Platelet-rich plasma (PRP) therapy, sometimes called PRP therapy, aims to take advantage of the blood’s natural healing properties to repair damaged cartilage, tendons, ligaments, muscles, or even bone.
Although not considered standard practice, a growing number of people are turning to PRP injections to treat an expanding list of orthopedic conditions, including osteoarthritis, lateral epicondylitis, Golfer’s Elbow, rotator cuff or shoulder degeneration, plantar fasciitis or ligament tears & sprains.
When treating orthopedic indications with platelet-rich plasma, a doctor injects PRP directly into the affected joint. The goal is to:
Platelet-rich plasma is taken from a sample of the patient’s own blood which is then placed in a centrifuge to separate out the platelets. The therapeutic injections contain plasma with a higher concentration of platelets than found in normal blood.
Plasma refers to the liquid component of blood; it is the medium for red and white blood cells and other material traveling through the blood stream. Plasma, although mainly water, also includes proteins, nutrients, glucose, antibodies and other components.
Platelets are a normal component of blood, like red and white blood cells. Alone they do not have any healing properties, but they do secrete growth factors and other proteins that regulate cell division, stimulate tissue regeneration, and promote healing.
The most common way to prepare PRP involves drawing a patient’s blood sample into a vial and centrifuging it at intensely high speeds. The spinning causes the blood to separate into layers:
Once the centrifuge process is finished, the doctor removes the vial from the centrifuge and prepares the PRP solution for injection.
The exact composition of platelet-rich plasma depends on the individual’s concentration of platelets, number of white blood cells, how much blood was drawn, the centrifugation process and the use (or not) of additives. Some physicians combine additives with the platelet-rich plasma such as thrombin and calcium chloride, which can artificially activate platelets and may boost the platelet-rich plasma’s regenerative properties.
Patients should be made aware that the use of PRP in conjunction with lifestyle changes and non-surgical options such as weight loss, physical therapy and use of NSAID’S may lead to a more favorable outcome.
When selecting a physician for platelet-rich plasma therapy, patients may want to know:
Before administering platelet-rich plasma injections, a doctor should also explain the:
Platelet-rich plasma injections are considered “experimental” by most insurance companies. A single treatment of one joint can cost $400 to $2,000 paid out-of-pocket by the patient.
Platelet-rich plasma injections are outpatient procedures. Because the patient’s blood must be drawn and prepared for injection, a typical procedure may take anywhere from 45 to 90 minutes.
The American Academy of Orthopaedic Surgeons recommends the following pre-injection guidelines:
Although the American Academy of Orthopaedic Surgeons published these pre-injection guidelines, the organization does not advocate for or against platelet-rich plasma treatment.
Patients are advised to take it easy for a few days and avoid putting strain on the affected area. The injection site may be swollen and painful for about 3 days, as the platelet-rich plasma typically stimulates a series of biological responses.
Doctors may recommend that the patient: