The use of platelet-rich plasma (PRP) injections is a novel treatment that has received a lot of attention lately because of its use by several high profile athletes. Athletes are drawn to platelet-rich plasma therapy because of claims that it significantly reduces healing time (sometimes up to four weeks – a significant amount of time in the professional sports world).
An additional benefit often seen with PRP therapy is the ability to repair damaged tissue as opposed to simply masking pain. That is what steroids do, is they mask pain well but don’t actually help repair tissue that has been damaged.
PRP is prepared by drawing a certain volume of venous blood from the patient, usually about 30 to 60 cc’s. This blood is then placed into a centrifuge and allowed to separate into three (3) layers: (1) the top layer of plasma; (2) the platelets and white blood cells (also known as “the buffy coat”); and (3) the red blood cells.
It is the second layer that is harvested for PRP. PRP can be three to eight times as concentrated as normal blood, and contains an increased amount of platelets and growth factors. It is theorized that injecting PRP can stimulate growth and regeneration of healthy tissue, increase blood supply, and promote the repair of damaged tissue.It can call in stem cells for repair as well.
This form of therapy is considered an elective treatment, often opted for when more conservative medical and physical therapies have failed. The following are some indications for the use of PRP:
- Tendinopathies – these refer to degenerative conditions of the tendon, resulting in significant decrease in tissue stability and strength. This may be caused by aging, repetitive stress, acute injury, among others. PRP has been shown by some studies to be effective in promoting regeneration of tissue.
- Ligament sprains and tears – damage to the ligaments, particularly the anterior cruciate ligament and medial collateral ligament can be treated by PRP. Studies have demonstrated favorable outcomes and improved recovery time.
- Muscle tears and strains – acute muscle tears and strains can theoretically improve from the hyperconcentrated growth factors of PRP, however there is insufficient human studies to validate this, although a case study has shown PRP can accelerate pain relief and return to functionality.
- Post-operative repair – it is theorized that PRP can promote faster recovery time and improve regeneration of healthy tissue at surgical sites. Some studies have used PRP in conjunction with arthroscopic repair, leading to reduced recovery time and comparable clinical outcomes.
- Meniscal pathologies – the central region of the meniscus (a knee ligament) is avascular (no blood supply), and because of this, healing this area is difficult. PRP has been shown in some case studies to promote healing in this area.