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What is a platelet-rich plasma therapy?
Platelet-rich plasma therapy (PRP) is a treatment option used to restart the healing process. It was originally developed 20 years ago to aide in wound healing and since has been found to heal a variety of tissues including damaged tendons, muscles, ligaments and cartilage. It restarts the healing process by reigniting the most critical stages in wound healing, that being the initial inflammatory and cell proliferation stages.
How does the PRP therapy work?
It is novel in that it uses platelets, better known for their clotting ability, from your own blood. They are specially-prepared and concentrated, then re-injected into the damaged tissue. The platelets are a key factor, as each one is a vast storehouse of numerous growth factors, or substances that enhance tissue healing. These growth factors include transforming growth factor beta, platelet derived growth factor and vascular endothelial growth factor. When injected into the damaged tissue, the platelets release all these growth factors creating a robust return of the healing inflammatory response. This allows the body to pick up where it left off to heal the damaged tissues. This treatment is in contrast to the more commonly used steroid injections which reduce pain by blocking the inflammatory process thereby stopping tissue repair entirely.
What are the key benefits of PRP therapy?
Are there any concerns with PRP?
Although extremely rare, as with any injection, side effects may include, but are not limited to bleeding, infection, allergic reaction to the medications, and a temporary increase in pain. The most common complication is a lack of improvement. Also because of its potential to be a performance-enhancing substance, it is forbidden to be used in athletes that are under the auspices of the World Anti-Doping Agency.
How do I prepare for a PRP therapy session?
First and foremost, it is critical to accurate diagnose the site of tissue damage. Imaging and anesthetic blocks are used to confirm the exact site of damage. It is also important to discontinue any anti-inflammatory medications such as aspirin, ibuprofen, Motrin, Aleve, Naprosyn one week prior to the treatment as well as one week after the treatment. You are allowed to use Tylenol as it does not have an effect on the inflammatory process.
How long does the procedure take?
PRP therapy sessions generally take one hour. This includes the time required for venipuncture, blood centrifugation, platelet preparation as well as image-guided injection of the PRP into the damaged tissue. Local anesthetic is used during the injection for patient comfort and affords several hours of relief following the injection.
What should I do after the procedure?
Depending on the structure being treated, it is often advisable to decrease weight bearing or impact on the limb for several weeks. A gradual return to normal activities is advised as new tissue is being formed. In general we advocate a gradual return to activity over four weeks with minimal exertion on the first week combined with stretching followed by a 25% increase in workouts each week with stretching and strengthening beginning the second week.Remember to refrain from NSAIDs for two weeks following the procedure. Also following the procedure it is important that you do not use ice as it acts as an anti-inflammatory by decreasing blood flow to the area. Occasionally patients report a flair-up of their pain. This is normal and signifies the return of the healing inflammatory process; it may last for several days. You may take pain medication prescribed by your physician. If you experience any increased redness, swelling, drainage from the injection site, fevers, or chills you should contact us immediately.
How long is the recovery period after a PRP therapy session?
This treatment utilizes the body’s own healing process so you should not think of this as a quick fix. It should be considered a more definitive treatment that will reduce or even eliminate the need for oral medications, cortisone injections, physical therapy or even surgery. Since new tissue is being formed, it usually takes up to 4-6 weeks to see an improvement.
How many PRP therapy sessions will I need?
Depending on the structure that we are attempting to treat it may require 1 to 4 sessions spaced about 4-6 weeks apart. The number of treatments depends also on your response to the first treatment. We often have patients that only require one treatment for substantial long term relief.
What research has been done on PRP therapy?
The roles of growth factors in tendon healing and ligament healing, Molloy T, Wang Y, Murrell AC. Sports Med 2003;33: 381–94Growth factor delivery methods in the management of sports injuries: the state of play. Creaney L, Hamilton B. British Journal of Sports Med. 2008 May;42(5):314-20.
Platelet-rich plasma: from basic science to clinical applications. Foster TE, Puskas BL, Mandelbaum BR, Gerhardt MB, Rodeo SA. American Journal of Sports Med. 2009 Nov;37(11):2259-72
Sampson S, Reed M, Silvers H, Meng M, Mandelbaum B. Injection of platelet-rich plasma in patients with primary and secondary knee osteoarthritis: a pilot study. Am J Phys Med Rehabil. 2010 Dec;89(12):961-9.
Please do not hesitate to address any further questions or concerns you may have before having a platelet-rich plasma therapy treatment.
Andre is very knowledgeable and did a thorough investigation of the issue. He is a great communicator and described the diagnoses and next steps clearly.