What Is Platelet Rich Plasma?
Platelet Rich Plasma or PRP is also known as APC or Autologous platelet concentrate. When we injure ourselves the blood rushes to the area and starts an inflammatory response to start the healing cycle. In the blood we have platelets which function first to cause clotting to stop the bleeding but than amazingly they also orchestrate the healing process. Inside and on the walls of platelets are hundreds of growth factors that tells the body what to do. Of importance to Orthopedics are fibroblast growth factor, epidermal growth factor, insulin growth factor and . PRP also contains a small amount of stem cells. When PRP comes in contact with cartilage or the injured area it turns on the DNA in those cells to cause that tissue to repair and regenerate itself to make new cells. It also attracts other stem cells circulating in the blood stream to the region to attach to the injured tissue to differentiate and create more tissue.
How Is PRP Obtained?
We draw typically between 30-60 ml of blood and than put it thru a special centrifuge and separating process to draw off and concentrate the platelets and some white blood cells. We than have between 3 to 9cc’s to work with for the treatment.
How Is The Treatment Performed?
The injured tendon, muscle, ligament, or joint is identified thru careful examination and image guidance with Ultrasound or X-ray fluoroscopy. MRI or CT knowledge aids in placing the PRP in the correct location. The region to be treated is cleaned with an asceptic technique and a local anesthetic is applied to make the procedure comfortable. Using “realtime” image guidance the PRP is transplanted and grafted to the injured site. It usually takes 3 to 7 treatments 4-6 weeks apart to eliminate the pain depending on the severity of the case.
What Am I To Expect Afterwards?
Since the PRP causes a healing inflammatory response there is usually some pain and swelling later that day. It can usually be controlled with rest, ice, and sometimes a mild pain medication is helpful. By the next day light exercise is encouraged to prevent stiffness. Sometimes splinting is necessary to promote healing. Discomfort usually goes away in 3-5 days. Anti-inflammatories and steroids are discouraged. Returning back to your sport is dependent on the extent of the injury and tissue damaged. The pain from your original injury may start to diminish as early as 1-2 weeks, but frequently it takes 3-4 treatments to know if it will work for you. The treatment may continue until healing is complete and the pain is gone.
What Are The Risks Of The Procedure?
There are very few risks of PRP since you are using your own blood. Infection is possible but very remote. There is more of a risk from the needle if you go to a physician who is inexperienced or just starting out with this procedure without extensive training.
Who Is A Candidate For PRP Treatment?
The following are only some of the conditions treated with PRP:
- Arthritis of any joint including shoulder, elbow, wrist, fingers, hip, knee, ankle, toes and TMJ joint.
- Tendonitis or tearing of any tendon including the rotator cuff, biceps, tennis or golfers elbow, tendinitis in the wrist and hand, hip tendinitis, patellar and Achilles tendinitis, and plantar fasciitis in the foot.
- Cartilage, meniscus, or labral tears in the shoulder, wrist, hip, and knee.
- Muscle tears, trigger points, scar tissue, spine and disc injuries.