PRP is a concentration of platelets, growth factors and cellular signaling factors that play a significant role in the biology of healing. It should also contain plasma proteins and protease inhibitors that work in a variety of ways to promote healing and prevent tissue degeneration. The therapeutic PRP dose delivers well over 1 billion platelets per milliliter of treatment which represents a 5-7 fold increase in platelet concentration compared to whole blood. By enhancing the body’s natural healing capacity, this treatment has been shown to lead to a more rapid, more efficient and more thorough restoration of the tissues to a healthy state.
After a blood sample is obtained from a patient, the blood is put into a centrifuge which separates the blood into its many components. Platelet rich plasma can then be collected and delivered to an injured area of bone or soft tissue, such as a tendon or ligament, via an injection. Ultrasound guidance is used in the precise placement of PRP in a process that takes a total of 20-30 minutes. There may be soreness at the site of the injection that can last for a few days. Most people return to work and normal day to day activities immediately after the injection.
A local anesthetic is used during the PRP injection procedure. This results in minimal discomfort. Since PRP is prepared from your own blood, there is no risk of rejection or disease transmission and virtually no risk of infection.
There have been numerous clinical studies that show significant healing and long lasting reduction in pain for a variety of injuries. Common injuries include tendon and ligament damage, disc degeneration, sports injuries as well as joint pain and arthritis. Results are proving PRP to be an effective and natural alternative to steroid injections which temporarily help alleviate pain symptoms but do not heal the cause of your pain. In a small study involving knee osteoarthritis, PRP treatment was shown to be more effective than Hyaluronic Acid Viscosupplementation treatments. PRP may eliminate the need for more aggressive treatments such as long-term medication or surgery.
No. Not all PRP is created equally. Most practitioners use bedside centrifuges to separate and concentrate platelets. These devices vary in cost, process, and performance but all are limited in their ability to obtain highly concentrated platelets. Most also do a poor job of completely eliminating red blood cells which are injurious to joint tissues. These bedside machines provide a set amount of PRP at a set concentration. This means that no matter what your issue may be, a ‘cookie cutter’ approach is applied by these machines. We process all blood samples by hand under a biosafety cabinet. This allows for customization of the platelet product to fit the patient’s issue. Hand processing permits extremely high levels of concentration when needed. Generally speaking, higher concentrations are required in more severe cases and when the patient is older. For example, younger patients do fine with concentrations 7 times their baseline platelet concentration. Patients older than 35 will require a concentration of 14 times baseline to get similar results. Hand processing also allows for the complete elimination of unwanted red blood cells form the PRP resulting in the distinctive golden yellow color of our PRP.
Many patients achieve considerable to complete relief after the first PRP injection. In some cases, especially when the problem has been chronic, additional PRP injections may be necessary. Up to three injections may be given within a six month time frame. These are usually performed at 4-6 weeks apart, if needed.
Both ultrasound and MRI images have shown definitive tissue repair after PRP therapy actually confirming the healing process. The need for surgery can also be greatly reduced by treating injured tissue before the damage progresses and the condition is irreversible. PRP therapy does not generally provide immediate relief. Instead, it sets in motion a repair mechanism that relies on tissue remodeling for long lasting pain relief. This process takes 6-12 weeks to show significant change in tissues though pain relief can occur much sooner on the basis of protease inhibitors found in platelets such as alpha-2-macroglobulin and TIMP. A study in the American Journal of Sports Medicine showed the following results in patients with elbow tendinosis:
>46% pain relief by week 4
>60% pain relief by week 8
>81% pain relief by 6 months
At the conclusion of the study, 93% of patients were completely satisfied with their PRP treatment and had avoided surgery.
While PRP has been used for decades, often in professional athletes who are looking to avoid surgery or prolonged recovery periods, its application in the treatment of pain is relatively new. Because of this, most insurance companies do not currently cover PRP therapy. You should check with your individual insurer for coverage.
The cost of PRP treatment varies depending on the procedure performed. Our office staff can assist you with payment options and any other questions you may have.