Platelet Rich Plasma (PRP)

Platelet Rich Plasma (PRP) was initially used in the late 1980s during open heart surgical procedures. Over the last 10 years PRP has become a hot topic in Sports Medicine when professional athletes began using PRP Therapy to return to play faster after sustaining a soft tissue injury. Superstars like Tiger Woods, Cliff Lee, Hines Ward and Kobe Bryant have all used PRP Therapy in quest for a quicker return back to their sport.

What is Platelet Rich Plasma (PRP)?

Platelet Rich Plasma is blood plasma with concentrated platelets. Most of us think of platelets when we are trying to stop bleeding (Hemostasis). In addition to containing products to help with hemostasis they also contain products called Growth Factors and Cytokines that may play an important role in initiating and supporting healing of injured connective tissues such as tendons, ligaments, muscles and articular cartilage. These Growth factors may increase the blood supply to the injured tissues and enhance the migration of mesenchymal Stem cells to the site of injury thereby promoting healing and tissue regeneration.

What is Platelet Rich Plasma Therapy?

PRP Therapy consists of concentration platelets by as much as 8 times the baseline level. This is done via a simple venipuncture blood draw. This blood is then centrifuged to isolate and concentrate platelets. Once the Platelet Rich plasma is obtained it can be activated outside (Exogenously) or inside the body (Endogenously). The entire process takes about 10 to 15 minutes.

Exogenous platelet activation occurs when a substance such as calcium chloride or thrombin is added to the PRP resulting in a gelatinous like substance that can be surgically placed into the injured or surgical repaired area. Endogenous platelet activation occurs when PRP in injected via a needle into the injured area. Either way the majority of the platelet's Growth Factors are released within the first 10 minutes and continues to have beneficial effects for months afterwards.

Because this is the patient's own blood (Autogenous), there is no concern about transmissible disease or rejection. The risk of endogenous PRP Therapy would be similar to any traditional percutaneous injection. The most common patient complaint after the injection is pain at the treatment site within the first 48 hours. This is felt to be related to the desired inflammatory phase of the healing process. The majority of times this pain can be treated successfully with over the counter Tylenol and ice (cryotherapy). We discourage the use of non-steroidal anti- inflammatory medicines (NSAIDs) such as Advil or Ibuprofen being the inflammatory phase is an important part of the healing process. PRP Therapy is contraindicated in patients who have a platelet dysfunction, thrombocytopenia or infection at the injury site or in the blood. It is also discouraged in patients who have been on NSAIDs 48 hours prior to the procedure and in patients who have received a steroid injection 1 month prior the PRP Therapy.

What disorders can be treated?

PRP Therapy has great potential in treating musculoskeletal disorders such as tendon, ligament and muscle injuries, difficult to heal fractures, articular cartilage injuries and early degenerative arthritis. In my practice, I have seen amazing results with PRP Therapy in treating disorders that traditional method have failed to improve.

Will my insurance pay for PRP treatment?

Unfortunately, because Lever 1 data to support its efficacy is still lacking, at this time insurance companies consider this to be an investigational procedure and will not pay for it. There are many studies in the literature that have showed a significant resolution of pain and restoration of function up to 1 year after treatment. However many of these studies differ in their centrification and activation protocols, the timing and frequency of PRP treatment and the post treatment rehabilitation protocol. Until an abundance of high level studies can demonstrate positive treatment effects, you are going to have to pay out of pocket.

Is PRP Therapy right for me?

If you have a tendon or ligament injury and traditional methods have not helped, then PRP therapy may be the solution. You will need an initial evaluation with Dr. Thomas Wall to see if PRP therapy will be right for you. You can make an appointment to see Dr. Wall by contacting The Athletic Institute of Medicine (480) 778-1400.