Platelet Rich Plasma Treatment

Whole blood may be separated into its composing parts which are plasma, platelets, and red and white blood cells.  PRP  or Platelet Rich Plasma is basically what’s left when blood cells are separated from the liquid component of human whole blood. The plasma portion contains water and proteins which include numerous biologic factors that have been shown to enhance healing in animal and human studies dating back to the 90’s.  It is now used as an alternative to traditional treatment options in care of tendinopathies and muscular injuries as it provides the patient with multiple advantages.

PRP treatment advantages:

1. It contains entirely natural products from a patient’s own blood.
2. There is little if any risk for injecting patient’s own blood product back into their body.
3. Traditional treatments for tendonitis do not have predictive results and have potential downfalls.
   1. Repeated cortisone injections into tissue can destroy and weaken that tissue
   2. Cortisone injections into tendons of the lower extremity can lead to rupture of those tendons
   3. Long term anti-inflammatory pills only treat the symptoms of the disease and in doing so prevent the necessary immobilization to promote healing.  They also may cause gastrointestinal and renal problems.
   4. While when indicated the surgical management is successful, the morbidity associated with surgery during the healing phase may be prohibitive in certain individuals, or the disease state may not be advanced enough to guarantee great improvement in function and treatment success.

The use of biologicals and biologic solutions including gene therapy is likely to increase and encompass a major part of the future of medicine and orthopedics. In fact, FDA has approved the use of PRP in other applications within the field of orthopedic surgery.

PRP disadvantages:

While there are studies under way to prove the efficacy of PRP injection for the treatment of tendonitis and the early results are promising, currently,  FDA approval is pending.   Therefore, PRP tendon injections are considered “off label use”.   This means the procedure cost will be out of pocket for you.

Indications/Ideal patients for PRP injections:

Patients who have long standing problems with tendonitis and

1. who have failed previous treatment or
2. are unable to tolerate oral anti- inflammatory medications

Contraindications:

1. Chronic use of blood thinners for medical problems
2. Need for chronic use of anti inflammatories
3. Inability to tolerate blood draws
4. Allergy to marcaine and lidocaine(used in the procedure.

Overview:

After care following PRP injection

1. Patient will be asked to remain in our office for 15 minutes to insure that the procedure was tolerated well.
2. It is recommended that the patient should rest the day of procedure.
3. Ice should be applied to the area of injection for about 20 minutes, 3 times per day for 48 hours.
4. DO NOT TAKE anti-inflammatory medications for 2 weeks.
5. There may be significant degree of pain post procedure.  Pain pills are prescribed for this purpose
   (no driving while taking narcotic medication!!).
6. Use of a brace or sling is mandatory and not for comfort only. It is to be used at all times except when showering or dressing.
7. After 2-3 days, normal activities are allowed with the brace or sling.
8. A follow up post procedure exam will be scheduled for about 2 weeks.