What is (PRP)?

Platelet-rich plasma or PRP is an "autologous blood therapy" that uses a patient's own blood components to stimulate a healing response in damaged tissues. In response to an injury or tissue damage, your body naturally recruits platelets and stem cells from the blood to initiate a healing response. Under normal conditions, platelets store numerous growth factors which are released in response to signals from the injured tissue. These growth factors include:

1.        
   

2. CTGF (Connective Tissue Growth Factor)
   

3.         PGDF (Platelet Derived Growth Factor)
   

4.         TGF-β (Transforming Growth Factor-beta)
   

5.         EGF (Epidermal Growth Factor)
   

6.         GF (Insulin Growth Factor)
   

7.         BFGF (Basic Fibroblast Growth Factor)
   

8.         VEGF (Vascular Endothelial Growth Factor
   

Modern technology allows us to concentrate platelets and stem cells from your blood, and induce this growth factor release as we inject the solution directly into injured tissue, simulating this same healing response in a more powerful form. By enhancing the body's natural healing capacity, the treatment may lead to a more rapid, more efficient, and more thorough restoration of the tissue to a healthy state.

Treatment Process:

The PRP process concentrates fibrin, mesenchymal stem cells, and platelets so that each cubic millimeter of solution contains 1.5 to 2 million platelets, resulting in up to a 600% increase in platelets and bioactive growth factors. Because it is so concentrated, PRP acts as a potent tissue growth stimulant, amplifying the natural process of tissue repair and healing. Studies show that PRP induces the production of new collagen by the fibroblasts, bone and cartilage cells at the site of the injection, rebuilding the joint cartilage and strengthening injured ligaments and tendons. This new collagen is naturally incorporated directly into your existing cartilage and ligaments, making them thicker, stronger and more elastic.

Treatment Plan:

Depending on the severity and duration of your injury, one to three PRP injections are suggested. Following the initial treatment with PRP, a follow up visit occurs 2-3 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 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.

Are PRP injections safe?

Autologous (patient derived) PRP has been used for over 30 years as an aid in recovery following certain surgical, orthopaedic and dental procedures. Research and clinical data show that PRP injections are extremely safe, with minimal risk for any adverse reaction or complication. Because PRP is 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 (4).

What kinds of injuries can PRP be used in?
Medical researchers are reporting remarkable results using a PRP in the treatment of common injuries, including tendinitis, the regeneration of cartilage in osteoarthritis of the thumbs, knees and hips, and in non-surgical repair of rotator cuff tears. Published studies show restoration and smoothing of roughened cartilage, improved range of motion, and resolution of pain in osteoarthritis of hips, knees and shoulders. Many other conditions respond to prolotherapy with PRP, including injuries to the back, neck, elbows, shoulders, hands, hips, knees, ankles and feet.

What to expect after your treatment:

Often, following the initial injection, 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. This restriction should be in place for about 4-6 weeks.  These medicines may block the effects of the intended healing response facilitated by the injection itself. The use of omega 3-fish oil and other natural anti-inflammatory agents do not seem to work the same way as the NSAIDS (non-steroidal anti-inflammatories) and are thus not restricted. 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. 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.

Selected References

1. Anitua E, S. M., Nurden A, Nurden P, Orive G, Andia I. (2006). "New insights into and novel applications for platelet-rich fibrin therapies." Trends in Biotechnology 24(5): 227-234.

2. Becker C, H. S., Drewlo S, Rodriguez SZ, Kramer J, Willburger RE. (2007). "Efficacy of epidural perineural injections with autologous conditioned serum for lumbar radicular compression." Spine 32(17): 1803-1808.

3. Mishra A, A. J., Anitua E, Andia I, Padilla S, Mujika I. (2007). "Treatment of chronic elbow tendinosis with buffered platelet-rich plasma." Am J of Sports Med 34(11): 1774-1778.

4. Moojen D, E. P., Schure R, et al. (2007). "Antimicrobial activity of platelet-leukocyte gel against Staphylococcus aureus." Journal of Orthopaedic Research DOI: 10.1002/jor.20519.

5. Sanchez M, A. E., Azofra J, Andia I, Padilla S, Mujika I. (2007). "Comparison of Surgically Repaired Achilles Tendon Tears Using Platelet-Rich Fibrin Matrices." Am J of Sports Med 10(10): 1-7.