Platelet Rich Plasma (PRP) has been used since the 1970’s. The last decade has seen tremendous focus on PRP applications in musculoskeletal medicine. The potential for PRP to promote tissue healing following injury or disease is attractive to many physicians, researchers, and patients alike. Unlike medications or cortisone injections, which suppress or mask the underlying problem, PRP shows the potential to heal. PRP is derived directly from a patient’s own blood.
In simplest form, when an injury occurs, the body’s own platelets release co-factors that stimulate recruitment of mesenchymal stem cells (MSCs) to the site of injury. Some of the known components of PRP included platelet-derived growth factors, insulin-like growth factor, transforming growth factor-beta, fibroblast growth factor-2. Each of these have differing functions in the healing and reparative process.
Published studies of PRP use in adults and in animal models have shown promise for a number of orthopedic conditions. This is especially the case for tendon and soft tissue injuries and a recent article in the American Journal of Sports Medicine looked at the use of Platelet Rich Plasma (PRP) injections for osteoarthritis of the knee both from a safety and efficacy standpoint. In this study, 30 patients who received an intra-articular PRP injection in the knee consecutively for 3 weeks. Specifically, 3 to 8 mL of PRP was injected. Patients in the control group received 3 intra-articular injections of saline. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score was used to assess outcome. One week after the first injection, and at every post-injection visit during the 12-month follow-up period, patients who received the PRP injections had better WOMAC scores than did patients who received placebos. One year after treatment, PRP improved WOMAC scores 78% compared to baseline. The scores of patients who received placebo injections only improved 7%. There were no complications or adverse reactions from PRP injections.
To date, many patients have been treated with PRP injections. Success rates that appear in the published literature and across the web vary considerably. Some are reported at greater than 90%. Caution must be exercised in interpreting these results as outcome measures vary. Again it is very difficult to compare studies or even one individual versus another due to the many different systems and variables used. However, the most recent literature promotes leukocytepoor (minimal white blood cells) PRP for treatment of osteoarthritis and leukocyte-rich (higher white blood cell content) for treatment of tendons and ligaments.
If you are considering this treatment, consider asking your healthcare professional about the optimal formulation for you and also remember to avoid ice for 24-48 hours after the procedure and Non-Steroidal Anti-Inflammatories (NSAIDS) for 1-2 weeks prior and 4 weeks after the treatment, as they inhibit platelet activation.
If you are interested in learning more about this treatment, contact us at 610-789-7767