Platelet Rich Plasma (PRP)

What is Platelet-Rich Plasma (PRP)?

The use of autologous (donor and recipient are the same) blood products [Platelet Rich Plasma(PRP)] in an effort to aid in healing via a variety of treatments has become more common.  In recent years, science and technology has provided a new perspective on understanding the wound healing process.  Platelets were once thought to act only with clotting, however, we now know platelets also release many bioactive proteins responsible for removal of necrotic tissue as well as enhancing tissue regeneration.  According to the World Health Organization(WHO), musculoskeletal injuries are the most common cause of severe long-term pain and physical disability.  Soft tissue injuries including tendon and ligament trauma accounts for 45% of all musculoskeletal injuries in the USA.  PRP provides an alternative to surgery by promoting safe and natural healing.

Platelet Rich Plasma(PRP) involves stimulating release of growth factors in an attempt to jump start the healing in chronic injuries as well as aid in acute injury healing.  To prepare PRP, a small amount of blood is taken from the patient.  The blood is then placed in a centrifuge.  The centrifuge spins and automatically produces the PRP.  Normal platelet concentration is 200,000 platelets/mcL and PRP can be expected to have a minimum of 4-6 times this baseline(1 million platelets/mcL).  There are also growth factors and other proteins present in the PRP that aid in healing.  Dr Z utilizes a comprehensive approach to PRP treatments including not only injecting the injured tendon or arthritic joint but also addressing ligament laxity via  PRP prolotherapy.

What conditions can be treated with Platelet Rich Plasma (PRP)?

Knee Pain

  • Tendon Injuries (Patellar Tendonitis, Quad
  • Muscle injuries
  • Ligament sprains or tears (MCL, LCL)
  • Bursitis
  • Osteoarthritis

Low Back and Hip Pain

  • Muscle pain or injury
  • Pyriformis syndrome
  • Greater Trochanteric Bursitis
  • Tendon Injuries
  • Sacroiliac joint pain
  • Hamstring tendonitis or tears
  • Osteoarthritis

Shoulder and Arm Pain

  • Rotator Cuff tendonitis, tendonopathy or partial tears
  • Bicipital tendonitis
  • Medial and Lateral epicondylitis (golfers & tennis elbow)
  • Ulnar Collateral Ligament sprain or tear

Lower Leg and Foot Pain

  • Plantar Fasciitis
  • Shin Splints
  • Peroneal tendonitis
  • Ankle sprains/ligament injury
  • Achilles tendonitis or partial tears

Platelet Rich Plasma (PRP) Treatment Process:

Following a formal evaluation and diagnostic workup we will discuss whether you are a candidate for Platelet Rich Plasma(PRP). A full explanation of the procedure including risks and benefits will be reviewed. Once written consent is obtained, blood is drawn from your arm and placed in a special processing unit, which separates platelets, white blood cells and serum from red blood cells. The platelets and white blood cells are then concentrated and collected into a sterile syringe. The skin and soft tissue is anesthetized with local anesthetic, followed by injection of the PRP into the tissue targeted for treatment. Depending on the size of the injured tissue, one or several needles are inserted to optimize placement of the product.

Platelet Rich Plasma (PRP) Treatment plan:

Depending on the severity and duration of your injury, one to three injections are suggested. Following the initial treatment with PRP, a follow up visit occurs 3-4 weeks later. At this visit an evaluation of your response to the initial therapy is performed and a decision is made regarding the need for additional PRP treatments. In general, chronic injuries often require more than one injection. In both acute and chronic injuries, injections may be combined with an exercise or physical therapy program to enhance the success of the treatment. This will include eccentric stretching.

Are Platelet Rich Plasma (PRP) injections safe?

Research and clinical data show that PRP injections are extremely safe, with minimal risk for any adverse reaction or complication. Because the injectable products are produced from your own blood, there is no concern for rejection or disease transmission. There is a small risk of infection from any injection into the body, but this is rare. Of note, recent research suggests that PRP may have an anti-bacterial property which protects against possible infection.

What to Expect after your Platelet Rich Plasma(PRP) treatment:

Often, following the initial Platelet Rich Plasma(PRP), an "achy" soreness is felt at the site of injury. This "soreness" is a positive sign that a healing response has been set in motion. This effect can last for several days and gradually decreases as healing and tissue repair occurs. It is important that anti-inflammatory medications such as Ibuprofen, Naproxen and Aspirin be avoided following PRP treatments. These medicines may block the effects of the intended healing response facilitated by the injection itself. It is acceptable to use over the counter pain medication, such as Tylenol and in some cases a prescribed analgesic, which does not have anti-inflammatory properties, to control discomfort as needed. Also icing the area treated is to be avoided and the use of a warm compresses for pain control is utilized. Pain management options will be discussed with you by the physician managing your treatment plan. You will be permitted to resume normal day to day activities and light exercise following injection. We suggest that you avoid strenuous lifting or high level exercise for at least several days after injection.