by Reiner Kremer
Platelet Rich Plasma Injection
Franktown Family Medicine is proud to offer platelet rich plasma (PRP) injections.
What is Platelet Rich Plasma?
Platelet rich plasma is a blood plasma which has been enriched with platelets. This product contains numerous growth factors and cytokines that stimulates healing of soft tissue and bones.
How does Platelet Rich Plasma work?
It is a simple concept but a complicated process. The whole blood is comprised of plasma and red and white blood cells. While the main function of the red and white blood cells are to deliver oxygen to the various parts of the body and fight minor infections, the plasma portions of the whole blood functions to heal from injury and tissue damage. When a body detects injury, the platelets work to stop the bleeding. As the body tries to stop the bleeding, the platelets will release a platelet derived growth factor stimulating the other growth factors and cytokines in the plasma to start the tissue healing process.
What are the growth factors and cytokines in the PRP?
These factors include; platelet derived growth factor, transforming growth factors, fibroblast derived growth factor, insulin like growth factor, vascular endothelial growth factor, epidermal growth factor, connective tissue growth factor and interleukin. All these individually have shown clinically or in a laboratory setting to enhance healing.
Who has had PRP treatment?
It has been administered worldwide for years but recently there have been numerous high profile professional athletes such as Todd Helton (back), James Harrison (knee), Kobie Bryant (ankle), Tigers Wood (achilles tendonitis) and Hines Ward (quadriceps tendonitis) treated with PRP bringing attention to this treatment.
Is PRP safe?
One of the greatest advantages of PRP treatment is its safety. Since the PRP is prepared from one’s own blood, there is no risk of disease transmission or side effects of drugs entering your blood system.
What conditions can be treated by PRP?
These conditions include the knee involving: patellar, quadriceps, and hamstring tendonitis, partially torn or strained major knee ligaments (LCL/MCL), cartilage damage; shoulder involving: rotator cuff tendonitis, impingement, bursitis, and biceps tendonitis; In the wrist and hand involving: wrist tenodonitis; In the elbow involving: tennis elbow and golfer’s elbow, biceps and triceps tendonitis; the hip involving iliotibial band tendinitis (ITB Syndrome), ilio-psoas tendonitis and bursitis, greater trochanteric bursitis, sacroiliac joint dysfunction; the ankle and foot involving: Achilles tendonitis, peroneal tendonitis, recurrent ankle sprains, and other foot or ankle tendonitis; neck and back involving: facet joint arthritis, rib problems.
Are there limitations of PRP?
Yes. Like any other treatment modalities PRP has limitations. It will not work for treating complete ruptures of the muscle, ligament or tendons.
How is PRP administered?
It is done in the office and takes about 30 minutes. About 20-40 cc of blood is drawn. Using a tubes, kit and a centrifuge, the whole blood is prepared where just the platelet rich plasma is obtained. The PRP, about 3 cc, is then injected using guidance to insure proper placement to the area of injury. No anti-inflammatory drugs such as aspirin, ibuprofen, Motrin or Celebrix should be used for 5-7 days prior to and after treatment.
How long does PRP take to work?
The first few days to a week, there may be an increase in discomfort. However, the healing process on a microvascular level start almost immediately. Clinically, reduction in pain will be noticed in about 2-6 weeks. Strength and endurance may improve for up to 6-9 months. Sometimes, more than one treatment of PRP may be needed. Unfortunately, there are no specific treatment protocols so decision process will be formulated between the physician and patient on an individual setting.
What is the literature on PRP?
There are numerous case reports in the literature with great success but only recently has there been comparison publications showing success. In tennis elbow, PRP vs. corticosteroids (Gosen, American Journal of Sports Medicine, 6/2011) corticosteroids returned to baseline while PRP improved at 2 year follow up.
Will my insurance pay for PRP?
No. As with any new technology and treatment modalities, it takes time for the insurance companies to realize the benefits. Since the comparative studies are just now being conducted and being published for all the various injured structures, it will take time for the insurance companies to embrace and pay for PRP treatments.