PRP – Platelet-Rich Plasma Therapy
What is PRP?
Platelet-rich plasma (PRP) is an innovative treatment that is gaining popularity for its effectiveness in treating a range of conditions, from sports injuries to hair loss. PRP therapy uses the patient’s own blood cells to accelerate healing in a specific area. Platelets, a type of blood cell that plays a crucial role in the healing process throughout the body, are the key component of PRP.
Platelets contain growth factors that can trigger cell reproduction and stimulate tissue regeneration or healing in the treated area. These growth factors are naturally present in the blood, but PRP therapy concentrates them to enhance their therapeutic potential. PRP is created by taking a small sample of the patient’s blood and placing it into a special device called a centrifuge. The centrifuge rapidly spins the sample, separating out the other components of the blood from the platelets and concentrating them within the plasma.
The resulting platelet-rich plasma is then injected into the targeted area, where it works to promote healing and tissue regeneration. PRP therapy is a safe and effective treatment option for a variety of conditions, including acute and chronic ligament and tendon sprains/strains, osteoarthritis, and sports injuries.
Why Does PRP Work?
Platelets are a specialized type of blood cell. Blood is made up of 93% red cells (RBCs), 6% platelets, 1% white blood cells (WBCs), and plasma. Most people associate platelets with clot formation. While that certainly is an important function of platelets, they are also very much involved in injury healing. Human platelets are naturally extremely rich in connective tissue growth factors.
Injecting these growth factors into damaged ligaments, tendons, and joints stimulates a natural repair process. But in order to benefit from these natural healing proteins, the platelets must first be concentrated. In other words, PRP recreates and stimulates the body’s natural healing process.
Corticosteroid or “cortisone” injection, as they are commonly referred to, cannot be injected into weight bearing tendons such as the patellar tendon of the knee and Achilles tendon of the ankle because then can weaken the tendon and cause it to rupture. PRP can safely be used in these tendons without the risk of rupture.
How is PRP Done?
In the office, blood is drawn from the patient (just like getting a blood test) and placed in a special centrifuge. The centrifuge separates the RBCs, and the remaining platelets and plasma are then highly concentrated. (The WBCs, which comprise only a fraction of the total cells, go along for the ride with the platelets and plasma.) The red blood cells are discarded, and the resulting platelet concentrate is used for treatment.
In most cases the injections are given under direct ultrasound guidance to insure accurate placement of the platelet concentrate in the damaged area. The entire treatment, from blood draw, to solution preparation, to injection, takes 45 minutes.
How Often are PRP Injections Given?
After the initial treatment, a follow up visit is scheduled 3-4 weeks later to evaluate healing progress. Some patients respond very well to just one treatment. However, 2-3 treatments may be necessary in some injuries. If multiple injections are given, injections are typically given every 3-4 weeks.
What Conditions Benefit From PRP?
PRP treatment works for acute and chronic ligament and tendon sprains/strains that have failed other conservative treatment, including:
- Rotator cuff injuries
- Shoulder pain and instability
- Tennis & golfer’s elbow
- Hamstring and hip strains
- Knee sprains and instability
- Patellofemoral syndrome and patellar tendinosis
- Ankle sprains
- Achilles tendinosis & plantar fasciitis
- Knee, hip, and other joint osteoarthritis
- Sports hernias & athletic pubalgia
- Other chronic tendon and ligament problems
In addition, PRP can be very helpful for many cases of osteoarthritis (the “wear & tear” kind). PRP can help stimulate a “smoothing over” of the roughened and arthritic cartilage, reducing the pain and disability of arthritis.
- Knee arthritis
- Hip joint arthritis
- And other joint arthritis
Is PRP Covered by Insurance?
PRP injections are generally not covered by insurance plans, including Medicare.
Do PRP Injections Hurt?
Because lidocaine interferes with the platelet function, it is not used during the PRP injection. Unlike a steroid injection, there may be pain for the next few days after an injection. For the days preceding the injection and for the first week after the injections it is critical to avoid anti-inflammatory medications, including Advil, Motrin, ibuprofen, Aleve, Celebrex and aspirin (unless prescribed by your heart doctor). These will interfere with the healing response. Tylenol is OK. Your doctor may prescribe pain medication also.
What is the Success Rate?
Studies suggest an improvement of 85-95%. Some patients experience complete relief of their pain. The results of PRP treatment are most noticeable after several weeks for joint injections and six months for scalp injections; the results are generally permanent; patients may require additional injections at the direction of a doctor.