What is Platelet-Rich Plasma (PRP)?
Our blood consists of a liquid component known as plasma. It also consists of three main solid components which include the red blood cells (RBCs), white blood cells (WBCs), and platelets. Platelets play an important role in forming blood clots. They also consist of special proteins, known as growth factors, which help with our body’s healing process. Platelet-rich plasma or PRP is a high concentration of platelets and plasma. A normal blood specimen contains only 6% platelets, while platelet-rich plasma contains 94% of platelets and 5 to 10 times the concentration of growth factors found in normal blood, thus greater healing properties.
What are the Indications for PRP Injections?
PRP is a relatively new method of treatment, used to treat several orthopedic conditions. Despite being deemed “experimental” by insurance, did you know that there are multiple conditions that have Level 1 studies to support its use? These studies compare the efficacy of PRP vs standard orthopedic treatment ie. cortisone, and hyaluronic acid injections (in osteoarthritis) and have proven that PRP is superior.
- Knee osteoarthritis: There are currently more than 30 level 1 studies revealing superior patient outcomes utilizing PRP when compared to steroid injections and hyaluronic acid injections.
- Medial Collateral Ligament
- Tendinopathies
- Medial/Lateral Epicondylitis (golfer/tennis elbow)
- Gluteal Tendinopathy (commonly misdiagnosed as hip bursitis)
- Achilles Tendinopathy
- Plantar Fasciitis
- Rotator cuff tear /tendinopathy (type and location of tear will determine efficacy)
Additional areas have been treated with PRP as well with success, but are not as well documented in the literature.
Platelet-Rich Plasma Injection Procedure
Your doctor will first draw between 30 to 120 cc’s of blood from the large vein in your elbow. The blood is then spun in a centrifuge machine for about 10 to 15 minutes to separate the platelets from the remaining blood components. The injured part of your body is then anesthetized with a local anesthetic. The PRP will be injected into the injured area under ultrasound guidance to ensure proper needle placement.
Post Procedural Care following PRP Injections
It is normal to feel discomfort at the injection site for a few days after your procedure.
- In some cases you will be prescribed pain medications by your doctor. You may also take Tylenol (acetaminophen) for pain unless you have been told not to by another doctor, have underlying liver disease or allergy to this medication.
- You will be given heat packs to be used at the injection site. Do NOT use cold at this area.
- No anti-inflammatory medication following for at least 2 weeks. This includes: Advil, Motrin, Ibuprofen, Aleve, Naproxen. If you are on daily Aspirin please discuss this with your doctor.
- You will be given specific instructions regarding your activity level following as each area and type of PRP requires different post procedural restrictions.
Risks and Complications of Platelet-Rich Plasma Injections
There are very minimal risks associated with PRP injections. Some of the potential risks include:
- Increased pain at the injection site
- Infection
- Damage to adjacent nerves or tissues
- Formation of scar tissue
- Calcification at the injection site