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Platelet-Rich Fibrin

Platelet Rich Plasma (PRP)

Platelet Rich Plasma therapy (PRP) is a ground breaking non-operative treatment option that relieves pain by naturally promoting long lasting healing of musculoskeletal conditions. The acronym PRP has most recently been featured in the news with the rising popularity of the treatment among professional athletes, recreational athletes, and highly functional individuals. Many have attributed PRP injections, particularly for athletic injuries, with enabling them to return back to regular activities and competition with minimal to no pain at all. This rapidly emerging technique shows very promising potential for many conditions such as arthritis, tendonitis, and ligament sprains and tears.

PRP therapy presents patients with a long lasting, permanent solution through the body’s natural healing process. PRP is not something that wears off over time as with a traditional pain injection.

How Does PRP Work?

Platelet rich plasma, commonly referred to as “PRP”, is human blood that is spun down and separated producing a concentration of platelets above normal values. Platelets are the clotting cells of our blood, but they also have great potential in enhancing healing of muscle, tendon, and ligaments. Studies suggest that growth factors released by platelets recruit reparative cells, may augment tissue repair, and accelerate soft tissue healing.

PRP has been used in surgery to augment shoulder rotator cuff and Achilles tendon repair. PRP has also shown great promise when injected into chronically injured tendons and when proper healing has not taken place. Many clinical trials are underway to determine the full spectrum of use for PRP. In a spine practice, clinicians have anecdotally noted promising results when PRP is injected into spinal ligaments, into facet joints, and/or intervertebral discs when other traditional treatments have failed.

PRP uses your own blood’s platelets, so the risk of allergic reaction or adverse effects is minimal. It promotes natural healing by harnessing the body’s innate repair mechanisms.

PRP therapy can be used for a variety of medical and cosmetic applications, from treating osteoarthritis and speeding up wound healing to improving skin texture and hair growth.

PRP is a minimally invasive procedure that usually requires only a short recovery time, making it convenient for people with busy lifestyles.

Though results can vary depending on the individual and the treatment area, PRP tends to offer more durable outcomes compared to other treatments. For cosmetic applications, the effects can last up to 18 months.

PRP can be combined with other treatments to enhance their efficacy. For example, using PRP with microneedling can improve the skin’s ability to absorb nutrients and heal.

Since PRP is derived from your own blood, there is a reduced risk of infection compared to other injectable treatments.

One of the key benefits in cosmetic applications is the stimulation of collagen, which can lead to firmer, smoother, and more youthful skin.

PRP treatments can be tailored to meet the specific needs of the individual, whether it’s joint pain, skin aging, or hair loss, providing a more targeted approach to healing and rejuvenation.

Most PRP treatments don’t require general anesthesia, often needing only a local anesthetic, making the procedure less risky and more cost-effective.

The procedure typically takes less than an hour, including preparation and recovery time, making it an efficient option for those looking for effective treatments without long clinic visits.

THE SCIENCE BEHIND THE TREATMENT

Our blood is made up of 93% red blood cells, 6% white blood cells, 1% platelets and plasma. Platelets are best known for their function of blood-clotting to stop bleeding. Platelets, however, are much more significant than this, as human platelets are also a critical component in injury healing.

Platelets are naturally extremely rich in the connective tissue growth and healing factors. The body’s first response to tissue injury is to deliver platelets to the area. Platelets initiate repair and attract stem cells to the injury. Injecting these growth factors into damaged ligaments, tendons, and joints stimulates the natural repair process. In order to maximize the healing process, the platelets must be concentrated and separated from the red blood cells. The goal of PRP is to maximize the number of platelets while minimizing the number of red blood cells in a solution that is injected into the injured or pained area(s). In summary, PRP creates, stimulates, and accelerates the body’s natural healing process.

WHICH CONDITIONS BENEFIT MOST FROM PRP?

