PRP - Patient Information
THE SCIENCE BEHIND IT
Platelet-rich plasma injections promote and accelerate the healing process providing a natural alternative way to manage soft tissue and joint injuries and degenerative conditions.
Platelets are small, colorless, disk-shaped cell fragments lacking a nucleus that are found in our blood. They play a key role in clot formation; but they also have antimicrobial properties and help control infection and they support tissue healing through the release of growth factors. These growth factors orchestrate the vital biological processes required for healing through new blood vessel formation, resolution of chronic soft tissue inflammation and tissue regeneration. Growth factors are necessary to initiate tissue repair at a wound site. Growth factors derived from platelets are responsible for soft tissue repair, bone regeneration, development of new blood vessels and stimulation of the wound healing process. By spinning down a volume of fresh blood drawn from a patient we can concentrate the platelets to between 4 and 6 times that found in the same volume of whole blood. These concentrated platelets are then injected into the injured soft tissue or joint to help optimize healing.
Plasma is the fluid component of blood that contains water, vital proteins, salts, minerals, sugars, fats, hormones and vitamins. Recently, plasma has been found to carry beneficial anti-inflammatory proteins such as Interleukin-1 Receptor Antagonist and Alpha-2-Macroglobulin. These proteins are known to “shut off” mechanisms that lead to degeneration and chronic inflammation in the body. Injecting this plasma also has benefits over and above just injecting the concentrated platelets.
The concept behind the clinical use of these blood components is to harness the natural biological ability of a patient’s blood―primarily platelets―to optimise the conditions for healing, improve inflammatory response, control infection and promote new blood vessel formation.
Platelets facilitate healing through the release of many growth factors actively involved in this process. Thus, PRP offers the physician an alternative to other injection treatments, such as corticosteroid injections. Corticosteroid injections provide short-term relief by masking symptoms such as pain and inflammation that are the result of an injury, rather than addressing the cause of the injury directly through the repair of damaged tissue.
Stem cells are at the core of the tissue regeneration process. They are required to rebuild and repair damaged tissue at an injury site. Platelets release several growth factors, such as SDF-1α, that function to induce migration of stem cells to the damaged tissue during the healing process. PRP provides these growth factors in high concentrations.
The PRP procedure is considered a safe treatment.
A sample of a patient’s blood is drawn from an accessible arm vein in the same manner as blood is drawn for blood tests. The blood is then spun in a special cartridge in a centrifuge machine to separate the platelets from the red blood cells and concentrate the platelets in the serum. The PRP solution is then withdrawn from the cartridge ensuring the appropriate cellular concentration and platelet counts for the injury or degenerative condition being treated. This plasma highly concentrated with platelets, and in some instances white blood cells, is then injected into the site of injury or tissue degeneration under ultrasound guidance with precise, advanced, minimally invasive techniques.
Each patient and injury is different. We do not support the use of PRP as a “one size fits all” treatment. This is because PRP utilizes your own blood, and this means there are variations between patients. We can individualize PRP treatments depending on the patient and the conditions we are treating. We incorporate ultrasound guidance to inject PRP to the affected areas accurately.
Indications for PRP Injections
Joint osteoarthritis, usually mild to moderate forms.
Refractory tendinosis, Examples - tennis elbow (lateral epicondylitis); golfers elbow; (medial epicondylitis); patellar tendinosis; Achilles tendinosis; Plantar fasciitis; Shoulder rotator cuff tendon tears.
Platelets are sensitive to the use of certain medications and so in order to ensure we are getting the best result out of your platelets for the procedure we ask you to discontinue use of any oral anti-inflammatory medications such as Ibuprofen, Diclofenac, Celecoxib, etc. a week before your date of injection.
PRP injections are designed to use platelets to trick your body into thinking that the affected area is injured, therefore triggering a regenerative response from your body. Anti-inflammatory medications should therefore be discontinued for 48 hours after the procedure.
You can be painful for up to 1 week, therefore you can take oral pain medications such as paracetamol, codeine or tramadol after the injection for a couple of weeks.
Rest, ice and elevate limb for 48 hours.
Initially cease all activities for the first week but can resume normal day to day activities thereafter.
In the second week, can resume light exercises and progressively build back to normal exercise after 4 weeks.
Most patients see the most benefit, approximately 4-6 weeks post-injection.