Wednesday, July 10, 2013

Demystifying PRP Or Platelet Rich Plasma


Recently, there has been a lot of buzz surrounding the use of PRP to heal injuries that have been resistant to other forms of treatment. So what is PRP?

Platelet Rich Plasma or PRP is the biologic factor that is obtained when human whole blood is spun in a centrifuge and is separated from other liquid blood components. The Plasma has been shown to contain many healing factors that aid the treatment of injuries in humans and animals.

Why is there so much excitement about it?

Studies have shown that a PRP injection can be more successful in treating tendonitis than treatment with cortisone and offers less risk than a surgical procedure. If PRP is not successful, its use does not preclude additional treatments or surgery. Because the factor is made entirely from the patient's own blood, it is entirely natural and does not cause the numerous side effects of NSAIDs and steroidal medications, whether taken orally or injected. Surgical treatment of tendonitis is not always successful and carries risks as well. FDA approval is pending for treatment of tendonitis, but the FDA has approved PRP for other orthopaedic indications. PRP is done as a single injection which can be repeated in 6 weeks if necessary.

Does insurance cover PRP injections?

Most do not cover PRP injections when used for tendonitis. If your carrier does not, you can self-pay your provider for PRP.

Who can have PRP injections and who cannot?

Any adult patient with a history of tendonitis which has not responded to other treatments, whose symptoms are significant enough that they are considering surgery or repeat steroid injections would be a good candidate.

Patients who would not be good candidates are those taking blood thinners, who cannot stop taking anti-inflammatory medicines, those who cannot follow the prescribed rest and rehabilitation regimen after PRP injection.

How is it done?

Patients are advised to discontinue use of anti-inflammatory medications (Aleve, ibuprofen, aspirin) for one week prior to their injection.

During a visit to the orthopaedist's office, blood is drawn from the patient's arm and is then spun in a high-speed centrifuge. After the blood components separate, only the platelet rich plasma is drawn off to be used for the injection into the patient. After numbing the injection site, the injured tendon is injected with the PRP. The patient is monitored for a short time after the injection. This process takes around 1 hour.

Will I have any special precautions to follow after the injection?

Patients are advised to rest, apply ice to the injection site and to take it easy for a few days. Anti-inflammatories continue to be a "no-no" for one week after the injection. Your physician will instruct you according to your own specific needs, but for most patients, sports activity will be limited, physical therapy will be prescribed and patients may be given a sling, a brace or crutches to use. You may be prescribed a medication for pain after the procedure.

Are there any downsides to having PRP?

As with any procedure or treatment, there are risks to be considered. Although minimal, there is a risk for infection at the injection site. There is also no guarantee that a PRP injection will provide relief or a reduction in symptoms. Discuss this and any other treatment option thoroughly with your doctor to make sure it is right for you.

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