Labtria be upset? Money.
It turns out that the economy of Labatria is run by government grants and discoveries. Hence, when something as simple as PRP comes around and works, it threatens the dollars being generated by grants and the discoveries of more complex solutions. For example, who wants to fund studies on new cell-based treatments for knee arthritis or license those discoveries when a solution is already in use that works? Hence, with its ability to earn income threatened, Latria is waging war on Medatria.
The War Is Fought in the Media
Unlike wars here on earth, on planet Academia, the wars are fought in the court of public opinion through the use of the media. The country ISSCR, every year, seeds stories to journalists that attend its annual conference, who armed with what they believe is accurate information, wage war on Medatria. Every once in a while, Medatria is able to get a journalist to expose the truth about the research behind PRP. Hence, we see the back and forth of the PRP wars.
Back in the Real World
While I may have watched far too many Star Trek episodes, hopefully, this parody helps you understand why you continue to see dueling media pieces on PRP. In the real world, these media pieces happen because PRP does threaten the “economy” of lab scientists. Hence, now you know, that few of these stories have anything to do with actual science or the scientific method, but instead represent two sides of US universities who are “warring” with each other.
The upshot? The positive randomized controlled trials on PRP continue to be published at a furious pace. In the real world, that’s fantastic for medical doctors looking for new ways to help their patients that are less destructive than surgery. However, far far away on the planet Academia and in the media, the wars continue. I mostly just ignore the drama and try to focus my energy on helping patients.