  • Lumbar spine disc pain
  • Rotator cuff injuries, including partial-thickness
  • Shoulder pain and instability
  • Tennis and golfer’s elbow
  • Hamstring and hip strains
  • Knee sprains and instability
  • Patellofemoral syndrome and patellar tendonitis
  • Ankle sprains
  • Achilles tendonitis & plantar fasciitis
  • Knee, hip, and other joint osteoarthritis
  • Nerve entrapment syndromes, such as Carpal Tunnel Syndrome
  • Sacroiliac (SI) joint dysfunction and pain
  • Lumbar and cervical facet dysfunction and pain

Additionally, PRP can be effective for many cases of osteoarthritis by stimulating healing of cartilage and reducing pain and disability. This includes:

  • Knee arthritis
  • Hip joint arthritis
  • Shoulder arthritis
  • Ankle arthritis

With any treatment option the outcome and sustained results are highly dependent on the extent of the injury. For example in the case of mild arthritis, PRP could potentially prevent the development of further degeneration. However, in advanced arthritic degeneration the goal of the treatment is to minimize pain and improve function. PRP (potentially if used in tandem with the use of stem cells) could avoid surgery such as joint replacements and potentially spinal fusion.

Creation of PRP is simple, painless, and conveniently done at an office visit. The entire process of drawing blood to solution preparation only takes approximately 25-30 minutes. A small amount of blood is drawn from the patient, just like a routine blood test. Once the blood is drawn it is then placed into a centrifuge. The centrifuge is a machine that spins the blood at high speeds in order to separate the blood into red blood cells and concentrated platelets. Once the blood is separated the red blood cells are discarded, and we are left with concentrated platelet rich plasma (PRP) which is ready to be used in the treatment process.

The injection process does not take more than an hour, which includes the creation of the PRP as explained above. The platelet-rich portion is collected and injected back into the injured tendon, ligament, muscle, joint, or disc that has been determined to be a source of pain and is not-healing appropriately. When structures around the spine are being injected, x-ray (i.e. fluoroscopy) guidance is used to assure safe and proper placement of PRP at the affected site. In the extremities, ultrasound-guidance is commonly used to inject PRP into the appropriate tendon, ligament or joint that is being targeted. Injections are performed under image guidance to assure precise placement of PRP. The number of injections varies based on each patient’s individualized condition but typically range anywhere from two to six injections done over time. Patients typically experience significant reduction in pain after the first or second injection.

Generally speaking PRP injections are not painful; however the discomfort level depends on the part of the body being treated. Injections into the joint are of minimal discomfort. There is sometimes a small amount of pain after the procedure; however this does not last more than a few days and can be minimized with over the counter Tylenol. It is critical to avoid anti-inflammatory medications such as Aleve, Motrin, Celebrex, Naprosyn, and Mobic. These drugs may impede the healing process.

The benefit to PRP therapy is that unlike other treatments it has a sustained outcome and is categorized as a permanent fix. The timeframe for experiencing results is dependent upon the area of injury and the extent of the injury. On average, most patients start to see signs of improvement in the form of reduced pain or increased function within four to six weeks. Continuing a well-designed course of physical therapy and avoidance of aggressive physical activity or overloading the injected tissues is advised in the weeks that follow the injections. This is done to allow the tissues to heal best.

Overall, PRP is an especially safe treatment option with no risk of allergic reaction because it is your own blood. However, anytime a needle is placed in the body, there is a risk of infection, bleeding, and nerve damage. These risks do not happen often, and are very rare. Other risks depend on the area being treated. If you are unsure of the risks of your specific condition, consult your physician. In general, PRP is not considered a first line treatment and is usually considered after other more traditional treatments have failed.

The number of treatments needed varies depending on the individual and the area being treated. Your healthcare provider will recommend a treatment plan tailored to your needs.

A typical PRP session lasts around 60 to 90 minutes, which includes drawing the blood, processing it, and administering the injections.

A local anesthetic is generally used to minimize discomfort during the procedure. Most patients describe the sensation as mildly uncomfortable but not painful.

Recovery time is generally minimal, and most people can return to their normal activities almost immediately. You may experience some minor swelling or bruising at the injection site.

While some people notice immediate improvements, the full benefits of PRP are generally seen several weeks after treatment as the body’s natural healing process takes effect.

Results from PRP are long-lasting but not permanent. The longevity of the results can vary depending on the area treated, and additional sessions may be recommended for maintaining the effects.

Yes, PRP is often used in conjunction with other treatments like microneedling or dermal fillers to enhance their effectiveness.

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