Platelet-Rich Plasma (PRP) Therapy

bigstock-Swimming-man-athlete-butterfly-47575588Platelet-rich plasma (PRP) therapy is an emerging technology and technique in orthopedic medicine and pain management. Many high profile athletes have used PRP therapy, such as Pittsburg Steelers Hines Ward and Troy Polamalu, Major League pitchers Bartolo Colon and Takashi Saito, as well as golf pro Tiger Woods.

What is PRP therapy?

PRP therapy is the injection of the patient’s own blood components directly into the site of injury. The platelets secrete growth factors, which stimulate tissue recovery by increased collagen production, stimulated blood flow, and enhanced tendon stem cell proliferation.

PRP activates substances called tenocytes, which produce collagen that is necessary for the repair of injured or diseased ligaments, tendons, cartilage, and muscles.

How is PRP administered?centrifuge

PRP therapy takes around 20 minutes to complete. A member of the medical staff will collect 30 milliliters of the patient’s blood, which is placed in a spinning unit called a centrifuge.

The centrifuge separates the platelets from the other components of the blood. The doctor then injects the concentrated platelets into the damaged, injured, or degenerated site. The natural reservoir of growth factors from the platelets will essentially repair the diseased or injured tissues.

How will I feel after PRP therapy?

In the days immediately after the PRP injection, you will feel a slight increase in pain. However, the pain lessens more and more with each passing day, and functional ability, strength, endurance, and mobility increase. The most improvement occurs between 2 to 6 weeks, but some patients report ongoing improvement as long as 9 months after the administration of PRP.

What injuries are treated by PRP therapy?

Studies that involve the use of MRI and ultrasound diagnostic tests show that there is definite tissue repair and recovery after PRP therapy, which supports the healing effect. By treating injured tissues before damage worsens, surgery can be avoided. PRP therapy is used to treat injuries of the rotator cuff, hamstring, quadriceps, Achilles tendon, and elbow.

Basically, any ligament or tendon injury responds to PRP therapy, with the exception of complete tears. PRP therapy reduces the downtime for athletes and decreases the chance for re-injury.

 

What painful conditions are treated with PRP therapy?

Many chronic conditions respond well to PRP therapy. These include:

  • Shoulder – Rotator cuff tendinitis, shoulder impingement, and bursitis
  • Wrist/hand – DeQuervain’s tenosynovitis, tendinitis, and ligament tears
  • Elbow – Tennis elbow and golfer’s elbow
  • Hip – Iliotibial band tendinitis, bursitis, and sacroiliac joint dysfunction
  • Knee – Patellar tendinitis, stained ligaments, and partially torn ligaments
  • Spine – Facet joint arthritis

Is PRP therapy a substitute for surgery?

PRP prp2can possibly substitute for surgery, with many acute and chronic conditions responding to this treatment, delaying or avoiding the need for immediate surgery.

Because there is poor blood supply to most tendons and ligaments, the body has a hard time healing these structures. With PRP, the body thinks the injury is new and initiates a healing response. The super-concentrated growth factors from the PRP regenerate the tissue, therefore, decrease the need for surgical intervention.

Do PRP injections work?

Several studies have proved that PRP injections are effective. One study involved 140 patients with elbow pain. At 8 weeks, 6 months, and 12-38 months following injection, there was a 60% pain improvement.

In another study of 130 participants with lateral epicondylitis who failed with physical therapy, researchers found a 66% success rate at 6 months. More recently, in 2013, a randomized clinical trial found that patient’s pain scores significantly improved following PRP injection.

Resources

Creaney L, Wallace A, Curtis M, Connell D. Growth factor-based therapies provide additional benefit beyond physical therapy in resistant elbow tendinopathy: a prospective, single-blind, randomised trial of autologous blood injections versus platelet-rich plasma injections. Br J Sports Med. Sep 2011;45(12):966-71.

Mishra A, Pavelko T. Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. Am J Sports Med. Nov 2006;34(11):1774-8.

Raeissadat SA, Sedighipour L, Rayegani SM, Bahrami MH, Bayat M, Rahimi R. Effect of Platelet-Rich Plasma (PRP) versus Autologous Whole Blood on Pain and Function Improvement in Tennis Elbow: A Randomized Clinical Trial. Pain Res Treat. 2014;2014:191525.