Platelet Rich Plasma Therapy

FAQ’s on Platelet Rich Plasma Therapy

What is platelet rich plasma therapy?

 

Platelet rich plasma (PRP) therapy is a medical procedure that has been found to
have great use in promoting healing of injuries, particularly those of the joints, ligaments, tendons, muscles, bones and other tissues. It involves the preparation of PRP from the patient’s own blood and injection to the site of injury. Positive outcomes have been consistently reported, and the therapy finds wide application across a broad spectrum of musculoskeletal injuries and conditions.

How does PRP therapy work?

 

Platelets are small, disk-shaped clear cell fragments that circulate in blood. The average lifespan may be just 5 to 9 days, however, these platelets are an important source of growth and hemostatic (blood clotting) factors. PRP is plasma that has been concentrated with platelets – and thereby with growth factors – to levels 5 to 10 times more than normal blood. It is theorized that these growth factors are essential to promoting healing and recovery from injury.

PRP therapy has been shown to increase the number and viability of cells that repair and reshape cartilage and bone, as well as to promote the reproduction of growth factors and repair proteins. PRP is thought to modulate the gene expression of cells such as chondrocytes, synoviocytes, macrophages, and mesenchymal stem cells, and thereby activate a state of growth and repair. For tissues that enter the anabolic state, this means less inflammation and pain.

Studies are being conducted to evaluate the effectiveness of PRP in treating various conditions. The effectiveness of PRP therapy varies with each condition, and depends on factors such as the nature of the injury, the patient’s baseline condition, among others. However, PRP has been found to be useful in the following conditions:

  • Chronic tendon injuries – injuries from repeated injury, such as tennis elbow, or Achilles tendinitis, have been shown to respond to PRP therapy.
  • Acute muscle and ligament injuries – much attention has been drawn to PRP therapy because of its use by high profile athletes. There is still no conclusive evidence that PRP can actually speed up healing of acute injuries.
  • Post-surgery – PRP has also been used to promote healing after surgery, particularly after plastic surgery procedures. Some studies have indicated a beneficial effect of PRP on wound healing and survival rates.
  • Osteoarthritis – this condition, caused by the degeneration and loss of bone-cartilage homeostasis, is theorized to respond to the growth factors present in PRP.
  • Pressure ulcers and diabetic foot ulcers – while some initial studies have shown the potential of PRP for pressure and diabetic foot ulcers, additional studies are needed to evaluate the effectiveness of PRP.
  • Fasciitis and inflammatory conditions – PRP has also been shown to improve these conditions; however, large-scale studies are still needed to prove its effectiveness.

 

What are the risks of PRP?

 

The risks associated with PRP are minimal, and are no different from other “typical” injections: there is a possibility of infection at the injection site, bleeding and hematoma formation, or damage to the surrounding muscles, nerves, and tissues. However, adverse outcomes are rarely reported, and the procedure is normally well tolerated by most patients.

 

References

 

Mehrannia M, Vaezi M, Yousefshahi F, Rouhipour N. Platelet rich plasma for treatment of nonhealing diabetic foot ulcers: a case report. Can J Diabetes. 2014 Feb;38(1):5-8. doi: 10.1016/j.jcjd.2013.08.271.

 

Shetty VD, Dhillon M, Hegde C, Jagtap P, Shetty S. A study to compare the efficacy of corticosteroid therapy with platelet-rich plasma therapy in recalcitrant plantar fasciitis: A preliminary report. Foot Ankle Surg. 2014 Mar;20(1):10-3. doi: 10.1016/j.fas.2013.08.002. Epub 2013 Aug 16.

 

Scarpone M, Rabago D, Snell E, et al. Effectiveness of Platelet-rich Plasma Injection for Rotator Cuff Tendinopathy: A Prospective Open-label Study. Glob Adv Health Med. 2013 Mar;2(2):26-31. doi: 10.7453/gahmj.2012.054.

 

Halpern B, Chaudhury S, Rodeo SA, Hayter C, Bogner E, Potter HG, Nguyen J. Clinical and MRI outcomes after platelet-rich plasma treatment for knee osteoarthritis. Clin J Sport Med. 2013 May;23(3):238-9. doi: 10.1097/JSM.0b013e31827c3846.

 

Sommeling CE, Heyneman A, Hoeksema H, Verbelen J, Stillaert FB, Monstrey S. The use of platelet-rich plasma in plastic surgery: a systematic review. J Plast Reconstr Aesthet Surg. 2013 Mar;66(3):301-11. doi: 10.1016/j.bjps.2012.11.009. Epub 2012 Dec 11.

 

Hsu WK, Mishra A, Rodeo SR, Fu F, Terry MA, Randelli P, Canale ST, Kelly FB. Platelet-rich plasma in orthopaedic applications: evidence-based recommendations for treatment. J Am Acad Orthop Surg. 2013 Dec;21(12):739-48. doi: 10.5435/JAAOS-21-12-739.