Platelet Rich Plasma Therapy
What Is it?
Blood is mainly a liquid (called plasma), it also contains solid components (red and white cells, and platelets). The platelet component of blood is best known for it’s importance in clotting blood. However, platelets also contain hundreds of proteins called growth factors, which are very important in the healing of injuries.
To develop a PRP preparation, blood is drawn from a patient. The platelets and plasma are separated from the red and white cells during a process called centrifugation. The platelet concentration is increased 2.5 to 10 times greater (or richer) than usual and the platelets are activated.
The PRP is injected into the injured area.
How Does PRP Work?
It is not exactly clear how PRP works. Platelets and their growth factors are part of the countless biological processes (cell migration, proliferation and angiogenesis) that regulate healing. Laboratory studies have shown that the increased concentration of growth factors in PRP can potentially speed up the healing process.
What Conditions can be treated with PRP?
Mild to moderate osteoarthritis of the hip knee and ankle.
Chronic Tendon Injuries
According to some research studies, PRP is effective in the treatment of chronic tendon injuries like Achilles tendinosis, Patella tendinosis (jumper’s knee), ITB friction syndrome and tennis elbow.
Acute Ligament and Muscle Injuries
Much of the publicity PRP therapy has received has been about the treatment of acute sports injuries, such as ligament and muscle injuries. PRP has been used to treat professional athletes with common sports injuries like pulled hamstring muscles in the thigh and knee ligament sprains. There is no definitive scientific evidence, however, that PRP therapy actually improves the healing process in these types of injuries. There are however many anecdotal cases including high profile sportsmen whom have claimed career saving success.
PRP has been used in a very limited way to speed the healing of broken bones. So far there is little evidence to support this.
Is It Effective?
Past and present research studies to evaluate the effectiveness of PRP treatment have had mixed or inconclusive results. The beneficial effect may be placebo.
The effectiveness of PRP therapy can vary. Factors that can influence the effectiveness of PRP treatment include:
- The area of the body being treated
- The overall health of the patient
- Whether the injury is acute (such as from a fall) or chronic (an injury developing over time)
- The severity of the condition
- The concentration of the PRP
Some initial research to evaluate the effectiveness of PRP in the treatment of the arthritic knee has concluded a 70% reduction in symptoms in 70% of patients for a 4 to 6 month period.
Treatment with platelet-rich plasma holds promise. Currently, however, the research studies to back up the claims in the media are lacking. Although PRP does appear to be effective in the treatment of chronic tendon injuries and knee arthritis, the medical community needs more scientific evidence before it can determine whether PRP therapy is truly effective in other conditions.
Even though the success of PRP therapy is still questionable, the risks associated with it are minimal: There may be increased pain at the injection site, but the incidence of other problems — infection, tissue damage, nerve injuries, appears to be no different from that associated with cortisone injections.
If you are considering treatment with PRP, be aware that few insurance plans, including Workcover provide reimbursement. It is mostly self funded.