The PRP injections have been used by various professional sports teams to treat orthopedic problems. PRP has been used for everything from tendon injuries, to ACL repairs. Doctors are injecting PRP into the knee to treat arthritis pain and inflammation in the knee. In several studies, PRP performed as well or better than cortisone shots at relieving knee pain. It also performed equally well as viscosupplementation using hyaluronic acid injection at relieving knee pain and improving function.
The platelet-rich plasma is used to promote the production of new tissues to replace damaged or worn tissues including cartilage. It can be used on patients with arthritis, patients looking for knee injuries, meniscus tears, tendon damage, ligament damage, and muscle sprains.
Platelets are an essential part of the blood’s clotting mechanism, but they also perform another important function – they release proteins that help stimulate cell growth and tissue repair. Platelet-rich plasma (PRP) therapy involves taking a small amount of blood from the patient and separating the platelets from the rest of the blood using a centrifuge. PRP is a concentrated mixture of platelets, fibrinogen and other proteins found naturally in the blood that helps promote healing of injured tissue by inducing angiogenesis factors such as fibrin and other clotting factors. Growth factors and cytokines such as platelet-derived growth factor (PDGF) and transforming growth factor beta1 (TGF-β1) stimulate cellular proliferation and tissue regeneration. The platelet-rich plasma is then injected into damaged tissue to stimulate tissue recovery and promote healing.
What Platelet Rich Plasma (PRP) Therapy can Treat
PRP injections are helpful when it comes to knee injuries because they can help restore cartilage function, strengthen ligaments and tendons, relieve pain, and improve joint stability. However, PRP injections are not a sure-shot cure for osteoarthritis patients since PRPs cannot reverse or stop the disease process. PRP treatments may be expensive, but they have been seen to produce favorable results when used alone or in combination with other procedures such as microfracture surgery or viscosupplementation injection.
The platelet-rich plasma has been shown in various medical studies to effectively improve pain from damaged knee cartilage. For example, platelet rich plasma injections have been shown in medical studies to reduce pain for osteoarthritis patients because platelet-rich plasma contains over 30 bioactive proteins that stimulate bone marrow stem cells. The platelet-rich plasma also stimulates protein synthesis which is very helpful for people with arthritis because these proteins may play a role in tissue regeneration.
Safety of Platelet Rich Plasma (PRP) Therapy
PRP therapy is a relatively safe procedure since it uses the patient’s own blood. Patients should consider platelet rich plasma injections as a possible alternative to knee surgery because this process does not involve incisions or anesthesia. However, it is important that platelet rich plasma is performed by a qualified healthcare professional with knowledge of platelets and platelet biology. Some studies suggest that platelet poor plasma (PPP) may be associated with negative effects such as clotting and inflammation so professionals should take care to use platelets from healthy donors. Side effects after the procedure include temporary pain during physical activity, swelling, bruising at the injection site, bleeding disorders, and allergic reactions. Platelets contain small amounts of calcium, which may lead to platelet clumping during platelet rich plasma injections. To prevent platelet aggregation, physicians should avoid mixing platelets with other agents such as anticoagulant medications or blood thinners. There is a very rare possibility of infection, as anytime you are introducing a needle into the joint brings the possibility of infection.
Cost of Platelet Rich Plasma (PRP) Therapy
The equipment used to produce PRP and the injections themselves are cleared by the FDA, this procedure is still considered investigational. It is not officially approved by the FDA for most uses. PRP is a derived from one’s own blood, it is not technically considered a drug. “Off-label” use means that doctors may prescribe and administer PRP if they believe it’s in the best interest of the patient. However, the lack of formal FDA approval means that PRP treatments is unlikely to be covered by insurance.
Administration of Platelet Rich Plasma (PRP)
Doctors use local anesthesia to inject platelet rich plasma directly into patients’ joints at four-to-six-week intervals. The platelet rich plasma injections typically reduce pain significantly so it is very helpful for osteoarthritis patients who cannot take long-term doses of nonsteroidal anti-inflammatory drugs (NSAIDs). Patients can expect their knee pain should improve within 1-2 weeks after getting platelet rich plasma injection if they receive treatment early.
Where can I get a Platelet Rich Plasma Injection?
Hospitals, outpatient centers, and doctors’ offices are the main places where platelet rich plasma injections are performed. The procedure takes about 45 minutes to 1 hour including consultation time, preparation of the platelet rich plasma injection, local anesthesia, and platelet rich plasma injections. Although platelet rich plasma injections can be expensive, they have been shown in various medical studies to effectively treat osteoarthritis knee patients by reducing pain and promoting healing of torn cartilage.
Platelet rich plasma injection therapy for knee injuries does not require any recovery time; patients can resume their regular activities after this procedure. Physicians may recommend that platelet rich plasma injections be used in conjunction with other forms of non-surgical treatments like physical therapy or anti-inflammatory medication to reduce pain and improve mobility.
You may undergo a CBC to confirm that you have enough platelets
Prior to the procedure, do not take the following medications:
NSAIDs (ibuprofen, naproxen, aspirin)
Stop taking the following supplements:
Black currant seed oil Krill oil
Borage oil Nattokinase
Evening primrose oil Serrapeptase
You are not a candidate for PRP injections if you have the following:
Abnormal platelet function
Active systemic infection
Your provider will ask you questions regarding your medical history and make sure that you are a candidate for the procedure. You will be given the opportunity to ask questions regarding Platelet Rich Plasma
You will have a blood draw to collect blood and platelets
A centrifuge will be used to concentrate the platelets
A local anesthetic is used on the affected area
Platelet Rich Plasma (PRP) is then re-injected under ultrasound guidance.
After the Examination:
You will have the opportunity to rest for a few minutes before getting up
Do not take any Aspirin, NSAIDs or other medications mentioned above for two weeks after the procedure
You may apply an ice-pack for 10-15 minutes on the affected area every 2 hours
Avoid major physical activity for at least 2 to 4 weeks after the procedure
Tylenol (Acetaminophen) or topical lidocaine are good medications to treat pain
You may elevate the affected extremity as necessary to rest.
There may be swelling and discomfort at the injection site for 1 -2 days.
You may repeat the injection for additional benefit over the next 4 to 6 weeks. Injections are sometimes repeated one or two times.
Most patients notice improvements after 2 to 6 weeks. The pain relief can from the PRP injections may last 6 to 9 months and can last up to 2 years.
Dr. Paul Norio Morton is a Board Certified Orthopedic Surgeon that practices on Oahu and the Big Island. He treats a broad range of orthopedic conditions including arthritis, sports injuries, hip and knee replacements, trauma, and robotic joint arthroplasty. He believes in treating his patients with a holistic approach – incorporating patient’s desires and expectations into the treatment of their musculoskeletal problems.