BACKGROUND: According to the American Academy of Orthopaedic Surgeons, one in seven people in the United States has a musculoskeletal impairment. Musculoskeletal conditions include injuries to bones, joints, muscles, ligaments or tendons. They also include chronic diseases such as arthritis and osteoporosis. In 2003, there were nearly 157 million visits to the doctor for musculoskeletal conditions, and more than 8 million people were hospitalized because of a musculoskeletal injury. Treating musculoskeletal disorders costs the United States about $215 billion each year and in 2003, caused employed workers to miss more than 147 million days of work.

RELIEVE THE PAIN WITH YOUR OWN BLOOD: Researchers are studying new ways to treat damaged tendons and other parts of the musculoskeletal system. Allan Mishra, M.D., from Stanford University Medical Center, has been studying platelet-rich plasma to heal the pain associated with tennis elbow. Platelet-rich plasma is derived from a patient's own blood. Dr. Mishra draws a patient's blood and simply spins it down in a centrifuge to separate the red blood cells from the platelet-rich plasma. Once it's separated, the platelet-rich plasma is drawn into a syringe and injected back into the patient near the injured area. In the initial studies, the platelet-rich plasma was injected into the damaged tendons of elbows -- and then knees. Dr. Mishra says, "The platelets in white blood cells have high concentrations of growth factors, which are small molecules that initiate tissue regeneration." In the first study, Dr. Mishra found platelet-rich plasma had a 93 percent success rate with an average two-year follow up. In comparison, the success rate for surgery is between 85 percent and 90 percent. Dr. Mishra says, "We're mimicking the surgical success rate with a simple injection procedure."

WHAT'S NEXT? Tendons aren't the only body parts Dr. Mishra thinks platelet-rich plasma will help. His research team plans to soon start a study looking at platelet-rich plasma as a way to regenerate cartilage in the knee. He says, "There are also some people in Europe looking at directly just injecting [platelet-rich plasma] into the knee for arthritis of the knee." Another promising area is the back. Dr. Misha hopes the procedure will help people with degenerative disc disease where there has been degradation of the cartilage, and the disk has dried out. He says, "If we could rehydrate the disc and have that last over time; that would be a dramatic improvement over what's available right now."

SIMPLICITY: Because the platelet-rich plasma comes from a patient's own blood and can be done as an outpatient procedure, there are no risks of disease contamination or rejection involved with the procedure. Dr. Mishra says, "It's your own stuff, your own blood, minimally processed and injected right back into you within an hour. The concept is ridiculously simple. The power to heal yourself comes from within. Your own body has developed the ability to take care of itself, and we're just simply trying to concentrate or maximize that ability."