Kobe Bryant went to Germany last month to have an innovative PRP procedure performed in his right knee. To clarify exactly what the procedure is, and if it can add some youth to Kobe’s right knee, the Voice of the Nation spoke with Dr. Bal Raj. A board certified Orthopedic Surgeon in Beverly Hills, specializing in sports & fitness procedures.
Below is the transcript of the interview:
David Brickley: What procedure did Kobe go to Germany for, to try to add some youth to those legs?
Dr. Raj: We have to clarify one thing about Kobe, he doesn’t have a classic arthritic knee. Arthritis is degradation of the cartilage within your knee that happens over time and there are genetic and environmental factors. With respect to Kobe, he’s a top athlete and he has damaged areas of his knee where he lost cartilage. This is what he has been dealing with and in May of 2010, he had surgery where he had fragments removed out of his knee.
When he went to Germany, he actually went to have PRP done. P stands for platelets, it’s derived from your own blood. After filtering your own blood, you take cells out and the plasma out and you have platelets remaining. The advantage of these platelets is that they are highly concentrated, about 10x the concentration of what is in your normal blood. They can be injected directly into damaged areas and [the platelets] catalyze the growth of normal and new tissue. Blood platelets contain what we call potent globe factors which are necessary to begin tissue repair and regenerate at our injury site.
This technology has been around since the 70s but as of recent, around the past five years, it’s become more and more popular because we’ve realized these concentrated platelets contain large reservoirs of globe factors and cytokines. Not only do they provide a scaffold for healing for tissues in damaged areas, they also induce those cells that are able to produce, such as chondrocytes, to produce more cartilage. On top of that, they are significant anti-inflammatory effects as well. In respect to Kobe’s knee, this actually is one of the best options that is out there at this point.
DB: Is there a reason he went to Germany, is this not approved yet in the USA or still in the process of getting approved?
Dr. Raj: I think the biggest reason he went to Germany is because in the US there has been a lot of controversy about the usage of PRP. We’ve had a lot of physicians start using it without understanding why and what they are using it for and for what indications. Because of that, there is a lack of data. In Europe, especially Germany, they tend to be a lot more advanced and a lot more accepting and don’t have as strong of regulatory factors as we do here in the USA. I would suspect because of the proven data and the data out there in Germany, that’s probably why he went to Germany to get this done.
Kevin Figgers: Kobe’s not the first athlete to try this. I believe Tiger Woods had this procedure done, and his career has yet to get back on track. I believe Brandon Roy had this procedure last season before he made his comeback with Portland in the postseason. I also think Batorlo Colon, the pitcher for the Yankees, also had that and he’s having a bounce back season. Is it a situation where this is still in the experimental process, is really not full proof, and can work for some athletes and not work for others? Are the exact results of this procedure inconclusive?
Dr. Raj: Kobe’s situation where he has damaged cartilage and loss of cartilage within his knee, his options are limited. You start jumping into the realm of replacements. You and I know a replacement and a young athlete, will destroy someone’s career. The goal is joint preserving technologies. The issue with PRP is, although we don’t have a lot of data, we do have studies. Such as Stanford in 2006, 20-25 patients had significantly positive result with PRP injections. There are studies supporting it, but there is currently no strong study out there. At the end of the day, when we’re talking about joint prevention, it’s a minor financial loss for these players but there is no harm in trying PHP.
Jason Riley: In the case of Laker center Andrew Bynum, based on what you know of his injuries, should it be expected that we’ll see more instances of this same kind of injury or is it something that he can clear up as time goes on.
Dr. Raj: I’ll be honest with you, at his young age right now and with his size, it’s going to be a perpetual problem for Andrew.
It’s two factors. Once you lose cartilage, cartilage doesn’t automatically regenerate back. You lose it, it’s gone. From damage and impact. What normal basketball players go through in terms of cycle and impact, it’s definitely not going to get better, and unfortunately, rest is not an option for players.
DB: Well we will see if this helps Kobe play at a prime level for a few more years.
Dr. Raj: I will say one thing that’s coming about right now, we’re starting to realize, in fact myself, the addition of stem cells with PRP for arthritis is becoming more and more en vogue because it is these stem cells that are going to be basically activated by growth factors of the platelets that will cause the production of cartilage in these areas that are devoid of cartilage.
To listen to the interview with Dr.Raj download Voice of the Nation #145