What is Platelet Rich Plasma (PRP)?
Platelet Rich Plasma (PRP) is a biological means to stimulate wound healing and tissue regeneration by providing growth factors.
- It is a volume of plasma that has a platelet count above that of whole blood.
- The Platelet count in PRP is usually 4-8x that in whole blood.
Initially, PRP was used by orthopedists and sports medicine physicians to stimulate healing of athletic injuries - tendons, ligaments, muscles and bursae.
In recent years, pain physicians began to study and apply its use for treatment of chronic conditions.
PRP works through the many ‘Growth Factors’ it contains. These Platelet Derived Growth Factors function by:
- Stimulating cells to divide and make copies of themselves
- Promoting new blood vessels to form.
- Promoting formation of new connective tissue for wound healing
- Promoting the growth of structural and biochemical support for the cells.
Contained within the platelets, are 30+ bioactive proteins. Many of these are growth factors some of which are, ILGF-1, SDF1alpha, BMP, GDF-5, PDGF, TGF- beta1, VEGF, FGF, EGF.
- Tendinitis, Tendinopathy
- Osteoarthritis or degenerative joint disease
- Carpal tunnel syndrome, Cubital tunnel syndrome, Tarsal tunnel syndrome
- Partial muscle tears, tendon tears and ligament tears
- Degenerative Disc Disease
- Lumbar Disc tears or rupture
- Facet Syndrome
- Sacro-iliac Joint Pain
- Level 1 evidence for treatment of Elbow epicondylitis, Patellar tendinitis, Plantar Fascitis, Rotator cuff tear, Annular tear lumbar spine, Osteoarthritis knee. Level 2 for trochanteric bursitis.
- PRP for elbow tendinitis (The American Journal of Sports Medicine Nov 2006 vol. 34 no. 11 1774-1778). Conclusions:
- Treatment of patients with chronic elbow tendinosis with PRP reduced pain significantly.
- PRP should be considered before surgery
- Further evaluation of this novel treatment is warranted
- 8 wks f/u: 60% improvement in VAS in PRP group vs. 16% with Bupivacaine.
- 6 months f/u: PRP group had 81% improved VAS.
- At mean 25.6 months f/u: PRP group had 93% improved VAS.
PRP injections are used to treat patients who have had temporary relief from steroid injections and require repeat injections on a regular basis. Patients with various tendon, ligament and joint injuries as well as spine pain.
PRP Patient Instructions
- Definitive results may take 3-6 months
- Recommend stop NSAIDs for 7 days before and up to 2 weeks or more after Injection.
- Avoid fluoroquinolones and statins if possible
- Refrain from steroid injections into the treating joint for at least one month prior to procedure and do not administer at all after procedure. (Instead repeat PRP Injection)
- Rest the joint for 1-6 weeks. Splinting of the joint may be required as directed by the physician.
- Resume or start physical therapy as directed by the physician.
- Re-evaluated after 6 weeks.