PRP (Platelet Rich Plasma)

Platelet-rich plasma (abbreviated PRP) is a treatment used for a variety of common orthopedic conditions. PRP is a concentration of platelet cells taken from your blood. These platelets have growth factors that help in the healing process of chronic injuries. Growth factors are chemicals that signal the body to initiate a healing response. By injecting PRP into areas of an injury, the hope is to stimulate and optimize your body's ability to heal the chronic conditions.

PRP  releases   various chemical signals that cause stem cells to activate,  tenocytes to lay down new tendon, chondrocytes to lay down new cartilage, etc.

Uses

PRP has been used in operating rooms for several decades to help with wound healing, and to stimulate bone formation in spinal fusion surgery. Recently, PRP has been used in outpatient settings for the treatment of common overuse conditions including:

  • Achilles Tendonitis
  • Rotator Cuff Tendonitis
  • Tennis Elbow
  • Patellar Tendonitis
  • Osteoarthritis of joints such as knees, hips, and  thumbs
  • Spinal injuries.
  • Hypermobility issues -  tightens loose ligaments and tendons.
  • Wound healing
  • Torn muscles
  • Stimulate hair growth
  • Stimulate collagen production to reduce skin wrinkles in areas such as the face and Décolletage

How PRP Is Obtained?

PRP is obtained from the patient who is being treated. Blood is withdrawn from a vein in the patient's arm and the blood is placed in a centrifuge, a machine that spins at a high speed to separate the different types of blood cells. The physician extracts the platelet-rich portion of the blood and injects this into the area of injury. There is not just platelets in the concentrated layer of the "spun" blood, but also other important growth factors, plasma, and some red blood cells.

How PRP Is Injected

PRP injections are given as soon as the blood has been spun and the platelets separated.  Some physicians may choose to add an "activating agent," usually  calcium chloride, while some inject just the platelets.

Are The Injections Painful?

There is some discomfort associated with   the actual injection itself. The procedure involve placing a needle through the skin. There are anesthetics that can be given to help alleviate some of the discomfort associated with the injection..

Side Effects?

  • Infection is less than 1%
  • Worsening pain is less than 1%
  • Weakness is less than 1%

Effectiveness

  • About  10-20% of patients  treated are non responders
  • 25% of patients will have rapid response to treatment
  • The majority have steady improvement in symptoms over a 6-12 weeks followed by a slower improvement phase.
  • Overall  80% of those treated with one session have greater than  70% long term pain relief.

Alternative to stimulate healing x x x
Course of Therapy 2-10 2-10 1-3
Number of injections per session Multiple 1-2 1-2
Injection additives Glucose solution to cause inflammation Ozone and anesthetic Blood product and anesthetic
Acute injury no yes yes
Chronic injury yes yes yes
Need to avoid anti-inflammatories after injection yes no no
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