What is PRP?
PRP, or “platelet-rich plasma,” is a revolutionary new treatment for chronic sports and musculoskeletal injuries that has become very popular with professional athletes. Seattle Mariners pitcher Cliff Lee used it for an abdominal strain. Denver Nuggets power forward Kenyon Martin used it on a strained left knee. Tiger Woods had injections of it in his left knee before four majors. Pittsburgh Steelers Troy Polamalu and Hines Ward used it to treat a strained calf and a sprained knee ligament before the team’s Super Bowl win in 2009. PRP will change the way we treat injuries in sports medicine and orthopedic conditions.
At AgeFocus we use Platelet Rich Plasma (PRP) for sports-related injuries and cosmetic procedures (“Vampire Facelift”). It is one of a growing number of therapies that enhance the body’s ability to heal itself.
We also use stem cells in combination with PRP in some treatments to further promote healing.
How Does PRP Work?
Platelets are a specialized type of blood cells commonly associated with blood clotting. Blood is made up of 93% red cells (RBCs), 6% platelets, 1% white blood cells (WBCs) and plasma.
After an injury, platelets are involved in clotting so we stop bleeding. But after this initial job is done, platelets are very involved in wound healing. Human platelets are naturally extremely rich in connective tissue growth factors. They release these factors to first clean the wound, then bring new blood vessels and stem cells into the area, stimulating their organized growth. They also stimulate our skin cells to divide and “cover” the wound.
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.
PRP vs. Cortisone Injections
Cortisone injections have been used for many years to treat acute/chronic injuries (tendons/ligaments/joints), and pain and inflammation subsides after a few days. But the healing process is also impaired because any repair is halted by this substance. PRP does the opposite. It promotes inflammation and healing, becoming the preferred treatment when the injury does not heal after a few days, or the patient can’t afford to to wait (i.e., professional athletes).
Many studies have shown than even when the injury is capable of healing on its own, PRP will decrease recovery time by 25% to 50%! But probably the most significant outcome is for those patients that have failed to improve with conservative treatment (including cortisone injections).
PRP has been used in dentistry since the 1970s, and is currently being used to treat orthopedic injuries, as well as sports-related injuries. PRP is sometimes used with surgery, but research shows that by itself it can sometimes remove the need for surgery. Since there is no foreign or banned substances being injected, it is legal to use for professional athletes.
Research from the American Academy of Orthopedic Surgeons found that PRP is very effective at treating tennis elbow, tendonitis and osteoarthritis. It’s also used to treat plantar fasciitis (inflammation of the bottom of the foot) and muscle injuries. Doctors are also now using it for hamstring, calf and oblique strains. Furthermore, heart surgeons are using PRP to strengthen tissues in bypass operations.
How Is PRP Prepared?
In our office blood is drawn from the patient (just like getting a blood test) and placed in a special centrifuge. The centrifuge separates the red cells, and the remaining platelets and plasma are then highly concentrated. The red blood cells are discarded, and the resulting platelet concentrate is used for treatment.
This process takes approximately 16 minutes. In the meantime the area to be treated can be injected with local anesthetic.
What Conditions Benefit from PRP?
PRP treatment works best for chronic ligament and tendon sprains/strains that have failed other conservative treatment, including:
Rotator cuff injuries.
Shoulder pain and instability.
Tennis and golfer’s elbow.
Hamstring and hip strains.
Knee sprains and instability.
Patellofemoral syndrome and patellar tendinosis.
Achilles tendinosis and plantar fasciitis.
Knee, hip and other joint osteoarthritis.
Sports hernias and athletic pubalgia.
Other chronic tendon and ligament problems.
In addition, PRP can be very helpful for many cases of osteoarthritis (the “wear and tear” kind). PRP can help stimulate a “smoothing over” of the roughened and arthritic cartilage, reducing the pain and disability of arthritis. Most of the time we combine PRP with stem cell injection for joint problems. PRP acts as the “fertilizer” while stem cells are the new “seeds” that will help on healing. This includes:
Hip joint arthritis.
And other joint arthritis.
In the past year we have been very successful by using PRP in our spine treatments, especially on patients suffering from chronic back/leg pain due to herniated discs and degenerative disc disease. PRP helps to heal the nerve irritation, as well as painful tears that occur in the outer part of the discs.
How Often Are Injections Given?
After the initial treatment, a follow-up visit is scheduled two weeks later to check on healing progress. Some patients respond very well to just one treatment. However, typically two to three treatments are necessary. Injections are given every four weeks.
Side Effects of PRP
While there aren’t many downsides to PRP because it uses your own tissue, some people report minor pain after the procedure. This occurs because PRP involves injecting fluid into tissue that normally doesn’t have much of it. Because inflammation starts after PRP, for 24 to 48 hours increased discomfort may occur. Usually the site will be given a numbing agent before the injection and pain medication will be given for 12 to 48 hours after the treatment. Studies suggest an improvement of 80% to 85%. Some patients experience complete relief of their pain. The results are generally permanent.