Understanding PRP

Understanding PRP

Clinical
Platelet Rich Plasma (PRP) Therapy

Summary

Platelet rich plasma (PRP) injections have shown a lot of promise in the field of orthopedics. The method uses the patient’s own platelets to promote healing. It is a minimally invasive procedure that finds applications in reducing joint pain and improving quality of life.

 

Question: Other than being world famous athletes, what do Tiger Woods and Rafael Nadal have in common?

Answer: They both used PRP treatment to recover from injuries.

Conditions that were traditionally treated with medicines, physiotherapy and sometimes even surgery are nowadays being treated with PRP. Not just sports injuries, PRP even finds applications in cosmetic procedures.

Being a relatively new therapeutic modality, there are many questions in people’s minds about PRP. This blog hopes to shed some light on what PRP is, how it works, the orthopedic conditions it is used for and how efficient it is.

Also Read: Orthobiologics for Treating Orthopedic Conditions

What Is PRP?

  • PRP stands for platelet rich plasma.
  • The liquid component of our blood is called plasma. Blood also contains various solid components – red blood cells (RBCs), white blood cells (WBCs) and blood platelets.
  • Of these, platelets are well-known for the role they play in the clotting of blood. What is not as well-known is that platelets also consist of around 300 proteins called growth factors which play a crucial part in mending injuries.
  • Platelet rich plasma as the name implies is plasma that is rich in the platelet component i.e., the platelet concentration is multiplied by around 5-10 times in platelet rich plasma compared to normal plasma. As a result, the concentration of growth factors is also multiplied.

How Is a PRP Injection Prepared?

The doctor will decide if PRP therapy will benefit your condition. If he thinks it will, your blood will be drawn and the PRP injection will be prepared.

  • The blood is drawn as usual from a vein – around 15-50 ml is the usual quantity drawn, the exact amount being determined by the condition it is to treat.
  • The drawn blood is then placed in a machine called a centrifuge. The machine makes the blood spin rapidly and separates the platelets from the other components.
  • The isolated platelets are then used to prepare the PRP injection.
  • Before injecting the PRP, the doctor will numb the area of application with a local anesthetic. Once the anesthetic has taken effect, the PRP injection will be administered.
  • It is to be noted that the injection will be administered directly at the injured area. For example, to treat a muscle injury, the injection is administered at various parts of the affected muscle itself.
  • Sometimes, doctors will use ultrasound guidance while injecting.
  • The procedure is usually completed within half an hour though this duration can vary depending on where the injection is given.
  • Once the platelets enter the injured area, they release growth factors which help in healing the injury.

Contraindications for PRP Injections

PRP injections are not allowed in the following cases:

  • The person has a low or abnormal platelet count.
  • The person has low hemoglobin.
  • Infections are a contraindication for PRP injections.
  • The person has conditions like hepatitis C, AIDS or cancer.

Orthopedic Conditions That PRP Can Help With

Tendon Injuries

  • Tennis elbow, a condition in which the tendons on the outside of the elbow are injured, can be treated with PRP.
  • Achilles tendinitis, another condition in which the Achilles tendon is injured, and jumper’s knee in which the patellar tendon is injured, are both conditions that have responded well to PRP.

Sporting Injuries

  • When a muscle is extended too much or suffers a tear, the condition is called a muscle strain.
  • Strains are painful and also quite common.
  • In fact, they constitute around 1/3rd of all sporting injuries.
  • Pulled hamstring muscles and knee sprains are some of the injuries that professional athletes are prone to.
  • PRP has been used to treat these conditions and other muscle and ligament injuries.
  • PRP therapy not only slows down injury progression but also promotes quicker healing.

Knee Osteoarthritis

  • While the effectiveness of PRP therapy for knee osteoarthritis is still under contention, many studies have shown that low and medium grade osteoarthritis patients do benefit from the treatment.
  • Pain reduction and improved functionality have been reported.
  • Knee osteoarthritis treatment is challenging because the knee cartilage has a low regenerative ability.
  • Therefore, the treatment is aimed at delaying surgery as much as possible and improving the patient’s quality of life by reducing pain.
  • Other factors which influence the results of PRP therapy include the patient’s age, the severity of the condition, weight and the frequency of PRP injections.
Also Read: Obesity and Osteoarthritis

Factors Affecting Outcome

As already stated above, studies have shown that tendon problems show improvement with PRP therapy. Many studies are also demonstrating that PRP helps with mild and moderate cases of knee osteoarthritis. However, there are some factors which influence the outcome:

  • The area under treatment
  • Whether the patient is in good health
  • Whether the injury was of sudden onset or a long-term one
  • The way the PRP is prepared

For How Long Does a PRP Injection’s Effect Last?

PRP therapy effect typically lasts for a few months. However, this differs from patient to patient depending on how severe the pain is.

Key Points to Keep in Mind

  • If you are taking any blood thinners, you will have to stop them before getting a PRP injection.
  • You might also have to stop taking supplements before the injection. Your doctor will guide you on this.
  • Side-effects with PRP injections are uncommon.
  • It is better you eat before a PRP procedure so that you do not experience any light-headedness.
  • After receiving the injection, the site of injection should not be washed for the next 2 days. While some slight inflammation may be present, severe pain should be reported immediately to the doctor.
  • Insurance coverage for PRP injections is dependent on the type of plan you possess.

PRP in Other Fields

Other than orthopedics, PRP also finds applications in skin and hair problems:

  • When injected into facial tissue, PRP is said to promote cell proliferation. This enhances the production of elastin and collagen which help to reduce wrinkles and fine lines. As a result, it reduces signs of aging.
  • PRP also finds applications in treating hair loss. Here, the PRP is injected into the scalp to promote hair growth. It is also believed that it helps maintain existing hair.