What Is Platelet-rich Plasma (PRP)?
Although blood is mainly a liquid (called plasma), it also contains small solid components (red cells, white cells, and platelets.) The platelets are best known for their importance in clotting blood. However, platelets also contain hundreds of proteins called growth factors which are very important in the healing of injuries. Platelet-rich Plasma is plasma with many more platelets than what is typically found in blood. The concentration of platelets — and, thereby, the concentration of growth factors — can be 5 to 10 times greater (or richer) than usual. To develop a PRP preparation, blood must first be drawn from a patient. The platelets are separated from other blood cells and their concentration is increased during a process called centrifugation. Then the increased concentration of platelets is combined with the remaining blood.
How Does PRP Work?
Although it is not exactly clear how Platelet-rich Plasma Therapy works, laboratory studies have shown that the increased concentration of growth factors in PRP can potentially speed up the healing process. To speed healing, the injury site is treated with the PRP preparation. This can be done in one of two ways:
PRP can be carefully injected into the injured area. For example, in Achilles tendonitis, a condition commonly seen in runners and tennis players, the heel cord can become swollen, inflamed, and painful. A mixture of PRP and local anesthetic can be injected directly into this inflamed tissue. Afterwards, the pain at the area of injection may actually increase for the first week or two, and it may be several weeks before the patient feels a beneficial effect.
PRP may also be used to improve healing after surgery for some injuries. For example, an athlete with a completely torn heel cord may require surgery to repair the tendon. Healing of the torn tendon can possibly be improved by treating the injured area with PRP during surgery. This is done by preparing the PRP in a special way that allows it to actually be stitched into torn tissues.
What Conditions Are Treated With PRP?
Research studies are currently being conducted to evaluate the effectiveness of PRP treatment. At this time, the results of these studies are inconclusive because the effectiveness of PRP therapy can vary. Factors that can influence the effectiveness of PRP treatment include:
- The area of the body being treated
- The overall health of the patient
- Whether the injury is acute (such as from a fall) or chronic (an injury developing over time)
Chronic Tendon Injuries
According to the research studies currently reported, PRP is most effective in the treatment of chronic tendon injuries, especially tennis elbow, a very common injury of the tendons on the outside of the elbow.
The use of PRP for other chronic tendon injuries — such as chronic Achilles tendonitis or inflammation of the patellar tendon at the knee (jumper’s knee) is promising. However, it is difficult to say at this time that Platelet-rich Plasma Therapy (PRP) is any more effective than traditional treatment of these problems.
Acute Ligament and Muscle Injuries
Much of the publicity Platelet-rich Plasma Therapy (PRP) has received has been about the treatment of acute sports injuries, such as ligament and muscle injuries. PRP has been used to treat professional athletes with common sports injuries like pulled hamstring muscles in the thigh and knee sprains. There is no definitive scientific evidence, however, that PRP therapy actually improves the healing process in these types of injuries.
Surgery
More recently, PRP has been used during certain types of surgery to help tissues heal. It was first thought to be beneficial in shoulder surgery to repair torn rotator cuff tendons. However, the results so far show little or no benefit when PRP is used in these types of surgical procedures. Surgery to repair torn knee ligaments, especially the anterior cruciate ligament (ACL) is another area where PRP has been applied. At this time, there appears to be little or no benefit from using PRP in this instance.
Knee Arthritis
Some initial research is being done to evaluate the effectiveness of PRP in the treatment of the arthritic knee. It is still too soon to determine if this form of treatment will be any more effective than current treatment methods.
Pain
Platelet rich plasma therapy (or PRP injections) is a new treatment that relieves pain by promoting long lasting healing of musculoskeletal conditions. This rapidly emerging technique is showing exciting potential with osteoarthritis of the knee, shoulder, hip and spine, rotator cuff tears, chronic plantar fasciitis, anterior cruciate ligament (ACL) injuries, pelvic pain and instability, back and neck injuries, tennis elbow, ankle sprains, tendonitis, and ligament sprains.
How Do PRP Injections Help?
The body’s first response to soft tissue injury is to deliver platelet cells. Packed with growth and healing factors, platelets initiate repair and attract the critical assistance of stem cells. Platelet Rich Plasma therapy’s natural healing process intensifies the body’s efforts by delivering a higher concentration of platelets. To create platelet rich plasma therapy, a small sample of your blood is drawn (similar to a lab test sample) and placed in a centrifuge that spins the blood at high speeds, separating the platelets from the other components. The concentrated PRP injection is then delivered into and around the point of injury, jump-starting and significantly strengthening the body’s natural healing signal. Because your own blood is used, there is no risk of a transmissible infection and a very low risk of allergic reaction.
How Long Does It Take To Get PRP Injections?
The Platelet Rich Plasma therapy takes approximately one to two hours, including preparation and recovery time. Performed safely in a medical office, PRP injections relieve pain without the risks of surgery, general anesthesia, or hospital stays and without a prolonged recovery. In fact, most people return to their jobs or usual activities right after the procedure. Up to three PRP injections may be given within a six-month time frame, usually performed two to three weeks apart. You may, however, gain considerable to complete relief after the first or second injection.
What Are The Expected Results?
Because the goal of platelet rich plasma therapy is to resolve pain through healing, it could prove to have lasting results. Initial improvement may be seen within a few weeks, gradually increasing as the healing progresses. Research studies and clinical practice have shown Platelet Rich Plasma therapy to be very effective at relieving pain and returning patients to their normal lives. Both ultrasound and MRI images have shown definitive tissue repair after PRP therapy, confirming the healing process. The need for surgery can also be greatly reduced by treating injured tissues before the damage progresses and the condition is irreversible.
Reimbursement & Insurance Information
While Platelet-rich Plasma Therapy (PRP) has been used for decades to treat a variety of diseases, its application in orthopedic and sports-related procedures is relatively new in the United States. As a result, most insurance companies do not currently cover these procedures, and payment is due in full advance by the patient.