During the past several years, much has been written about a preparation called platelet-rich plasma (PRP) and its potential effectiveness in the treatment of injuries.
Many famous athletes — Tiger Woods, tennis star Rafael Nadal, and several others — have received PRP for various problems, such as sprained knees and chronic tendon injuries. These types of conditions have typically been treated with medications, physical therapy, or even surgery. Some athletes have credited PRP with their being able to return more quickly to competition.
There’s a variety of important questions regarding PRP for those interested in learning more. See below for a quick survey of some of those questions.
What Is Platelet-rich Plasma (PRP)?
Although blood is mainly a liquid (called plasma), it also contains small solid components (red cells, white cells, and platelets.) The platelets are best known for their importance in clotting blood. However, platelets also contain hundreds of proteins called growth factors which are very important in the healing of injuries.
PRP is plasma with many more platelets than what is typically found in blood. The concentration of platelets — and, thereby, the concentration of growth factors — can be 5 to 10 times greater (or richer) than usual.
To develop a PRP preparation, blood must first be drawn from a patient. The platelets are separated from other blood cells and their concentration is increased during a process called centrifugation. Then the increased concentration of platelets is combined with the remaining blood.
Which injuries are usually treated with PRP therapy?
Injuries treated with PRP therapy include: rotator cuff, quadriceps, hamstring, Achilles tendon injuries and tennis elbow. Essentially any tendon or ligament injury except complete tears may be treated successfully with PRP. PRP therapy is exactly the treatment needed to reduce the downtime of the athlete while also reducing the chance for re-injury or perhaps the risk of a more serious injury that will result in surgical intervention or permanent disability.
How is PRP administered?
PRP therapy, which takes approximately twenty minutes to complete, begins with collection of 30 milliliters of the patient’s blood. The blood sample is placed in a centrifuge to separate the platelet-rich plasma from the other components of whole blood. Doctors then inject the concentrated platelets into the site of the injury often using ultrasound guidance for accuracy. Platelets function as a natural reservoir for growth factors that are essential to repair injured tissues. The growth factors that the platelets secrete stimulate tissue recovery by increasing collagen production, enhancing tendon stem cell proliferation, and tenocyte-related gene and protein expression. These growth factors also stimulate blood flow and cause cartilage to become more firm and resilient. PRP activates tenocytes to proliferate quickly and produce collagen to repair injured tendons, ligaments, cartilage, and muscles.
Is PRP therapy a substitute for surgery? Why does it (in theory) work?
Not necessarily. While many chronic conditions may respond to PRP therapy, obviating the need for a surgical procedure, it is impossible to predict which will respond and which will fail to do so. A chronic, incompletely healed condition is characterized by excessive scar tissue within the tendon/ligament. This may lead to impaired joint function or leave the tendon or ligament susceptible to re-injury or complete disruption. This inferior, or in some cases, aborted, healing process is due to poor blood supply to the injury site. Most tendons have a poor blood supply and often are the site of microscopic tears or chronic scarring. The body naturally has a difficult time healing these structures. PRP is thought to initiate a response that makes the chronic condition appear to be a new injury, and thus, provoke a new/renewed healing response. This new healing response is then augmented by the super-concentrated healing factors contained within the PRP. Therefore, with PRP therapy in combination with appropriate reconditioning, we may improve the chance of healing and diminish the opportunity for escalation of the injury. A positive result may lead to a decrease need for surgical intervention.
What is Genesis’ position on PRP Therapy?
Genesis Orthopedics & Sports Medicine believes that implementing PRP therapy as a viable procedure may: decrease the progression of more serious injuries, decrease the overall time for healing, and ultimately decrease the overall need for surgical intervention. This promising adjunctive form of therapy holds the potential of healing previously problematic chronic injuries, provide a treatment option for debilitating injuries previously deemed untreatable, and serve as an alternative to surgical intervention.