The Chiropractic Forward Podcast: Evidence-based Chiropractic Advocacy

PRP For Knee Osteoarthritis & Cervical Dizziness With Cervical Spondylosis


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CF 337: PRP For Knee Osteoarthritis & Cervical Dizziness With Cervical Spondylosis
Today we’re going to talk about PRP For Knee Osteoarthritis & Cervical Dizziness With Cervical Spondylosis
But first, here’s that sweet sweet bumper music
 

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OK, we are back and you have found the Chiropractic Forward Podcast where we are giving evidence-based chiropractic a little personality and making it profitable.
We’re not the stuffy, elitist, pretentious kind of research. We’re research talk over a couple of beers. So grab you a bushel. 
I’m Dr. Jeff Williams and I’m your host for the Chiropractic Forward podcast.  I’m so glad you’re spending your time with us learning together. 
Chiropractors – I’m hiring at my personal clinic. I need talent, ambition, smarts, personality, and easy to get along with associates. If this is you and Amarillo, TX is your speed, send me an email at [email protected]
If you haven’t yet I have a few things you should do. 
  • Go to Amazon and check our my book called The Remarkable Truth About Chiropractic: A Unique Journey Into The Research. It’s excellent resource for you and is categorized into sections so the information is easy to find and written in a way that is easy to understand for everyone. It’s on Amazon. That’s the Remarkable Truth About Chiropractic by Jeff Williams. 
  • Like our Chiropractic Forward Facebook page, 
  • Join our private Chiropractic Forward Facebook group, and then 
  • Review our podcast on wherever you listen to it 
  • Last thing real quick, we also have an evidence-based brochure and poster store at chiropracticforward.com
  • You have found yourself smack dab in the middle of Episode #337
    Now if you missed last week’s episode, we talked about Spinal Manipulative Treatment And Lumbar Discectomy & Initial Providers Matter. 
    Make sure you don’t miss that info. Keep up with the class. 
    On the personal end of things…..
    I just returned from a big weekend in Frisco, TX. Which is basically Dallas. It’s where we held the big Texas Chiropractic Association ChiroTexpo which is what we call our state convention, basically. 
    We had abotu 300 registered attendees. It’s not up there with Parker Vegas or the Florida state convention but it was well-attended and had some reminders of the way the conventions were prior to COVID. I think that’s our generation’s measuring stick now. 
    Life before COVID and life after COVID. 
    I’m trying to quit measuring my practice to pre-COVID. It’s still not there but we have a new reality and we still have goals so…..that’s going to have to be good enough. My goals are pretty clear and defined. For me personally, I got it figured out. Here’s how it goes. 
    I have three long days and 2 short days. On the long days, I need to see 42 each of the three long days and 30 on each of the 2 short days. 
    These are relatively easy and straightforward days and at the end of the week, we’ll have seen 186 patients. That’s more than enough to keep my train rolling down the tracks. I’m probably in the area of around 155-160 per week at the moment. And, as you can probably tell, that depends on which week you ask me about it. It’s so up and down lately that it gets pretty frustrating but it seems to be trending up and up overall. 
    I hope you’re staying involved in your state association. You develop old friends, colleagues, and a network. Not only in the association but, in case you didn’t know it, a lot of folks, when they age out of the association leadership and positions, they transition over to the regulatory board of the state. Which means you also have connections and a network on that board as well and that’s always good to be a part of and have some insight in. 
    We evidence-based providers sit around fussing about the woo and the crazies in our industry and I promise you….you can’t change it by bitching about it. You HAVE to be active. You HAVE to wield influence and you can only do that if you are involved, if you volunteer, if you sit on committees, if you head departments, if you sit on the Board for a couple of years. 
    These are the ways we start to have an impact. If you’re so inclined, you can go through the chairs and sit as President of your state association. I promise you can. They need people and all you have to do is start raising   it. 
    Former State Presidents transition over to the ACA many times and continue to wield influence over there on a national level. The only thing keeping you from doing it is you. 
    So basically……Quit bitching and raise your hands. 
    Item #1
    Today’s first one is called, “Platelet-Rich Plasma Therapy: An Effective Approach for Managing Knee Osteoarthritis” by Crowley et al and published in Cureus in December of 2023 and it’s steamy!
    Remember, the citations can be found at chiropracticforward.com under this episode. 
    Crowley JL, Soti V. Platelet-Rich Plasma Therapy: An Effective Approach for Managing Knee Osteoarthritis. Cureus. 2023 Dec 19;15(12):e50774. doi: 10.7759/cureus.50774. PMID: 38116024; PMCID: PMC10729545.
    Why They Did It
    • Platelet-rich plasma (PRP) is a promising non-invasive therapeutic intervention for knee osteoarthritis (KOA) that has generated significant interest due to anecdotal accounts of its efficacy, resulting in reduced recovery time in various orthopedic interventions. 
    • This systematic review examines the effectiveness of PRP in managing KOA. 
    • Specifically, it seeks to determine the extent to which PRP can treat KOA patients effectively, alleviate KOA symptoms, and improve patient outcomes. 
    • Additionally, the review aims to identify the optimal concentration and composition of PRP required to achieve therapeutic results in KOA. 
    • Furthermore, the review investigates whether PRP can modify the synovial environment structurally and immunologically to improve outcomes in KOA patients. 
    • How They Did It
      We conducted a comprehensive literature search on PubMed, Orthogate, Clinicaltrials.gov, and Embase of clinical trials investigating PRP treatment in KOA patients in the last five years. 
      What They Found
      • The results indicated that PRP is effective in treating KOA patients. 
      • Evidence shows that PRP therapy can alleviate pain, enhance joint function, increase range of motion, and improve mobility in KOA patients. 
      • PRP was effective in treating KOA when the mean platelet concentration of PRP treatment was 4.83 to 5.91 times higher than the baseline whole blood platelet concentration. 
      • However, studies investigating PRP with a mean platelet concentration of 3.48 to 4.04 times higher than baseline failed to demonstrate statistically significant improvements. 
      • Wrap It Up
        • PRP therapy slowed down KOA progression, which validates its effectiveness in impeding further structural damage and arresting the degenerative impact of the disease. 
        • Nonetheless, further investigation is necessary to examine how PRP therapy can modify the progression of the disease. 
        • Furthermore, future research should identify the most effective platelet concentration levels that provide optimal symptom relief. 
        • There is a need for further research to identify the specific PRP configuration that is most pertinent in a clinical setting, as there is a lack of standardization in PRP manufacturing protocols, including the variety of experimental setups and dosing schedules utilized in different studies.
        • Item #2
          The second one is called, “Risk of Cervical Dizziness in Patients With Cervical Spondylosis” by Chang et al and published in JAMA network in December of 2023 and it’s equally steamy….
          Chang T, Wang Z, Lee X, Kuo Y, Schubert MC. Risk of Cervical Dizziness in Patients With Cervical Spondylosis. JAMA Otolaryngol Head Neck Surg. 2024;150(2):93–98. doi:10.1001/jamaoto.2023.3810
          Why They Did It
          • To compare the risk of dizziness between patients with cervical spondylosis and matched controls (ie, patients with lumbar spondylosis after propensity score matching [PSM]).
          • Are patients with cervical spondylosis more likely than patients with lumbar spondylosis to have cervical dizziness?
          • How They Did It
            • This cohort study used medical claims data from the National Health Insurance Research Database of Taiwan for patients 60 years or older with cervical or lumbar spondylosis newly diagnosed in any outpatient department between January 1, 2010, and December 31, 2015. 
            • Patients diagnosed with cervical spondylosis were included as the study cohort, and those diagnosed with lumbar spondylosis who were matched to the study cohort via propensity score matching were selected as the control cohort. 
            • Both cohorts were followed up for 1 year unless they were diagnosed with dizziness, censored by death, or withdrew from the health insurance program. 
            • The main outcome was the date of outpatient diagnosis of dizziness. The risks of dizziness were compared between groups. The relative risk and incidence rate difference were calculated.
            • A total of 3,638 patients with cervical spondylosis and 3,638 patients with lumbar spondylosis after propensity score matching were selected as the study and control cohorts, respectively.
            • What They Found
              • The patients with cervical spondylosis had higher risk of dizziness than matched controls, with a 1-year relative risk of 1.20. 
              • The 1-year incidence of dizziness was 10.2% in patients with cervical spondylosis and 8.6% in the matched group of lumbar spondylosis. 
              • The incidence rate difference between the groups was 1.6%
              • Wrap It Up
                • These data support the association between dizziness and cervical spondylosis, but the small difference between groups reveals that dizziness associated with cervical spondylosis is uncommon. 
                • Clinicians should be wary of diagnosing a cervical cause for dizziness based on an actual history of cervical spondylosis.
                • Alright, that’s it. Now you know stuff you didn’t know before. 
                  Keep on keepin’ on. Keep changing our profession from your corner of the world. The world needs evidence-based, patient-centered practitioners driving the bus. The profession needs us in the ACA and involved in leadership of state associations. So quit griping about the profession if you’re doing nothing to make it better. Get active, get involved, and make it happen.
                  Let’s get to the message. Same as it is every week. 
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                  Purchase Dr. Williams’s book, a perfect educational tool and chiropractic research reference for the daily practitioner, from the Amazon store TODAY!

