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PRP (Platelet Rich Plasma) Joint Therapy

Introduction

PRP has been used by physicians for joint, ligament, tendon, muscle treatment and rejuvenation of the skin and hair restoration since the 1990’s.  PRP treatments enhance and speed up the natural healing response of the body.

What Is PRP

Platelet-rich plasma (PRP) is blood plasma that has been enriched with a concentrated amount of platelets above the normal baseline in the blood. It is a treatment that utilizes a patient’s own blood (autologous) to stimulate the body’s natural ability to heal itself.

PRP applications and injections promote tissue restoration by activating the inflammatory response to a concentrated amount of platelets being delivered to an injury site. Having an increased platelet concentration promotes healing of tendons, ligaments, muscle and joints and when topically applied, induces healing and rejuvenation of the skin.

PRP intends to resolve pain and rejuvenate tissue by speeding up your own body’s natural healing response.

Platelets function as a natural reservoir for regenerative receptor proteins called growth factors essential to the repair of injured tissues and encourage new tissue growth. During a typical response to an injury, platelets clot together at the point of injury, creating an inflammatory reaction where growth factors are released that stimulate the typical wound and soft tissue healing.

Platelets contain many factors that are essential for cell recruitment, multiplication and specialization. The platelets release a number of enzymes and proteins to attract stem cells that play a significant role in the biology of healing. When PRP is injected/applied topically into the target area, it triggers an enhanced healing response.

History

PRP has been established for over 20 years for its wound healing properties. It was first introduced by Dr. Ferrari & Dr. Valbonesi for an application in open-heart surgery in 1987.

Today it is used in many fields, i.e. sports medicine, orthopedics, urology and dermatology. It has been used in maxillofacial (dental) and plastic surgery since the 1990s. Its emergence into aesthetics and skin rejuvenation first began in 2004 in Europe, Asia, Australia, and South America.

Its use in sports medicine is growing, given its potential to enhance muscle and tendon/ligament healing. Highlighted when Tiger Woods received 4 PRP treatments following knee surgery to accelerate the healing of his knee. In the future, PRP is likely to become the gold standard for treating tendonitis, whether in the knee, shoulder or elbow.

Applications for PRP:

  • Cosmetic/Topical Application
    • skin rejuvenation
    • hair restoration
  • Injections
    • Shoulder
    • Hip
    • Knee
  • Tendon/ligament
    • Shoulder Rotator Cuff
    • Tennis or Golfer’s Elbow
    • Hamstring or pectoral tendons
    • Knee –ACL, MCL Injuries, Patella Tendons
    • Achilles heel
    • Plantar Fasciitis
    • General Tendonitis or Bursitis
    • Ligament strain or sprain
  • Muscle
    • Neck
    • Bicep
    • Back
    • Pelvis
    • Hamstring, Quadricep, Calf
    • General muscle strains
  •  Other
    • Osteoarthritis of shoulder, spine, hip, knee

PRP therapy may be considered if you have been diagnosed with arthritis or have an injury to a tendon, ligament or muscle. The injury may be either recent or chronic.   

PRP offers an alternative treatment for those who do not wish to have surgery. An evaluation will determine if PRP is a potential treatment option. While other treatments (such as cortisone injections) provide temporary relief, PRP therapy is designed to promote the injury’s long-term healing.

Benefits of PRP

Along with the benefit of using your own platelets for healing, there is virtually no allergic reaction to the injected or applied PRP as it is from your own blood.

PRP improves function and relieves pain when injected into the joints, ligaments/tendons and muscles.

  • Promotes the growth of specific types of cells and tissues required for proper healing
  • Increases development of new blood vessels
  • Accelerate the regeneration of connective tissue
  • Increases collagen in the skin

PRP can also be applied topically for skin rejuvenation

PRP has been shown to have overall rejuvenating effects on the skin including:  

  • Improving skin texture, thickness, fine lines and wrinkles
  • Increasing volume via the increased production of collagen and elastin
  • Diminishing and improving the appearance of scars
  • Hair restoration

The most dramatic results to date have been crepey skin problems in areas such as under the eyes, neck, and décolletage. Other benefits include minimal risk, shorter recovery time when used after laser treatments and natural-looking results.

