PRP (Platelet Rich Plasma) Therapy
PRP therapy is gaining grounds among physicians and patients as the desired treatment for joint pains. Patients that do not want surgery, or are not good candidates, and those who do not want to take pain medications for the rest of their life, are seeking other therapies that promote joint healing. PRP has shown to be one of the most effective natural treatments that promote the body’s own natural healing properties. PRP can help heal traumatized joints or injured muscles.
PRP Regenerative Therapy
It is considered a Regenerative Therapy by using the platelet component of the patient’s blood. Platelets are blood cells that are immediately involved into healing injured tissues. They release growth factors that cause the laying down of new collagen, fibroblasts, and regeneration of other cells. With the proper technology, physicians can separate the platelets from the blood in a 15 minute in office procedure which is safe and easy.
When a person sprains a joint, the ligaments and tendons supporting that joint are stretched. Because these tissues don’t have a good blood supply, the healing process can be extremely slow or ineffective; that leaves the joint in a loose unstable state which causes it to “wobble”. The body does not like this instability and tries several methods to stabilize the traumatized and unhealed joint. The first is to recruit the muscles above and below the joint to hold the joint tight. Since the muscles are not designed primarily for this type of work, fatigue and spasms start leading to referred pain.
If the instability goes on long enough, the second method the body uses to stabilize the joint is to calcify the inflamed areas. This leads to osteophyte formations and what we know as arthritis. Using the PRP injections, we can target those injured tissues and the body’s own healing factors within the platelets restart the repair process effectively.
What is PRP ?
PRP stands for Platelet Rich Plasma. It is an advanced therapy that applies the patient’s own natural healing mechanisms in the platelets to repair injured tendons, ligaments, and muscles which support the joints. Joints become painful and non-healing with repetitive injury, poor nutrition, or use of anti-inflammatory medications. PRP can accelerate the healing in acute injuries or restart the slow repair process in chronic injuries.
How does it work?
When a joint is injured, the ligaments and tendons are stretched. The first cells to start the healing process are usually the platelets. They move into the damaged tissue and stop the bleeding at the sites of tears. Then they release growth factors which start the healing cascade. These growth factors call in new cells and cause new blood vessels to form in the tendons and ligaments. Eventually, stem cells remodel the tissues and lay down new collagen and fibroblasts. When patients have chronic injuries, somewhere this healing process becomes ineffective. By injecting the PRP into the injured ligaments and tendons we are able to restart the healing process at the sites that need it.
How long does it take?
The PRP process takes about 30-60 minutes in the office. Blood is drawn from the patient and placed in a special separator cup and centrifuged for 15 minutes. This patented process yields the greatest concentration of platelets. Not all devices in the market have the same capability. Before injecting the PRP, the ligaments and tendons of the joint are anesthetized with local anesthetic. After the PRP has been separated and concentrated by the centrifuge, it is then injected into the injured joint.
Which joints can be treated?
Any injured joint can be treated such as ankles, knees, hip, low back, shoulders, elbows and wrists. The injury can be acute or chronic.
How does this compare to cortisone?
Cortisone does the opposite of PRP. It causes the tissues to thin and become weaker. It temporarily reduces inflammation and discomfort but does not promote healing. PRP, on the other hand, causes the tendons and ligaments to thicken and strengthen, by temporarily increasing inflammation.
What kind of result can I expect?
Several studies have shown as much as 80% of the patients achieving at least 60% improvement in symptoms. Patients had injuries for a couple months to a several decades and most of them usually feel better in a week or two. An average of 1-2 treatments per joint are required. Some of the improvements are increased stability, less joint pain, more mobility, less use of pain medicines, and better sleeping. Different studies show close to 85% of patients being satisfied or very satisfied with the treatment.
Down Time/When can I return to normal activities?
Patients are asked to do light activity for a week and resume heavier activity after that, but still exercising caution as the healing process is still going on.
Is the treatment covered by insurance?
Most, PPO insurances typically cover the procedure. Our office can check with your insurance carrier for re-imbursement prior to treatment.
Who is using PRP?
It has been used by professional athletes to get back in the game quicker without surgery. They avoid lengthy downtime and lengthy physical therapy commitments. Tiger Woods, Hines Ward and various professional football and baseball players that remained anonymous, have used PRP to recover from injuries.
PRP History and Current Studies
PRP was initially used over 20 years ago in dentistry to enhance wound healing in cancer patients with jaw reconstruction. Soon afterward, its applications extended across many fields of medicine from cardiovascular surgery to orthopedics. Multiple studies are underway to help further refine the treatment and demonstrate its efficacy.
Gosens and Sluimer in a prospective, randomized controlled trial of 100 patients with tennis elbow found PRP beat cortisone injections in reducing pain and improving function within 24 weeks. This excellent study confirms platelet rich plasma performs better than the “gold standard” of treatment for patients with tennis elbow that don’t respond to simple treatments.