                  The Message
                  I want you to know with absolute certainty that when Chiropractic is at its best, you can’t beat the risk vs reward ratio because spinal pain is primarily a movement-related pain and typically responds better to movement-related treatment rather than chemical treatments like pills and shots.
                  When compared to the traditional medical model, research and clinical experience show us patients can get good to excellent results for headaches, neck pain, back pain, and joint pain to name just a few.
                  It’s safe and cost-effective can decrease surgeries & disability and we do it through conservative, non-surgical means with minimal hassle to the patient.
                  And, if the patient treats preventatively after initial recovery, we can usually keep it that way while raising the overall level of health!
                  Key Point:
                  At the end of the day, patients should have the guarantee of having the best treatment that offers the least harm. When it comes to non-complicated musculoskeletal complaints….
                  That’s Chiropractic!
                  Contact
                  Send us an email at dr dot williams at chiropracticforward.com and let us know what you think of our show and tell us your suggestions for future episodes. 
                  Feedback and constructive criticism is a blessing and so are subscribes and excellent reviews on podcast platforms. 
                  We know how this works by now. If you value something, you have to share it, interact with it, review it, talk about it from time to time, and actively hit a few buttons to support it here and there when asked. It really does make a big difference. 
                  Connect
                  We can’t wait to connect with you again next week. From the Chiropractic Forward Podcast flight deck, this is Dr. Jeff Williams saying upward, onward, and forward.
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                  About the Author & Host
                  Dr. Jeff Williams – Fellow of the International Academy of Neuromusculoskeletal Medicine (FIANM) and Board Certified Diplomate of the American Board of Forensic Professionals (DABFP) – Chiropractor in Amarillo, TX, Chiropractic Advocate, Author, Entrepreneur, Educator, Businessman, Marketer, and Healthcare Blogger & Vlogger

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