PLATELET RICH PLASMA (PRP)
What is platelet rich plasma (PRP)?
PRP is a concentration of platelets, growth factors and cellular signaling factors that play a significant role in the biology of healing. It should also contain plasma proteins and proteases that work in a variety of ways to promote healing and prevent tissue degeneration. The therapeutic PRP dose delivers over 1 billion platelets per mL of treatment; this represents a 4-6 fold increase in platelet concentration compared to whole blood.
How is it performed?
After a blood sample is obtained from a patient, the blood is put into a centrifuge which separates the blood into its many components. Platelet rich plasma can then be collected and delivered to an injured area of bone or soft tissue, such as tendon or ligament, via an injection. Ultrasound guidance assists in the precise placement of PRP in a process that takes a total of 20-30 minutes. There may be soreness at the site of the injection that can last for a few days. Most people return to work and normal day to day activities immediately after the injection.
Does it hurt? Is it safe?
A local anesthetic is used. This results in minimal discomfort. Since PRP is prepared from your own blood, there is no risk of rejection or disease transmission and virtually no risk of infection.
How well does it work?
There have been numerous clinical studies that show significant healing and long lasting reduction in pain for a variety of injuries. Common injuries include tendon and ligament damage, disc degeneration, sports injuries as well as joint pain and arthritis. Results are proving PRP to be an effective and natural alternative to steroid injections, which temporarily help alleviate pain symptoms but do not heal the cause of your pain. In a small study involving knee osteoarthritis, PRP treatment was shown to be more effective than hyaluronic acid viscosupplementation treatments. PRP may eliminate the need for more aggressive treatments such as long-term medication and surgery.
Are all PRP concentrating devices and PRP treatments created equally?
No. A number of PRP concentrating devices are available commercially, each with varying cost, process and performance. Significant biological differences exist between PRP systems, which may explain some variability in clinical outcomes, not to mention your own platelet contact. It is therefore to know what makes a good quality PRP treatment:
- A therapeutic dose of platelets (over 1 billion platelets/mL)
- A high dose of growth factors released at the site of injury.
- A high platelet yield which recovers over 80% of platelets present in your blood.
- A pure PRP treatment, which removes most red and white blood cells.
We have opted to use the EmCyte PRP system, which delivers all of the above characteristics for a clinically significant outcome. Cheaper devices that require small blood draws and/or use standard test tubes provide low quality PRP ,which results in the need for repeat treatments and negative clinical outcomes. Not all PRP is created equally.
How often should I repeat this procedure?
You may gain considerable to complete relief after the first PRP treatment. In some cases, especially when the problem has been chronic, additional PRP injections may be necessary. Up to 3 injections may be given within a six month time frame. These are usually performed at 4-6 week intervals if needed.
What are the expected results?
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 tissue before the damage progresses and the condition is irreversible. PRP therapy does not provide immediate relief; instead, it sets in motion a repair mechanism that takes 2-3 weeks before pain relief is appreciated. A study in the American Journal of Sports Medicine showed the following results in patients with elbow tendinosis: 46% pain relief by week 4, 60% pain relief by week 8, 81% pain relief by 6 months. At the conclusion of the study, 93% of patients were completely satisfied with their treatment and had avoided surgery.