Platelet Rich Plasma
Regeneration, Repair and Healing
Platelet Rich Plasma
Platelet Rich Plasma, or PRP, is blood plasma with concentrated platelets & other growth factors. The concentrated platelets found in PRP contain huge reservoirs of bioactive proteins, including growth factors & signalling proteins that are vital to initiate and accelerate tissue repair & regeneration. These growth factors number at least a dozen different factors. These bioactive proteins initiate connective tissue healing in tissues such as meniscus (knee) & rotator cuff tissue, bone & articular cartilage regeneration & repair, promote development of new blood vessels, & stimulate the wound healing process.
What is the method?
The PRP signals the body to send in stem cells to repair the area of injury. PRP injections are sometimes done under fluoroscopic guidance (living X ray). This is done for precise localised delivery of these healing factors into injured ligaments, muscles, and joints.
Who needs the therapy?
Platelet Rich Plasma Therapy is a treatment option for various orthopaedic injuries and conditions, which have traditionally required surgery or other extensive treatments. PRP injections are being utilised in orthopaedics with increasing frequency and effectiveness.
Injuries currently being treated with the PRP therapy are arthritis of the hip, knee, shoulder, ankle and other joints. PRP also is utilised for soft tissue injuries such as tendonitis, muscle sprains and tears, and various types of ligament injuries. These include common tendon injuries such as tennis and golfers’ elbow, Achilles tendonitis and knee tendonitis. PRP is also used to treat various injuries and conditions affecting (joint) injuries. These include rotator cuff and meniscus injuries.
Although PRP technology is considered cutting edge technology, it was initially developed 20 years ago for heart surgery to aid with the wound healing and blood loss. Its benefits are now being applied towards the facilitating of healing muscle, tendons, ligaments, articular and meniscal injuries. In fact, PRP has been widely used in Europe for many years.
How is PRP prepared?
To prepare PRP, a small amount of blood is taken from the patient’s arm. The blood is then placed in a centrifuge. The centrifuge spins & separates the platelets form the rest of the blood components. The entire process takes less than 15 minutes and increases the concentration of platelets & growth factors up to 600%. Using the patient’s own blood, specially prepared platelets are taken and re-injected into the affected area. These platelets release special growth factors that lead to tissue healing. By using the concentrated platelets, we increase the growth factors up to eight times which promotes temporary relief and stops inflammation. PRP injections actually heal the area over a period of time. This can be anywhere from one to three months.
The human body has a remarkable ability to heal itself, and by re-injecting concentrated platelets, we are facilitating the natural healing process. The PRP injections are calling in stem cells to repair the area. When performing these injections, we must do whatever we can to maximise stem cell release to optimise healing.
What are the advantages of PRP in Orthopaedics?
What are the indications where PRP can be used?
What should be avoided during PRP treatment?
We know certain factors diminish stem cell release such as smoking & alcohol intake. Obviously, avoiding these pitfalls will do nothing but increase the success of the procedure. The platelets work by causing an inflammatory reaction. If we somehow diminish this inflammatory reaction than we may significantly decrease the chances of having a good result. For this reason, the use of anti-inflammatory drugs such as Advil, Aleve, Motrin, Ibuprophen, etc. are not recommended. This restriction should be in place for about 4-6 weeks.
The use of omega 3-fish oil and other natural anti-inflammatory agents do not seem to work the same way as the NSAIDS (non-steroidal anti-inflammatories) and are thus not restricted.
What is the number of injections that are administered?
The number of injections performed depends upon the severity and the type of condition being treated. Age also seems to have an effect on the number of injections given. Typically, younger people generally need fewer injections for the same condition than a person who is older.
Is there any pain involved?
After the injection is given, there is usually a marked increase in pain for anywhere from 5-10 days. Tylenol & possibly a mild narcotic usually handle this pain. The pain may start up again only later to go away. A good analogy is that of a roller coaster where the initial few days are like the big drop on the roller coaster than the remaining few days are like smaller dips on a roller coaster!