Friday, March 27, 2015

Platelet-Rich Plasma Injections

Platelet-Rich Plasma Injections

Within the last few years, much has been written about a therapy technique called platelet-rich plasma (PRP) and its potential effectiveness in the treatment of athletic injuries. Many famous athletes — golfer Tiger Woods, tennis star Rafael Nadal, and several others — have received PRP for various problems, such as chronic tendon injuries and sprained ligaments. They have even been used to help speed up the healing process after surgeries or peripheral meniscal tears. These types of conditions have typically been treated with rehabilitations, modalities, and medications. Some athletes have credited PRP for them to return to play more quickly. So the question is, what is a PRP injection and how does it work?

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.1

To develop a PRP injection, blood must be taken from the patient. Once the blood has been drawn from the patient's vein, the blood is placed in a centrifuge, a machine that spins at a high speed to separate the different types of blood cells. The physician extracts the platelet-rich portion of the blood, and injects this into the area of injury.2

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Research studies are currently being conducted to evaluate the effectiveness of PRP treatment. At this time, the results of these studies are inconclusive because the effectiveness of PRP therapy can vary. Here are a few types of injuries where PRP treatment is used:

Chronic Tendon Injuries

According to recent research studies, PRP is most effective in treating chronic tendon injuries, especially tennis elbow, a common injury that affects the tendons on the outside of the elbow. The use of PRP for other chronic tendon injuries — such as chronic tendonitis or inflammation of the patellar tendon and Achilles tendon. However, it is hard to tell at this time if PRP therapy is any more effective than traditional rehabilitation and treatment of these injuries.1

Acute Ligament and Muscle Injuries

Much of the publicity PRP therapy has received has been about the treatment of acute sports injuries, such as ligament and muscle injuries. PRP has been used to treat athletes with common sports injuries like strained hamstring and quadriceps strains, as well as sprained ligaments. There is no scientific evidence that PRP therapy actually improves the healing process in these types of injuries.1

Surgery

More recently, PRP has been used during certain types of surgery to help tissues heal. Surgery to repair torn knee ligaments, such as the anterior cruciate ligament (ACL), meniscus tears in the knee, or even rotator cuff tendons in the shoulder have been paired with PRP injections. At this time, there appears to be little or no benefit from using PRP in this instance.1

There are multiple ways to treat any type of athletic injury, whether acute or chronic. Studies still need to be done to determine the full effectiveness and potential of this therapy. At the end of the day,  PRP injections are another tool for physicians to possibly use if other treatments are no longer successful to help get the best outcome for their patient.


Sources:

1 Kelley, F., (2011). Platelet-Rich Plasma (PRP). Retrieved from: http://orthoinfo.aaos.org/topic.cfm?topic=A00648

2 Cluett, J., (2014). PRP Injections for Joint Pain and Muscle Strains. Retrieved from: http://orthopedics.about.com/od/injectio2/p/prp.htm





4 comments:

  1. I know several people who have received this injection. Some say it worked really well and helped them recover at a much faster rate and others said that it did nothing for them. Have you had any athletes get this injection? And if so did it work? Personally I like these injections as an athletic trainer because it allows us to have one more treatment option for our athletes and can only help them, not hurt them if done properly.

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  2. I have personally received PRP injections as an alternate route of surgery for a torn patellar tendon. I received this treatment two summers in a row for a total of 7 injections. These injections seemed to help for the first 2 shots that I received and then for some reason after the 3rd shot my pain level shot back up forcing me to have surgery. The exact same thing happened to me the next summer after I tore my patellar tendon for the second time ending my football career...injections seemed to work for a month or so and then after my last injection the pain came back. Would love to see if there is any research out there on why this may occur. Great read!

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  4. I have heard about this type of treatment from a couple of buddies who play baseball and have had elbow problems. I would really like to see what the results are from a study on this topic, because if it helped an athlete return from injury faster I bet this would be one of the rehabs that everyone would seek out. The most interesting part about the PRP injections would be to see if they work better on one part of the body than the rest.

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