PRP (Platelet Rich Plasma)
A natural treatment for pain and injury, PRP is a well-established injection series and is gaining popularity among high school, collegiate, and professional athletes in order to more rapidly return them to competition and potentially avoid surgery for certain injuries. World-class athletes such as Tiger Woods, Hines Ward of the Pittsburgh Steelers, and Rafael Nadal have used PRP to treat both acute and chronic injuries with amazing results.
In addition, PRP has been found to be beneficial in relieving pain and improving functioning people with arthritis. Platelets, a component of blood, are thought to be responsible for the beneficial effect of PRP through the release of various growth factors. These growth factors can aid in the growth of new tissue, new bone, new blood vessels, and many other natural healing properties of your body.
How is it made?
PRP is made by using a sample of your own blood drawn on the day of the injection. By use of a special centrifuge, a sample of blood can be spun down (hard spin) allowing the components to separate based on weight leaving a sample of plasma on top android blood cells on bottom. The plasma portion can be extracted, and another spin cycle(soft spin) will further separate the platelet-rich plasma from the platelet-poor plasma.
How is it given?
PRP is given as an injection, typically under ultrasound guidance. On average it takes about 45 minutes from blood draw until the PRP is ready. During that time your physician will locate and mark the area the PRP will be injected and will prep the area for the procedure.
How long will it last?
The goal is that after one injection, your pain is significantly, or entirely, eliminated and you will be able to return to your normal function. Clinical studies are evolving regarding the long-term results to say with absolute certainty the duration of the advantageous effects. Some patients require more than one PRP injection. This will be evaluated six weeks after the procedure has been performed.
What are the side effects?
Injection side effects, such as soreness at the area of injection, are common. Infection is always a risk with any type of injection; however, the risk is less than the risks associated with much more commonly performed corticosteroid injections. Because PRP is composed of your own blood, there is no risk of transmissible diseases such as HIV and hepatitis, as there are in other blood products from anonymous donors.
When is it indicated?
PRP is primarily used to treat chronic tendon and ligament injuries, such as lateral and medial epicondylitis (tennis and golfer’s elbow, respectively). It is a treatment option when more conservative options have failed to provide adequate relief. Conservative options include rest, icing/bracing, physical therapy, corticosteroid injections, osteopathic manipulative treatment (OMT) and/or nonsteroidal anti-inflammatory drugs(NSAIDs). It is also becoming an emerging treatment for patients with arthritis. PRP could be an alternate treatment option for you to discuss with your physician. PRP is generally indicated in areas of the body that do not have an adequate blood supply to promote proper healing. It is also being utilized as an adjunct to surgery in the repair of tendons such as anterior cruciate ligament (ACL) repairs.
What is the evidence?
Several studies of lateral epicondylitis (tennis elbow) demonstrate a significant pain reduction over the course of 1-3 years, with significant improvement in pain after 1 year when compared with corticosteroid injections. Studies have demonstrated that PRP out performed corticosteroid and visco-supplementation injections (a commonly performed therapy for osteoarthritis), especially in those with more advanced disease. Other studies also indicate that PRP is useful for the management of chronic low backpain, especially those with sacroiliac instability. While insurance companies still see PRP as being experimental, it is a very well-studied treatment and the evidences owing its efficacy continues to grow each year. There are numerous research papers, case studies, and articles advocating PRP therapy for injuries involving rotator cuff, hamstring tears, plantar fasciitis, and meniscus tears.
How much does it cost?
PRP has not been approved by the FDA and is typically not covered by insurance. Thecost of the procedure will be discussed at your consultation. You can use your medical flexible spending accounts to pay for this procedure
What happens after the procedure?
Your physician may temporarily place you in a sling (for upper extremity procedures) ora boot, brace, and/or crutches (for lower extremity procedures). A rehabilitation program will be designed specifically for your condition.