Innovative Treatment Keeps Athlete in Motion After Troubling Knee Injury

August 31, 2021

Jamie Christensen, 28, is constantly on the go at work and play. Her occupational therapist duties at JFK Johnson Rehabilitation Institute revolve around helping patients after illness or injury to relearn basic self-care tasks such as transitioning out of bed to sitting, standing or other daily activities. An avid runner since age 12, Jamie also added weightlifting and intramural team sports to her activities in recent years, using exercise as a physical and social outlet.

When the stress of her activities injured her left knee—leading to throbbing pain and limiting her ability to pursue her passions—the Bridgewater, New Jersey, woman turned to her colleagues and the expert physicians at JFK Johnson Rehabilitation Institute for a novel, in-office treatment that used her own cells to help her heal.

“Anytime I would squat to bend down with a patient, it would hurt a lot. Whether getting in and out of the car or walking up the stairs, it seemed I was in pain all the time,” Jamie recalls. “Having pain on the job and not having an outlet to run, lift weights or see my friends was very challenging.”

Mounting Evidence for Benefits 

Previously treated for a foot injury by physiatrist Craig Van Dien, M.D., at the Center for Sports and Spine Medicine at JFK Johnson Rehabilitation Institute, she again turned to Dr. Van Dien when knee pain struck in early 2019. He diagnosed her with a partial tear of the patellar tendon, which attaches the kneecap to the shinbone and helps thigh muscles straighten the leg.

“Patellar tendinopathies are commonly encountered in athletes,” explains Dr. Van Dien, who specializes in sports and musculoskeletal medicine (injuries to bones, tendons, ligaments and muscles). “Tasks that repeatedly stress the tendon, like jumping, may result in tendon injury and discomfort.”

After a short period of rest, ice and elevation, followed by an eight-week course of physical therapy, didn’t significantly improve Jamie’s symptoms, Dr. Van Dien recommended an innovative treatment called platelet-rich plasma therapy, or PRP. Increasingly tapped since the 1980s, the technique injects concentrated platelets from a patient’s own blood into injured or diseased tissue to enhance the healing process and reduce pain.

“Platelets are cells that already exist within blood and function to form a clot when you bleed,” Dr. Van Dien explains. “They’re also a rich source of growth factors that have the potential to promote tissue repair.”

While PRP use has “increased significantly” for musculoskeletal conditions like Jamie’s, Dr. Van Dien notes, the procedure is not generally covered by health insurance. But mounting research is demonstrating PRP’s benefits. “The idea is to try to augment healing in an area that doesn’t tend to heal well on its own, such as tendons,” he says.

The treatment is both quick and straightforward. Drawing Jamie’s blood, Dr. Van Dien placed it in a centrifuge to separate platelets from red and white blood cells. He then used ultrasound imaging to guide his injection of platelets into the front of Jamie’s knee in the region of her injured tendon. Local anesthesia tends to “deactivate” PRP cells, he says, so it was not used.

“The procedure lasted about 10 minutes,” Jamie says. “It was painful, but Dr. Van Dien was honest about that, so I knew what to expect. He was very good about explaining everything to me.”

Returning to Cherished Activities

The 24 hours after Jamie’s PRP treatment also proved uncomfortable. Beyond that, however, Jamie felt no lingering pain from the procedure, noticing over weeks that her knee gained strength and hurt less. As with all PRP patients, Dr. Van Dien recommended a gradual return to normal movement.

“Our hope is by six weeks they can get back to full activity,” he explains. “A patient’s clinical response—how they feel—is always the most important thing to me.”

Dr. Van Dien was encouraged by Jamie’s reports of less pain, while follow-up ultrasounds showed significant healing of her patellar tendon. Jamie is gratefully back to running and weightlifting, feeling confident in her knee’s ability to also handle her physically demanding job.

“If we can get a patient back to doing what they were doing, that’s a wonderful outcome,” Dr. Van Dien says. “That’s our endpoint. For Jamie, the fact she was able to return to previous activities meant success.”

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