PRP JOINT AND TENDON
Platelet-rich plasma (abbreviated PRP) is a treatment used for a variety of common orthopaedic conditions.
PRP is a concentration of platelet cells taken from your blood. These platelets have growth factors that help in the healing process of chronic injuries. Growth factors are chemicals that signal the body to initiate a healing response. By injecting PRP into areas of injury, results in stimulating and optimizing your body's ability to heal the chronic conditions.
PRP contains a high concentration of platelets, other blood cells important in healing, and growth factors.
PRP injections can be done in a physician's office. The procedure takes about 30 minutes in order to withdraw the blood, spin the blood in the centrifuge, and inject the PRP into the injured area.
How PRP is Obtained?
PRP is obtained from the patient who is being treated. Blood is withdrawn from a vein in the patient's arm and the blood is placed in a centrifuge, a machine that spins at a high speed to separate the different types of blood cells. The physician extracts the platelet-rich portion of the blood and injects this into the area of injury. There is not just platelets in the concentrated layer of the "spun" blood, but also other important growth factors, plasma, and some red blood cells.
How PRP Is Injected?
PRP injections are given as soon as the blood has been spun and the platelets separated. Some physicians may choose to add an "activating agent," usually either thrombin or calcium chloride, while some inject just the platelets. Studies have shown that the tendons being injected can also activate the PRP, so the activating agent may not be necessary.
There is no clear science to justify a particular quantity of PRP and the number of injections needed. Most physicians perform one injection, although sometimes PRP injections are given as a series of injections over a span of several weeks.
Are The Injections Painful?
There is some discomfort associated with actual injection.
The procedure involves placing a needle through the skin. There are anaesthetics that can be given prior to help alleviate some of the discomfort associated with placing a needle into the skin.
The relief found from a PRP injection is not immediate, often like people experience with a cortisone injection.
We know from laboratory studies that PRP can help increase certain growth factors that are important in the healing process.
Smaller studies done show that PRP offers healing of these injuries.
PRP has been shown to have some beneficial effects for Tennis elbow, Achilles injuries and even Knee Arthritis and Plantar Fascitis.
Unfortunately, these are relatively small studies that follow the patients for a relatively short duration. Because of this, most doctors, and definitely most insurance companies, consider PRP to be experimental.
Side effects are uncommon, but they are possible. Whenever a needle is inserted through the skin, an infection can occur. The other more common side effect of PRP injections is a transient increase in inflammation and pain after the injection.
PRP injections are not recommended in individuals with bleeding disorders, those taking anti-coagulation medications (e.g. Coumadin), or those who have cancer, active infections, or are pregnant.
Advantages of Platelet-Rich Plasma (PRP) Therapy
People diagnosed with tendinosis or tendinopathy might consider PRP therapy for several reasons:
Other traditional treatments may fail to provide adequate relief.
PRP is derived from the patient’s own blood, and the injections carry few risks.
Other treatments have side effects or drawbacks:
Physical therapy is often effective but does not always satisfactorily relieve symptoms or improve function.
Cortisone injections can temporarily reduce pain; however, symptoms can recur. In addition, tendons exposed to cortisone may weaken, making the injury worse.
Non-steroidal anti-inflammatory medications (NSAIDs) such as aspirin and ibuprofen may effectively reduce pain, but habitual use can cause or aggravate stomach problems, blood pressure, and heart problems.
Minor surgeries to treat tendon damage and degradation, such as arthroscopic debridement, do not always work, tend to carry more risks and have a longer recovery