Platelet Rich Plasma (PRP) Injection Therapy
During the past several years, much has been written about a preparation called Platelet Rich Plasma (PRP) and its potential effectiveness in the treatment of injuries.
Many famous athletes such as Tiger Woods, tennis star Rafael Nadal, and several others, have received PRP for various problems, such as sprained knees and chronic tendon injuries. These types of conditions have typically been treated with medications, physical therapy, or even surgery. Some athletes have credited PRP with their being able to return more quickly to competition.
What is Platelet Rich Plasma (PRP)?
Blood is mainly a liquid (called plasma), it also contains small solid components (red cells, white cells, and platelets.) The platelets are best known for their importance in clotting blood. However, platelets also contain hundreds of proteins called growth factors which are very important in the healing of injuries.
PRP is plasma with many more platelets than what is typically found in blood. The concentration of platelets — and, thereby, the concentration of growth factors — can be 5 to 10 times greater (or richer) than usual.
To develop a PRP preparation, blood must first be drawn from a patient. The platelets are separated from other blood cells and their concentration is increased during a process called centrifugation. Then the increased concentration of platelets is combined with the remaining blood.
Why would someone undergo a PRP treatment?
To speed healing, the injury site is treated with the PRP preparation. This can be done in one of two ways:
- PRP Injection can be carefully injected into the injured area. For example, in Achilles tendonitis, a condition commonly seen in runners and tennis players, the heel cord can become swollen, inflamed, and painful. A mixture of Platelet Rich Plasma (PRP) and local anesthetic can be injected directly into this inflamed tissue. Afterwards, the pain at the area of injection may actually increase for the first week or two, and it may be several weeks before the patient feels a beneficial effect.
- PRP Injection may also be used to improve healing after surgery for some injuries. For example, an athlete with a completely torn heel cord may require surgery to repair the tendon. Healing of the torn tendon can possibly be improved by treating the injured area with Platelet Rich Plasma (PRP) during surgery. This is done by preparing the PRP in a special way that allows it to actually be stitched into torn tissues.
Platelet Rich Plasma (PRP) Injection Procedure
- PRP Injections are performed as an outpatient procedure. Because the patient’s blood must be drawn and prepared for injection, a typical procedure may take anywhere from 45 to 90 minutes.
- Sports Medicine Physician will perform the injections. The use of imaging technology, such as ultrasound or fluoroscopy will be used to ensure a safe and precise placement of the injection into the damaged tendon.
- Blood is drawn from a vein in the patient’s arm into a syringe
- The blood is processed using a centrifuge machine.
- A doctor prepares the centrifuged Platelet Rich Plasma for injection.
- The affected joint area is cleansed with disinfectant such as alcohol or iodine.
- A lidocaine injection and/or another local anesthetic may be used to numb the injection site.
- An ultrasound probe will be pressed against the gel-covered skin. A live image of the tendon will be projected onscreen for the doctor and patient to see.
- The patient is asked to relax; this will facilitate the injection and also can make the injection less painful.
- Using a syringe and needle, the doctor injects a small amount (often just 3 to 6 mL) of platelet-rich plasma into the affected tendon.
- The injection area is cleansed and bandaged.
What to Expect Following Platelet Rich Plasma Injection
Platelet rich plasma injections may cause temporary inflammation, pain, and swelling. Patients are often advised to take it easy for a few days and avoid putting strain on the affected joint.
If the patient does not have a physically demanding job, he or she can usually go back to work the next day. Patients can usually resume normal activities a few days after the injections, when swelling and pain subside. Patients should not begin taking anti-inflammatory medications until approved by the doctor.
Which Conditions Benefit Most From Platelet Rich Plasma (PRP) Injection Treatment?
- Lumbar spine disc pain
- Rotator cuff injuries, including partial-thickness
- Shoulder pain and instability
- Chronic sports injuries such as Tennis Elbow and Golfer’s Elbow
- Hamstring and hip strains
- Knee sprains and instability
- Patellofemoral syndrome and patellar tendonitis
- Ankle sprains
- Achilles tendonitis & plantar fasciitis
- Knee, hip, and other joint osteoarthritis
- Nerve entrapment syndromes, such as Carpal Tunnel Syndrome
- Sacroiliac (SI) joint dysfunction and pain
- Lumbar and cervical facet dysfunction and pain
- Cartilage injuries
- Acute ligamentous injuries
- Knee meniscus tear
- Shoulder labrum tear
Additionally, PRP Injections Treatment can be effective for many cases of osteoarthritis by stimulating healing of cartilage and reducing pain and disability. This includes:
- Knee arthritis
- Hip joint arthritis
- Shoulder arthritis
- Ankle arthritis
Who should not undergo PRP Injection Treatment?
Platelet Rich Plasma (PRP) Injections may not be appropriate for a patients who:
- Have a medical condition that could worsen or spread with injections, such as an active infection, a metastatic disease, or certain skin diseases
- Has certain blood and bleeding disorders
- Is undergoing anticoagulation therapy (and cannot temporarily suspend treatment)
- Is anemic
- Is pregnant