PRP injectionsPlatelet-rich plasma (PRP) is a component of everyone’s blood. It is obtained by drawing blood from a patient and placing the blood in a centrifuge. The centrifuge separates the blood into components, primarily plasma and red blood cells. A portion of the plasma, PRP, contains a high concentration of factors known to be important in healing and pain relief.

Platelet-rich plasma works in at least 2 ways. First, the platelets and growth factors cause a signaling cascade that promotes new blood vessel growth and proliferation of healing cells (e.g. fibroblasts and tenocytes). Secondly, the PRP suppresses the release of factors responsible for inhibition of early healing. These mechanisms are particularly important in tissues in the body that have relatively poor blood supply and a tendency towards degeneration, such as joint cartilage, the achilles tendon or the tendons responsible for tennis elbow.

Research has been ongoing into the best applications for PRP for many years now. In many cases it is still unclear how powerful an effect PRP treatment may have on certain diseases. There is excellent ‘in-vitro’ evidence that PRP has a positive effect on the healing of cartilage and tendon (1). Clinical studies have found positive effects of PRP in various diseases including knee arthritis (2), ankle cartilage lesions (3), ankle sprains (4), rotator cuff tears (5), achilles (6) or patellar tendinopathy (7), and tennis elbow (8) among others. Again, the research into PRP is still young and clarification with larger studies is necessary to further define the best applications of PRP in the clinical setting.

PRP has been shown in several recent studies to have a beneficial effect on knee arthritis. PRP injection has been compared to the injection of hyaluronic acid (Synvisc, Durolane) with favorable results. In one recent study, PRP was found to be much more effective at improving outcomes than hyaluronic acid in patients with knee arthritis out to 6 months (9) and several other research papers also conclude that PRP improves symptoms and function better than other injection options such as corticosteroid or hyaluronic acid (10, 11).

We are pleased to offer PRP injection at POSM as part of the full compliment of orthopedic treatment options for musculoskeletal disease. We are happy to discuss whether PRP is an option for you.


Surgeons

Alan Baggoo
Victor Jando
Mark McConkey
Kostas Panagiotopoulos
Adam Sidky
Peter Zarkadas
Shannon Samler


References

  1. Smyth NA, Murawski CD, Fortier LA, Cole BJ, Kennedy JG. Platelet-rich plasma in the pathologic processes of cartilage: review of basic science evidence. Arthroscopy 2013;29:1399-1409.
  2. Patel S, Dhillon MS, Aggarwal S, Marwaha N, Jain A. Treatment with platelet-rich plasma is more effective than placebo for knee osteoarthritis: a prospective, double-blind, randomized trial. Am J Sports Med 2013;41:356-364.
  3. Mei-Dan O, Carmont MR, Laver L, Mann G, Maffulli N, Nyska M. Platelet-rich plasma or hyaluronate in the management of osteochondral lesions of the talus. Am J Sports Med 2012;40:534-541.
  4. Laver L, Carmont MR, McConkey MO, et al. Platelet-rich plasma as a treatment for high ankle sprains in elite athletes – a preliminary randomized controlled trial. Knee Surg Traumatol Arthrosc. Submitted.
  5. Jo CH, Shin JS, Lee YG, Shin WH, Kim H, Lee SY, Yoon KS, Shin S. Platelet-rich plasma for arthroscopic repair of large to massive rotator cuff tears: A randomized, single-blind, parallel-group trial. Am J Sports Med 2013;41:2240-2248.
  6. Gaweda K, Tarczynska M, Krzyzanowski W. Treatment of achilles tendinopathy with platelet-rich plasma. Int J Sports Med 2010;31:577-583.
  7. Kon E, Filardo G, Delcogliano M et al. Platelet-rich plasma: new clinical application: a pilot study for treatment of jumper’s knee. Injury 2009;40:598-603.
  8. Peerbooms JC, Sluimer J, Bruijn DJ, et al. Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up. Am J Sports Med 2010;38:255-262.
  9. Cerza F, Carni S, Carcangiu A, et al. Comparison between hyaluronic acid and platelet-rich plasma, intra-articular infiltration in the treatment of gonarthrosis. Am J Sports Med 2012;40:2822-2827.
  10. Khoshbin A, Leroux T, Wasserstein D, et al. The efficacy of platelet-rich plasma in the treatment of symptomatic knee osteoarthritis: a systematic review with quantitative synthesis. Arthroscopy 2013;29:2037-2048.
  11. Say F, Gurler D, Yener K, Bulbul M, Malkoc M. Platelet-rich plasma injection is more effective than hyaluronic acid in the treatment of knee osteoarthritis. Acta Chir Orthop Traumatol Cech 2013;80:278-283.