Platelet-rich plasma (PRP) has received significant media attention recently. Platelet-rich plasma injections utilize the patient’s own blood components to stimulate a healing response in damaged tissues.
Normal blood is composed of plasma (which is mostly water), red blood cells (which carry oxygen), white blood cells (which fight infection), and platelets (which perform a variety of functions including assisting in clot formation). In the setting of an injury in the body, the platelets normally migrate to the site of injury and help initiate a healing response. Platelets release numerous growth factors and other proteins which assist with the healing process.
Platelet-rich plasma can be created after a normal sample of blood is obtained. The sample is placed in a centrifuge to separate the platelets and plasma from the red and white blood cells. The red and white blood cells can be discarded and the remaining fluid is plasma extremely concentrated with platelets and the healing factors they contain; this remaining fluid is known as platelet-rich plasma, or PRP.
This PRP can then be injected directly into the site of an injury in an effort to stimulate a powerful healing response. By enhancing the body’s natural healing capacity, PRP injections may lead to a more rapid, more efficient, and more thorough restoration of the tissue to a healthy state.
Conditions that may be treated by PRP:
PRP injections can be used to treat a variety of injuries to muscles and tendons, especially if they are failing to heal with typical conservative treatment modalities, such as time, rest, physical therapy, and anti-inflammatory medications. PRP injections have been used successfully in the following conditions:
– Patellar tendonitis/tendinosis
– Quadriceps muscle injuries
– Knee osteoarthritis
– Hip osteoarthritis
– Rotator Cuff tendonitis, tendonopathy or partial tears
– Biceps tendonitis
– Medial and Lateral epicondylitis of the elbow (golfers & tennis elbow)
– Ulnar Collateral Ligament sprain or tear
– Achilles tendonitis or partial tears
As more research with PRP is performed, it is likely that this list will expand to include numerous other orthopaedic conditions.
Studies showing the benefits of PRP
Although PRP is a relatively new treatment there are several recent high-quality studies showing the benefits over PRP as compared to more traditional treatment measures. Please click on any of the following links to read these studies.
Recent studies have shown PRP to be more effective than steroid injections or viscosupplementation injections for the treatment of osteoarthritis of the knee, especially in younger patients with less severe forms of arthritis.
Knee Study #1
Knee Study #2
Knee Study #3
Recent research shows that patient’s with hip osteoarthritis achieve greater improvements and for a longer duration following PRP injections as compared to viscosupplementation (hyaluronic acid) injections. Click to read Hip Study #1
Other studies have shown PRP to be superior to steroid injections for the treatment of lateral epicondylitis or “tennis elbow”.
Elbow Study #1
Elbow Study #2
In addition there have been studies showing PRP to be superior to standard conservative treatment options for the treatment of chronic patellar tendinopathy in athletes.
Patellar Tendon PRP
PRP Injection Procedure:
In the office, blood is drawn from the patient’s arm and placed in a special processing unit, which separates the platelets from the rest of the cells in the blood and creates the PRP fluid. The PRP fluid is then collected into a sterile syringe. The skin and soft tissues over the injection site is anesthetized with a local anesthetic. After allowing several minutes for the local anesthetic to set in, an injection of the PRP into the tissue targeted for treatment is performed.
For a video animation illustrating the process of creating the PRP or ACP fluid, click the box below.
Depending on the severity and duration of the injury, it is possible that more than one PRP injection will be needed. Following the initial treatment with PRP, a follow up visit occurs 2-3 weeks later. At this visit an evaluation of the response to the initial injection is performed and a decision is made regarding the need for additional PRP treatments.
Often patients complain of an “achy” soreness at the injection site. This effect can last for several days and gradually decreases with time.
It is important that anti-inflammatory medications such as Ibuprofen, Naproxen, Voltaren, and Aspirin be avoided following PRP treatments because these medicines may block the beneficial effects of the PRP. It is acceptable to use Tylenol after the injection.
Although normal day to day activities and light exercise are permitted following PRP injections, it is recommended to avoid strenuous lifting or high level exercise for at least several days after the injection.
Watch this video to hear Dr. Farber describe PRP Therapy: