Platelet Rich Plasma (PRP) Therapy
Platelet Rich Plasma Therapy (PRP), an innovative and increasingly popular cellular treatment in Regenerative Orthopedics, promotes and accelerates the body's natural healing process of soft tissue injuries and osteoarthritis. PRP effectively bridges the gap between medications, which can mask pain but are not curative, and invasive surgeries.
Plasma, the liquid portion of blood, acts primarily as a transport medium for blood cells, nutrients, and metabolic waste products, contributing to the physiological stability of the body. Platelets are among the many blood cells in plasma that not only play an important role in forming blood clots, but also contain growth factors, such as alpha-granules, that are central to the body's healing process. Blood cells called macrophages remove the damaged tissue to prepare the injury for healing.
A portion of the plasma from the patient's blood, combined with concentrated platelets, is injected through use of ultrasound guidance into and around the injured tissue. Large quantities of activated platelets are released at the site of injury to stimulate activation of localized stem cells and promote a healing response in surrounding tissue. An induced inflammatory reaction results in a healing cascade, depositing collagen molecules to repair and strengthen tissue. The growth factors contained in the platelets and plasma stimulate blood flow, promote matrix formation of soft tissue, and restore tendon and ligamentous proteins that may have been previously compromised. Cartilage, ligaments, and tendons heal to become more firm and resilient.
- Q. What types of conditions can be treated?
A. PRP is particularly beneficial to torn or strained ligaments, tendons. It is also helps to restore cartilage that has degenerated due to injury or osteoarthritis.
- Q. Why PRP instead of cortisone?
A. Cortisone injections (also known as corticosteroid injections) and PRP injections are both very effective at reducing joint pain, but for very different reasons. They are essentially opposite ends of the same spectrum.
Corticosteroid injections stop the inflammatory process. The problem is that if you have a small tear in the tissue that needs to heal, you have essentially stopped the healing process. In addition, the corticosteroids are well known for breaking up collagen bonds. Tendons are a huge cable made of collagen. Corticosteroid injections can weaken the tendon and make it more likely to rupture or completely tear.
- Q. What's the difference between PRP and stem cell therapy?
A. PRP costs substantially less than stem cell therapy and does not require harvesting of fat or bone marrow. However, it takes about 3-4 treatments versus 1 for stem cell therapy. If the injury or degeneration is not too severe and the patient is healthy, PRP is a good option.
- Q. What if I have already had surgery?
A. Surgery to damaged connective tissue, or even joint replacement, is generally limited to the immediate site of the condition. PRP can help the primary area heal more quickly, but it also benefits the surrounding tissue that has been affected by the surgery and the body's compensation for the injured area.
- Q. Is PRP covered by insurance?
A. No, insurance does not cover PRP. We try to mitigate costs, however, by billing for the office visit.
More Information on PRP
- Alderman D, Robbins SC. Platelet rich plasma prolotherapy for rotator cuff tears: case challenge. Practical Pain Management. 2012;12(8).
- Hauser RA, Phillips HJ, Maddela HS. The case for utilizing prolotherapy as first-line treatment for meniscal pathology: a retrospective study shows prolotherapy is effective in the treatment of MRI-documented meniscal tears and degeneration. Journal of Prolotherapy. 2010;2(3):416-437.
- Hospital for Special Surgery. Platelet-Rich Plasma (PRP) Injections.
- Kon E, Buda R, Filardo G, et al. Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions. Knee Surgery, Sports Traumatology, Arthroscopy. 2010;18(4):472-479.
- Monto RR. Platelet-rich plasma efficacy versus corticosteroid injection treatment for chronic severe plantar fasciitis. Foot Ankle Int. 2014 Apr;35(4):313-318.
- Meheux CJ, McCulloch PC, Lintner DM, Varner KE, Harris JD. Efficacy of intra-articular platelet-rich plasma injections in knee osteoarthritis: a systematic review. Arthroscopy. 2016;32(3):495-505.
PRP: Procedure Snapshot
The patient's blood is drawn and spun in a centrifuge to isolate the platelets and their associated growth factors. Centrifuging then increases the level of platelets from a concentration of 6% to 94%. This concentration of cells is added to the patient's plasma which contains a variety of proteins that are essential to connective tissue healing. Using ultrasound guidance, this preparation is then injected into the damaged area, stimulating release of stem cells that accelerate and enhance new cell growth. Collagen molecules are subsequently deposited on the damaged tissue, resulting in tissue regeneration and restored blood flow.
Because the injected solution is prepared from the your own blood using aseptic technique, your body has no risk of rejection or exposure to blood-borne diseases.
The procedure takes about 1 hour and the patient can return home the same day. Healing from the procedure treatment takes about 1 week. Many patients require 3-4 treatments and healing depends on the severity of the injury and healing tendencies of the individual.
Adverse reactions associated with PRP injections are remote and usually of minor severity-most commonly, injection site pain and infection.
Many professional athletes have used PRP therapy with great success.
Many professional athletes have used PRP therapy with great success, including:
- Tiger Woods - PRP as a follow-up procedure to ACL surgery on his knee.
- Hines Ward - the Super Bowl MVP received PRP therapy on his right knee.
- Stephen Curry - used PRP therapy for a quick return from knee injury.
- Kobe Bryant - traveled to Germany for PRP for irreversible cartilage in his knee that had previously been surgically repaired.
- Alex Rodriguez - five treatments after hip surgery. His trainers were amazed how quickly he was back to baseball.
Conditions treated include:
PRP is a good option for treating damage to ligaments and tendons. Not only can it prevent or delay the need for surgery, PRP can also allow the patient to return to activity within a shorter period. If the injury is severe enough to require surgery, PRP is a valuable follow-up procedure to enhance healing of both the surgical site itself and surrounding tissue.
- Degenerative joint disease
- Spine arthritis
- Meniscus tears
- Tendon tears
- Hamstring Strains
- Tendon pain on thumb side of wrist (De Quervains Tenosynovitis)
- Labrum tears
- Ligament sprains, strains, and tears
- Tennis and golfers elbow
- Plantar fasciitis
- SI joint problems
- Osteoarthritis. Traditional treatment has primarily been to mask the pain with drugs (eg, NSAIDS or cortisone). PRP, however, helps to stimulate the body to regenerate, or re-grow, new cartilage tissue, both reducing further damage and promoting new tissue.
- Ligament and tendon injuries. Damage to these tissues is generally difficult to treat as they have poor blood flow which is apparent from their white color. Muscles, on the other hand, are red because they have a very good blood supply. The lack of adequate blood flow makes ligaments and tendons prone to incomplete healing from injury.
All of our biological procedures are performed on the same day with minimal manipulation of blood, bone marrow, or adipose tissue & are therefore compliant with FDA CFR 21 Part 1271, falling under the same surgery exemption in FDA rule in 1271.15 (b).