For athletes, the field of regenerative medicine has been of particular interest in recent years because it has been promoted as a way to recover from sports injuries faster, often through the use of biological substances like platelet rich plasma (PRP).
While the efficacy of biological treatments is still under investigation, it’s important for athletes to understand how the use of orthobiologics is handled under the World Anti-Doping Code. Keep reading to explore the complicated field of regenerative medicine and learn more about PRP, which is just one of many biological therapies.
What does the term orthobiologics mean?
Most commonly associated with sports injuries, orthobiologics are biological substances, such as platelet-rich plasma (PRP) or stem cells, used to speed the healing process for musculoskeletal injuries. They may be used alone or in combination with conventional pharmaceutical and non-pharmaceutical based treatment. More specifically, orthobiologic therapies introduce high concentrations of naturally occurring cellular concentrates to an injury site with the intention of expediting the healing of muscles, ligaments, tendons, bones, and other tissues; thereby shortening recovery time and decreasing injury-related inflammation and pain.
In sports medicine, orthobiologic treatments are used to treat both acute and chronic conditions, including common conditions caused by overuse. Athletes and orthopedists often turn to orthobiologic therapies in the hope of returning an athlete to preinjury physical condition as soon as possible. For the most part, orthopedists will attempt to use biologics in place of pharmaceuticals and/or invasive surgery.
What is PRP?
Even though blood is primarily a liquid (plasma), it also holds microscopic solid elements, or white blood cells, red blood cells, and platelets. Platelets play an integral role in clotting blood, but they also contain proteins known as growth factors, which support healing and recovery processes.
With PRP, the plasma contains significantly more platelets than normal, so the concentration of growth factors can be five to 10 times higher than normal. Platelets are known to provide a diverse array of growth promoters that have the ability to work independently or with other proteins and cells to improve the healing process.
How is PRP used in regenerative medicine?
For PRP therapy, a patient first provides a blood sample, which goes through a process known as centrifugation to separate and concentrate the platelets from the other cells. The PRP is then injected at the injury site to treat various conditions, such as chronic Achilles tendonitis.
Does the WADA Prohibited List prohibit the use of PRP?
According to WADA regulations, PRP is not prohibited, although individual growth factors are still prohibited when given separately as purified substances, per S.2.5 of the WADA Prohibited List. PRP therapy is prohibited if it offers performance-enhancing effects, or if the PRP was altered in a way that can produce performance-enhancing benefits.
As such, the only result of PRP therapy should be the restoration of pre-injury level of function. Because the use of PRP cannot justify a positive doping test, athletes should also discuss these guidelines with their physician, contact our Drug Reference team at drugreference@USADA.org, or call Athlete Express at (866) 601-2632, with any questions.