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PRP vs ACP - or advantages of ACP

Posted: Wed Jun 22, 2022 10:18 am
by gaoshanfelix
Dr. Miten Sheth talks about Autologous Conditioned Plasma (ACP) and how it is different from Platelet Rich Plasma (PRP) during the Orthobiologics Webinar organised by Arthrex Inc. (USA).

Quite an interesting video. Essentially PRP and ACP are very similar - but ACP has a much better ratio of anabolic vs catabolic content. Some doctors may actually give you ACP and label it as PRP. The cost should be the same, as the time/effort for the injections is identical - it's only a different type of centrifuge.

One thing for sure is however, don't expect a huge difference. ACP likely just being a bit more effective than PRP - but if PRP isn't helping you, ACP won't either. Or maybe I'm falling for the sales pitch here in which way Arthrex wants to market it's centrifuges. It does sound quite plausible however. Likely other medical device producers may switch to something similar if it is true anyhow. Quite a few doctors that talk about PRP injections - actually have that Arthrex centrifuge anyhow so when you request PRP they may give you "ACP".

Also there is no study comparing ACP with traditional PRP. So you can only hope that the theory behind is correct (it's plausible at least).

Should you do HA or PRP/ACP. I would give a round of both a shot and see what works better for you. Start with PRP/ACP as in studies it was more effective - but personal factors can differ.

It surely showcases one of the main problems in this field, be it PRP, ACP, HA and so on. If it's not a brand name / you don't exactly know what you're getting - and different studies on one thing could be based on different actual content. It's like flour - there are many shades between a coarse full grain and fine white flour - but all will be sold as flour. Just that with the medical stuff you as patient have no clue what you're actually getting and can only trust your doctor (who will likely buy most of his equipment from on of the 3-4 big companies and just choose from one catalogue).

Actually a lot of the other injections, bone marrow aspirate, fat pad, and so on also all work on the same principle. Creating an environment in your knee that promotes self healing. PRP was shown in studies to be better than HA. So I would just choose the cheapest place (where I feel save the doctor knows where to insert the needle - because he is a knee surgeon with lots of experience) that does ACP. 60-80€ per injection in Germany is a going rate. Guess in Eastern Europe or India you could get it at 30-40€ per injection (enough to give a nice hourly salary). Surely I think this is the best bet out of this field. I really would not spend more on this and think food supplements are equivalent of better in the long run vs a single round of injections. Much more important anyhow is a healthy lifestyle, with decent amount of sports and a low BMI (without being underweight). If you have knee problems without accident - then a change of lifestyle is needed - else all will fail. If it's from accident(s) - then think about if it's worth it to continue doing dangerous activities. I will continue doing dangerous sports and just hope that I stay clear of further accidents - and hope every decade or so treatments/supplements get a bit better/knowledge about what works and what doesn't improve. But I do live very healthy with lots of sports to compensate for the risk factor because I psychologically cannot be happy without adventure sports, altitude/exposure/speed. I got my knee into a s**t condition that cost me 1 year to get back (if not more) - so I will reduce my risks a bit / think about more sustainable way of getting adrenaline via sports.

Here is a good article to give you some thought: ... snake-oil/

The treatment that actually looks best for me is HGH or HGH with PRP/ACP injections. Sadly this is the most expensive and hard to get. But HGH injections sound like actually the only injection that can regrow cartilage (though likely best before stage 4 arthritis). However before I would do a treatment regiment like Dr. Dunn which couples HGH injections with 6 weeks of non weight bearing, and further restrictions for 6 months - I would get a proper knee cartilage surgery. The pain may be less but the restrictions are similar - and there is no evidence of stage 4 cartilage regrowth simply with HGH and a 6 months rehab protocol.
While the studies by Dunn were not really professional (Centeno-Schultz has an explanation for that - though take anything from Centeno with a grain of salt as he wants to sell you Regenexx) - there was a recent study of HGH after ACL reconstruction - and a side effect of that was improved cartilage markers. This was HGH into the belly fat however. So not unlikely HGH will just act the same wherever it's injected. It will too work the same way as food supplements - creating an environment that is more favourable for cartilage regrowth. In Europe it's sadly really hard to get HGH. In US it's much easier to get a prescription.

Re: PRP vs ACP - or advantages of ACP

Posted: Sat Jul 16, 2022 9:50 pm
by Robert_Lloyd
gaoshanfelix wrote: However before I would do a treatment regiment like Dr. Dunn which couples HGH injections with 6 weeks of non weight bearing, and further restrictions for 6 months - I would get a proper knee cartilage surgery. The pain may be less but the restrictions are similar - and there is no evidence of stage 4 cartilage regrowth simply with HGH and a 6 months rehab protocol.
Well said. Dr. Dunn had me on crutches for many months following IAGH and it didn't regrow any cartilage. He claimed it did, but MRIs and follow up scopes showed otherwise. I wasted all this time on crutches for a worthless IAGH procedure. I flew to Florida many times for worthless follow up IAGH injections. I think IAGH is a total scam, but that's only my opinion. Now if Dr. Dunn had said IAGH only works on grade 2 damage we would be having an entirely different conversation. He promised IAGH works for grade 4 damage like I had.

Re: PRP vs ACP - or advantages of ACP

Posted: Fri Jul 22, 2022 12:05 am
by gaoshanfelix
I believe HGH could speed up/work if there are chondrocytes attaching and growing. So if you have MACI/Autocart/Microfracture and so on and your MRI shows undergrowth - then add some HGH and get a better chance of getting to full cartilage regrowth. If you are trending for overgrowth stay the heck away from it.

Similarily - I think HGH could help if the damage is small and rather from recent injury than from chronic use. If minced cartilage works - any abrasion on cartilage should also set free some chondrocytes - but the environment in your knee usually does not allow it to regrow. So there could be a chance for HGH to work also for grade 4 damage - but that chance being quite small.
And yes - most likely it doesn't batter at all if the HGH is right in your knee or into belly fat or wherever. It is about creating a more favourable environment for regrowth and if you're lucky kinda be that tipping point - more likely to just slow down degradation like food additivies.
Plus if you take a long break from sports - and just have HGH once - how is this gonna work? By resting your HGH levels fall. I think you should rather tackle HGH like bodybuilders do for doping for a 5-6 months period and take a break from any impact activities but continue bicycle/elliptical and later hiking and so on before getting back to running no earlier than 8-9 months. And yeah only by such an approach I would be willing to give it a try.