Platelet Rich Plasma Therapy

Platelet rich plasma (PRP) therapy is a new form of treatment for injury.  It can help heal some orthopaedic injuries.  For instance a torn rotator cuff. Where steroid injections and physical therapy have not helped and the patient does not want surgery then platelet rich plasma therapy is an option.  It is a treatment that uses the body’s natural healing properties to mend injuries.  

The procedure involves collecting several ounces of blood from the patient’s arm. The blood is spun in a centrifuge to concentrate the platelets. These platelets are injected into the injury site. The goal is to promote healing.  Platelets are the blood cells that promote clotting.  They contain hundreds of proteins.  Those proteins are growth factors that help repair injuries.  This form of therapy works by acting like a stem cell magnet.  It releases growth factors. They signal stem cells to come and help regenerate the injured area.  As a result the PRP actually creates new blood vessels. These feed the injured body part with the nutrients that help to heal.

Platelet Rich Plasma Therapy Treats Orthopedic Injuries

This treatment has been effective in dealing with torn rotator cuffs, tennis elbow and plantar fasciitis. Also it helps with Achilles tendonitis and hamstring tears.  It can even provide relief for some forms of osteoarthritis.

In regards to such things as a rotator cuff tear the first thing to be done is an ultrasound and/or an MRI. This gives a picture of the tear.  The treater then must find if the tear is the source of the pain and weakness the patient is having. This is done by injecting an anesthetic into the tear. Certain strength tests are then run.  If the strength was improved with the anesthetic present, that tends to mean that the tear was causing the problems. Call, or contact us for a free consult.

The PRP therapy can be painful. The aching from the treatment can persist for more than a day. After the injection the patient needs to rest the body part. You need to avoid medicine such as ibuprofen.  The goal is to cause blood to go to that area and thereby promote healing.

Platelet Rich Plasma Therapy Is Not Covered

This form of therapy still tends not to be covered by insurance.  As a result there is very little movement towards doing studies. There is nothing for the FDA to approve or disapprove since what is being put into the body came from the body. The centrifuges already are licensed. The procedure uses the patient’s own blood which is regarded as safe.

In looking for a doctor who does this type of treatment you need to find a repeater. That is someone who does the procedure several times a day. That doctor needs to be well versed in this form of treatment. The injection should be done under direct visualization with ultrasound. This allows the doctor to see the needle, the fluid and where they are going. This is a form of treatment that is new. It is not fully tested but has tremendous promise.

There is conflict as to how effective the treatment is. The volume of treatment being rendered has ballooned from $45 million in 2009. By 2016 it was up to $126 million. However questions still remain as to whether it really works.  A study conducted by the Cochrane Collaborative, a group of independent medical experts, examined 19 different trials of this treatment. They concluded that the evidence was not enough to recommend it for musculoskeletal soft-tissue injuries.

Platelet Rich Therapy Downsides

There is generally thought to be very little downside to the treatment other than the cost. A study put out by the New England Journal of Medicine in 2014 concluded that platelet treatment is no better than a placebo for hamstring injuries.

The absence of uniform results from the studies may be a function of the absence of any standards for the delivery of the treatment. The treatment is used for a wide range of conditions. They include chronic tendon injuries and acute muscle and ligament injuries. In addition osteoarthritis of the knee and measures to speed recovery from surgery and fractures are becoming common uses.

Most of the treatment is either by orthopaedic doctors or pain medicine doctors. Many of these doctors have found the treatment not only to be successful but also returning a nice profit.

Some doctors recommend other treatments first. In other words they suggest physical therapy, medication, activity changes, bracing or steroid injections before trying PRP.

In addition there is some dispute as to what is the best means to prepare the platelets. Also subject to some debate are what volume should be used, the frequency of treatment and how many treatments each patient should get.

Until there are some standards in this regard any study results on platelet treatment are going to be unclear.

Call, or contact us for a free consult. For more information on this, see the pages on Wikipedia and see the page on orthopedics.