Frequently Asked Questions
Platelet Rich Plasma (PRP) is a concentration of platelets, drawn from the patients own blood stream. First, a blood sample is taken then spun in a centrifuge. The process of centrifugation separates the blood cells and platelets. The platelets are then injected back into the patient at the site of injury. Platelets work naturally in the body to heal injuries; they are filled with a protein also known as growth factors.
The body’s first response to heal soft tissue injury, is to deliver platelet cells. Platelet cells are rich in growth factor proteins which speed up clotting and recovery. PRP enhances this natural healing process by delivering a higher concentration of these platelets to the area needed. PRP can either be injected into an injured area or can be used post-surgery to speed healing. To create PRP, a sample of the patients’ blood is drawn. It is placed into a centrifuge and spun for separation of its components. The platelets are then re-injected back into the area of injury to strengthen and speed the recovery process.
Ultrasound and MRI images have shown tissue repair after PRP therapy. It has been proven to reduce or eliminate the need for surgery. Most patients experience some dull pain post-therapy, but report increased function and zero pain in four to six weeks, especially if they avoid physical or strenuous activity within those four to six weeks, to allow for full recovery. Pain also depends on the area treated, over the counter Tylenol could relieve discomfort. It is important to AVOID using anti-inflammatory medications such as Celebrex, Motrin, Aleve, Mobic and Naprosyn, which could impede the healing process.
A good example of how platelets injected to the site of injury can be helpful would be in the Achilles. Since it is a tendon with poor blood supply, the body has a tough time healing it when it has chronic scarring or microscopic tears. Many tendon injuries (tendonitis, Achilles tendonitis, tennis elbow, patellar tendonitis, etc.) can become chronic and the formation of scar tissues. Concentrated platelet injections, PRP injections, allows the body to enhance recovery because of the growth factors and added nutrients.
Proteins, known as growth factors, are found in platelets. They stimulate stem cells regeneration of new tissues to assist the body in repairing itself. Growth factors include platelet-derived growth factors (PDGF), transforming growth factor beta (TGF), and insulin-like growth factor (ILGF). The larger amount of growth factors released, the more stem cells stimulated to produce new collagen.
PRP treatment results vary. Factors that can influence the effect of PRP in patients include: the overall health of the patient, whether the injury is chronic or acute, and the area of the body being treated. Chronic Tendon Injuries and Acute Ligament/Muscle Injuries have seen promising results with PRP therapy. Recently, PRP has been used in surgery to speed up the recovery of tissues, broken bones to speed the healing process, and arthritis in the knee. PRP has also picked up popularity for more aesthetic procedures; injections into the scalp to increase hair growth, as well as crow’s feet and under eye discoloration.
PRP treatments are performed in a medical office, by a trained physician or technician. The procedure typically takes a couple hours, including preparation, injection and recovery time. Most patients can return to their jobs or usual activities immediately following the procedure. PRP therapy relieves pain without the risks of surgery, anesthesia, or prolonged recovery and hospital stays. If the injections are being administered in the extremities, ultra-sound guidance is occasionally used so the injection reaches the appropriate ligament, joint, or tendon. If the treatment is being used for the area around the spine, fluoroscopy (x-ray) guidance is used to assure correct placement and safety for the affected site.
Many patients can feel relief after the first or second injection, but up to three injections could be administered in a six-month time frame. Factors that can influence the amount of PRP injections needed include: the overall health of the patient, whether the injury is chronic or acute, and the area of the body being treated.
PRP treatment has shown to be a safe option and no risk of allergic reactions since it is your own blood. PRP is low risk and has few side effects. Hyperplasia has been raised as a concern, regarding the use of growth factors. There have been no documented cases of hyperplasia, tumor growth, or carcinogenesis associated with the use of PRP. It is important to AVOID using anti-inflammatory medications such as Celebrex, Motrin, Aleve, Mobic and Naprosyn, which could impede the healing process. Over the counter Tylenol is safe to use though. Some agencies consider PRP to be a performance-enhancing substance, containing endogenous growth factors. Currently, the World and the US Anti-Doping Agency forbid the use of PRP injections into the muscle.
Most insurance plans, including Medicare, will NOT cover PRP injections.