Platelet-Rich Plasma (PRP)
Platelet-rich plasma is used in musculoskeletal medicine to focus your own body’s ability to heal. PRP has been in clinical use since the 1990’s. Many published randomized control trials (RCT) demonstrate both its effectiveness and safety for a range of injuries. These conditions include osteoarthritis, tendinopathies, and damaged vertebral discs.
Many people know that platelets form a clot if there is a cut in the skin. However, platelets do more than form clots. They also start the body’s own repair process. When platelets activate to form a clot, they also release alpha granules, which have hundreds of chemical messengers in them that initiate and organize repair to the damaged tissue.
Precisely placing PRP into the site of injury can initiate the healing process by activating on the damaged cartilage or tendon. This is an inflammatory process, and inflammation is the vital first phase of healing.
What to Expect
Platelet rich plasma is made by taking some of your blood and performing a two-stage centrifuge process on it to concentrate the PRP.
First, your blood is drawn into a syringe with a small amount of anti-coagulant in it to keep the blood from clotting during this process. The amount of blood drawn is usually about 50 milliliters, but 100 milliliters may also be drawn depending on how much PRP is needed for the treatment. For comparison, there are 355 milliliters in a 12- ounce soda can.
Then the blood is transferred in a sterile fashion into a centrifuge tube and centrifuged for the first cycle. This cycle seperates the plasma from the blood cells.
In the second centrifuge cycle, the platelet-rich fraction of the remaining plasma is concentrated and placed in a syringe.
The skin at the injection site is numbed with a small needle and local anesthetic (buffered lidocaine). Your physician will then precisely inject the PRP into the injury site using ultrasound or fluoroscopic guidance.
Your provider will prescribe specific medicine to control any discomfort you may have after the procedure. Patients usually need very little or no medication.
Avoid NSAIDs like ibuprofen. Acetaminophen can be used for mild pain. Let us know if you have a history of opioid addiction so we can use appropriate pain medication.
Avoid showering for 1 day and avoid immersion in water for 3 days.
Any bandages can be removed after 1 day.
Depending on the part of the body treated, you may need a sling or crutches for 1 to 3 days. Do your best not to tense or load the treated area during this time.
After 3 days, unless otherwise instructed, the treated body part should be used and slowly moved through its full range of motion. It will be sore, but you will not be doing damage by moving it, in fact it needs to move to heal.
Exercise is vital to good health and finding a way to cross train around your injury is important not only for your physical health, but for your mental health as well.
Ten minutes or less period of heat or ice therapy will not hurt the therapy, but it is not required.
Depending on the initial injury, physical therapy is started 2 to 4 weeks after injection.
Improvements in pain and function should be expected 8 to 12 weeks after injection and some injuries may require more than one treatment.