PRP PROCEDURE


PRP treatment involves:

  • The blood draw, PRP preparation, injection, or topically applied procedure will take on average 45-60 minutes depending on the area to be treated.
  • the doctor will draw 10-50 cc of your blood – similar to that required for a regular blood test
  • the blood will be centrifuged to separate it into its major components – red blood cells, white blood cells, platelets and plasma; centrifuging will have concentrated your platelets above your normal baseline in the blood.
  • The concentrated platelets and plasma (PRP) will be drawn up and prepared for injection or topical application.

PRP will cause a mild inflammation that triggers the healing response.

  • The clotted platelets release growth factors to accelerate tissue and wound healing, including stem cell proliferation, to repair the damaged area.
  • The growth factors stimulate tissue recovery by increasing collagen production and increasing blood flow.
  • Cartilage becomes firmer and more resilient.
  • PRP can activate tenocytes (tendon cells) which initiates the collagen production necessary to repair injured tendons, ligaments, cartilage and muscle tissue.

When treating injured or sun and time damaged tissue, PRP can induce a much healthier and younger state’s remodelling.

Applied topically for skin rejuvenation, PRP encourages new collagen to develop. As the collagen matures, it begins to shrink, causing tightening and strengthening of the damaged area.

PRP is given to optimize the anti-inflammatory response to healing – therefore, anti-inflammatory medications should be stopped at the time of PRP treatment.

Number of treatments

Injected PRP

  • Generally, 3 injections over a 6 month period are recommended. Usually, the first 2 will be spaced 2-6 weeks apart, depending on the area injected. You may feel the effect after 2 weeks from the 1st injection, or it may take till the 2nd to take effect.
  • Gradually healing will increase as time goes on for tissue repair and to strengthen muscle and connective tissue.  
  • PRP therapy can accelerate the healing of acute injuries, but chronic problems may require a longer recovery period.

Topically Applied PRP

  • Commonly 2-3 treatments are advised. However, more may be necessary for some individuals.
  • Touch-up treatments may be done once a year after the initial group of treatments to boost and maintain the results.

Results

PRP injections for joints, tendons, ligaments, muscle:

  • Results are generally noticed at 2-3 weeks and continue to improve gradually over the next 3-6 months. Each individual is unique, so there will be variations in results from one person to the next. It is difficult to predict exactly who will respond and who will not, and to what degree.
  • Pain may occur at the injection site, and there may be some swelling from the induced inflammation. There may be a notable increase in pain in the days immediately following the injection.  Pain intensity will become less each day as functional mobility increases along with endurance and strength.
  • You will notice gradual improvement 2-6 weeks after PRP therapy.  Some patients report ongoing improvement 6-9 months after PRP therapy is administered.  Patients with six-week-old injuries recover more rapidly than those patients who’ve been suffering from a decade-old injury.  

PRP for aesthetic treatment:

  • Results are generally visible at 4 weeks and continue to improve gradually over 3-6 months with improvement in texture and tone.
  • Individuals are different, so there will be variations from one person to the next.

Some of the Potential Side Effects of Platelet Rich Plasma include:

Pain or Itching in the treated area

  • An acute ache, soreness or itching at the injection site may occur, lasting 2-3 days on average.

Bleeding, Swelling, Bruising or Infection

  • Bleeding, swelling and bruising may occur after the injection but should subside within 24 hours.
  • Even though precaution is taken when injecting a patient with PRP and sterilization procedures are followed closely for each treatment, an infection can occur in the injured area on rare occasions.

Allergic Reaction

  • This is very rare as you are injecting your own platelets.

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