Giving you your own blood – the basics of platelet – rich plasma (PRP) treatment
Basically, blood is mainly a suspension of solid particles called blood cells (which are red cells, white blood cells and platelets) in a liquid solvent (called plasma). These cells vary in structures and functions. The platelets are best known for their importance in clotting blood and they also contain hundreds of proteins called growth factors which are very important in the healing of injuries.
PRP is therefore plasma with many more platelets than what is typically found in blood. The concentration of platelets — and, thereby, the concentration of growth factors — can be 5 to 10 times greater (or richer) than usual.
How it is obtained
PRP is obtained from a person’s own blood. Thus, getting a PRP injection simply means giving your own blood back to you. To develop a PRP preparation, blood must first be drawn from a patient. The platelets are separated from other blood cells and their concentration is increased during a process called centrifugation. Then the increased concentration of platelets is combined with the remaining blood. Platelet rich plasma can then be collected and treated before it is delivered to an injured area of bone or soft tissue, such as a tendon or ligament.
PRP is given to patients through an injection, and ultrasound guidance can assist in the precise placement of PRP. After the injection, a patient must avoid exercise for a short period of time before beginning a rehabilitation exercise program.
Several basic science studies in animal models suggest that PRP treatment can improve healing in soft tissue and bone. For example, increased numbers of cells and improved tendon strength have been noted in Achilles tendon injuries, and improved muscle regeneration has been shown in gastrocnemius (calf) muscle injuries.
These favorable findings in animal models have led to the widespread use of PRP treatment for a variety of conditions, including acute and chronic tendon problems, as well as injuries to ligaments and muscles. Some early-stage clinical studies in humans have been promising, but are limited by their study design and few patients.
In a small study involving knee osteoarthritis, PRP treatment was shown to be more effective than hyaluronic acid treatment. PRP has also resulted in positive or similar results when used in the treatment of rotator cuff tears and medial collateral ligament (MCL) injuries in the knee.
Overall, there is limited support of PRP treatment in published clinical studies. However, because PRP is created from a patient’s own blood, it is considered a relatively low-risk treatment with the potential to improve or speed healing.
Concerns Involving PRP Treatment
Because PRP is given in the hopes of optimizing the initial inflammatory response of healing, anti-inflammatory medications should likely be stopped at the time of PRP treatment.
Also, PRP does contain endogenous growth factors, so some agencies consider it to be a performance-enhancing substance. For instance, the World Anti-Doping Agency and the United States Anti-Doping Agency forbid the injection of PRP within muscles because of the possibility that the growth factors could enhance a person’s performance. However, there are currently no data to suggest that PRP is actually a performance-enhancing substance. Major professional sports leagues have not yet addressed the topic of PRP.
Conditions that can be treated with PRP
Research studies are currently being conducted to evaluate the effectiveness of PRP treatment. At this time, the results of these studies are inconclusive because the effectiveness of PRP therapy can vary but the therapy may be used for the following conditions:
- Chronic Tendon Injuries
- Acute Ligament and Muscle Injuries
- Heal tissues during surgery
- Knee Arthritis
The side effects of PRP injections are very limited as the patient is utilizing their own blood, which they should have no reaction to. Some relative rest is needed immediately following the procedure, then usually followed by a progressive stretching and strengthening program.