Platelet Rich Plasma Injections (PRP)
Blood is comprised of several parts, including red blood cells, white blood cells, and platelets. Each of these parts serves an important role. Red blood cells primarily carry oxygen. White blood cells are involved with the body’s immune system, by fighting infections. Platelets have their own unique role.
For decades scientists have known that platelets have many purposes in the body. The most commonly understood function is their role in clotting blood after injuries, but platelets also carry other chemicals known as growth factors. These growth factors have been studied for more than 20 years, because they signal the body to start the healing process. Scientists have been able to prove certain other cells respond to the growth factors by growing, remodeling, or healing. Naturally, all scientists and physicians involved have wanted to see how the growth factors in platelets could be harnessed to help people heal. Studies performed to isolate and concentrate an individual’s platelets, for injection into injuries and other degenerative sites, have been very telling. There appears to be a role in the treatment of tendon and ligament injuries, as well as even typical arthritis of joints, using concentrated platelet rich plasma injections.
For most patients, these procedures are relatively simple and well tolerated. Blood is drawn from a vein like any other blood laboratory test. That blood is separated into concentrated platelets using a special machine called a centrifuge. The centrifuge increases the concentration of platelets 3-10 times what they would be in blood alone. Other components of blood are also removed, although sometimes the white blood cells are left within the concentrate to play other roles in healing.
The process of concentration takes 10-25 minutes. The concentrated platelets are then injected into the structures that a physician and patient would like to see healed. The injection can take 1-5 minutes depending on the specific structure injected.
Is it painful?
Pain is generally minimal. Local anesthetic techniques can be used on the skin. However, anesthetics are known to deactivate or decrease platelet activities, so clinicians purposely avoid putting them in the same place as the platelets. The final site of injection may have no or minimal pain.
What do I do before the procedure?
The main understanding that patients need to know before the procedure is to avoid non-steroidal anti-inflammatories (NSAIDs) for 5 days before the procedure. Examples include over-the-counter medicines, like ibuprofen (Motrin) or naproxen (Aleve), and prescription strength NSAIDs such as Mobic, Diclofenac, Arthrotec, etc. It is believed that these medications can decrease the effect of the healing process that we are trying to stimulate.
In most cases, patients can drive themselves to and from the procedure. Plans may need to be made to avoid work or sport activities for a few days following the procedure.
What happens afterwards?
Platelet Rich Plasma is designed to restart the healing process. Part of that process is restarting some inflammatory actions. Therefore, most patients are sore for at least 2-3 days following the procedure. This is a sign that the procedure is working. Icing for 10-minute periods, once per hour, may decrease soreness. Over-the-counter pain medicines, like Tylenol, can be used for patients who do not have contraindications to that medication. In rare cases, the provider will prescribe other pain medicines.
Most people need to take 2-3 days away from any strenuous activity involving the area of the body where the procedure is performed.
Often, rehabilitation exercises will likely be prescribed to start a few days after the injection. This may be done at home or formally with a physical therapist.
Often, a physician can complete the injection by feeling the appropriate body structures. However, sometimes these procedures are directed at structures that are small or otherwise difficult to access without assistance. Ultrasound is helpful in these situations, allowing trained physicians to make sure that the stem cells get to where they are supposed to go. This is very important in gaining the planned result for many patients.
Is it done just once or multiple times?
This will be up to you and your physician. Many times one treatment is enough. Based on your responses, you and your physician will decide the appropriate medical course of action.
What does it cost?
Payment will be discussed before the procedure is scheduled. At this time, insurance providers have opted not to pay for this advanced procedure. Therefore, the patient usually pays out-of-pocket. Hopefully in the future, third party payers will assist in payment.
Call now to schedule your consultation with one of our physicians to see if you may benefit from one of these advanced therapies, or to review your non-operative options! The consultation is covered by insurance.