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pilot study prp arthrose

Mesotherapy & Traumatology up to date

Meso Aesthetic

To inject successfully in aesthetic medicine, the trainee has to be an expert using point per point technique (PPP) and nappage bouncing (N). The needle utilized is between 4 and 13 mm length (27G to 32G). FACE MESOLIFT Usually we mix unlinked hyaluronic acid, multi vitamins and procaine for the face. We disagree with the use of linked hyaluronic acid because it contains BDDE (Buthanediol, Diglycidyl, Ether) and this could induce side effects. The technique for face mesolift is nappage bouncing. Avoid the use of the meso-roller devices sold online. Experts condemn the use of the roller device. At the present, it is not clear which PM (Molecule weight) and concentration per ml is linked with which results. It could be interesting to add in hyaluronic acid, sorbutol or glycerol. Some hospital studies on skin kept alive and treated with meso shows effectiveness of these treatments. In clinical practice we recommend 3 sessions one month apart. Presently we have not found any serious studies concerning PRP (Platelets with Plasma) injections for mesolift. On dark, more pigmented skin, we prefer to use the PPP technique. HAND MESOLIFT The technique is the same as for the face. We read an interesting study using ultra sound before and after session to prove that after 4 sessions with hyaluronic acid rejuvenation of the skin occurred. MESOTHERAPY USE FOR TOBACCO CESSATION Mesotherapy has proved extremely useful in esthetic and anti-aging medicine. More than 12,000 cases treated since 1976 (Dr Walter). Cocktail used: PROCAINE 2% 0.5 cc- MAG2 0.5 cc- BEVITINE 1 cc (Note unpleasant smell and taste of B1 Vitamin)- 6 intradermal papules of 0.1 cc each (I.D.S.)- Injection into the nasogenial fold, base of the antehelix (point 0 in acupunture) and a point located at 3 finger breaths above the top of the ear ( main drug treatment point # 8 VB in acupuncture)-70% of positive results at 1 year follow-up( 60% at 10 or 20 years FU). BODY Cellulite: Meso Fat dissolution: Active ingredients are not used since the fat dissolution is caused by the dynamic osmolarity effect of the decrease of the Intracellular osmolarity from 300 mosm/l to 130 mosm/l. The main ingredient used is water at more than 90% in a mixture which includes Xylocaine and Normal Saline. A preliminary test was performed by the author with the use of a 6 mm needle for injection. Echography control tests performed before and after treatment showed the ineffectiveness of the method. The author is a strong advocate of undertaking a new study with the use of a 13 mm needle instead and an increased dose at the injection points. Localized fat deposits: The use of PPC (Phosphatidylcholine) is not authorized in France. However, our foreign colleagues who are present attest to its usefulness. Some positive results have been obtained both with PPC and DC (Deoxycholate). News update on mesotherapy: Several products have been unfortunately taken off the market. Among those still available are ETAMSYLATE or DICYNONE, ISKEDIL and PROCAINE or CALCITONINS with their vaso-active properties. CHELATRAN has been replaced by CALCIUM SODIUM EDETATE 5% manufactured by SERB laboratories. It is offered in boxes of 10 ampullas of 10cc, costing approximately 70 ? (For use in the treatment of calcifications, Dupuytren?s disease, Peyronie?s disease). Interesting use of Vitamin E Napalm in the treatment of fibrosis has been reported. Use of Polyvitamins: SOLUVIT and CERNEVIT. CAFEINE 25mg/cc and CONJONCTYL are still available on the market.

1. Mesotherapy For Best Results: One session per week If no results after 3 sessions reconsider your diagnosis or consider a different treatment; Dilute medicines with procaine, lidocaine or normal saline; Never inject cortisone; Use-1 syringe-one needle per patient; Do not prepare the medication mixtures in advance (a long time before injecting); Never use pure NSAID?s; No physiotherapy or manual treatment on the same day as a mesotherapy treatment; No concomitant treatment with shock waves; It is possible to do sports the day of treatment; There should be no pain and no bruising with injections when the technique is done correctly. Step One-disinfect the skin; Step Two-pull up the skin; Step Three-inject into the fold created by the tension on the skin; Introduce the needle quickly and inject small amounts of solution slowly. 2. Platelet Rich Plasma The Autologous Platelet Rich Plasma (A-PRP) is a bioactive substance prepared from your own blood. Thanks to a dedicated and authorized medical device, through a single step of centrifugation, blood components are separated to collect int he plasma the greatest number of platelets. These cells release signals, through little proteins called growth factors, to stimulate the process of tissue regeneration. For the past 3 years I have used platelets rich plasma injecting with a 6 or 13 mm length needle (27 or 30 G) for treatment of the superficial tendons (Achilles, epicondilytis, patella). A study I just have finished on epicondilytis shows 86% response rate to this approach. 3. Prolotherapy (American origin) Inject into the tendon or into the joint; Diluted dextrose. In France I have used this technique for 30 years with a small 30G needle injecting into the superficial tendons-Achilles or patella tendon with glucose 30% and have achieved good results.



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