Platelet therapy has some fans, others ambivalent

SEATTLE — Mariners pitcher Cliff Lee isn't sure how he got the abdominal strain that kept him on the bench early this season.

Was he throwing too hard? Did something rip when he collided with a catcher in spring training?

Likewise, Lee can't say whether the curious treatment he tried — injecting a therapeutic component of his own blood into the sore spot — accelerated his recovery.

"It seemed like it should help, but who really knows?" said the 2008 American League Cy Young Award winner.

The scientific evidence to support the treatment, called platelet-rich plasma, or PRP, is equally ambiguous.

But that hasn't kept athletes, both amateur and pro, from clamoring for it. And while some doctors advise caution, others now rely on PRP as one of their main tools to treat patients with stubborn tendon and joint pain.

"We've had some amazing successes with it, and we've had some people who haven't gotten better," said University of Washington sports-medicine specialist Dr. Kim Harmon, who estimates she and her colleagues have administered at least 400 of the injections.

Demand is fueled partly by the examples of high-profile athletes, such as golfer Tiger Woods and Pittsburgh Steelers wide receiver Hines Ward, who both used it for knee problems. Other drivers are the desperation of folks hobbled by their fraying infrastructure, and the frustration of doctors with few other options to offer.

Enthusiasm has so outpaced research that an editorial in the American Journal of Sports Medicine warned PRP has been "elevated to the level of platelet-rich panacea." Even the cost, which can range from $800 to $1,200 or more and isn't covered by most insurance, hasn't proved much of a deterrent.

With a $9 million salary, price was no object for Lee. His goal was to return to the mound as quickly as possible. So when team doctor Ed Khalfayan suggested PRP, Lee did some research and decided it was worth a shot.

"In professional baseball, if you can cut recovery time from three weeks to two-and-a-half weeks, that's a big deal," he said.

In the treatment, a couple of tablespoons of the patient's blood are spun in a centrifuge to separate out tiny cells called platelets. Best known for their role in blood clotting, platelets also contain dozens of growth factors and other substances that help clear away dead tissue, patch up damaged areas and attract other repair cells to a wound.