• Platelets are small discs are derived from fragmentation of precursor megakaryocytes.  
• Platelets play a fundamental role in hemostasis and are a natural source of growth factors. They circulate in the blood of mammals and are involved in the formation of blood clots.

What is Platelet Rich Plasma?

• Platelet Rich Plasma, or PRP, is blood plasma with concentrated platelets and other growth factors.  The concentrated platelets found in PRP contain huge reservoirs of bioactive proteins, including growth factors and signaling proteins that are vital to initiate and accelerate tissue repair and regeneration.  
  
  “Studies in basic science have shown a dose-response relationship between the platelet concentration and levels of secretory proteins, as well as between platelet concentration and certain proliferative events of significance to the healing wound”. (Pietrzak, Scientific Foundations)

To create PRP therapy, a small amount of blood is taken from the patient's arm. The blood is then placed in a centrifuge. The centrifuge spins and separates the platelets form the rest of the blood components. The entire process takes less than 15 minutes and increases the concentration of platelets and growth factors up to 500%. These specially prepared platelets are taken and re-injected into and around the point of injury. Platelets release special growth factors that lead to tissue healing. By using the concentrated platelets, we increase the growth factors up to five times which promotes temporary relief, is thought to promote healing and stops inflammation.

PRP is a treatment option for various orthopaedic injuries and conditions, which have traditionally required surgery or other extensive treatments.  PRP injections are being utilized in orthopaedics with increasing frequency and effectiveness.  Injuries currently being treated with the PRP technique are arthritis of the hip, knee, shoulder, ankle and other joints.  PRP also is utilized for soft tissue injuries such as tendonitis, muscle sprains and tears, and various types of ligament injuries.  These include common tendon injuries such as tennis and golfers’ elbow, Achilles tendonitis and knee tendonitis.  PRP is also used to treat various injuries and conditions affecting (joint) injuries.   These include rotator cuff and meniscus injuries.

“It is hypothesized that platelets can act as an exogogenous source of growth factors that could potentially stimulate bone formation.15 Gruber et al41 showed that platelets can stimulate the formation of osteoclast-like cells, which can help with bone growth and remodeling.” (Foster, The American Journal of Sports Medicine)

1) The patient’s blood is drawn and processed. The PRP component is isolated and contained

2) The skin is numbed with a small injection of xylocaine (novacaine)

3) The PRP mixture is injected into and around the area of damage

• Patients can see a significant reduction of pain and improvement in symptons.  This may eliminate the need for more aggressive treatments such as long-term medication or surgery as well as a remarkable return of function.
• Patients should stop taking anti-inflammatory medication before and after the PRP injection.
• It may be necessary to repeat the PRP injection.
• The risks include those signs/symptoms associated with any injection including: pain, infection, allergic reaction, nerve injury, skin discoloration, calcification, no relief of symptoms, worsening of symptoms, blood clot, scarring, or loss of fat in the affected area.  All of these risks are uncommon.

In a report published in The American Journal of Sports Medicine on the use of PRP for the treatment of tendonitis, Peerbloom stated “Treatment of patients with chronic lateral epicondylitis with PRP reduces pain and significantly increases function, exceeding the effect of corticosteroid injection. Future decisions for application of the PRP for lateral epicondylitis should be confirmed by further follow-up from this trial and should take into account possible costs and harms as well as benefits”

Preliminary PRP study demonstrates improvement in knee OA patients.

Data from a pilot study published in the December issue of the American Journal of Physical Medicine & Rehabilitation provide positive support for further clinical testing to determine whether platelet-rich plasma (PRP) is safe and effective for the treatment of knee osteoarthritis (OA). The authors conducted a single-center, uncontrolled, prospective study of 14 patients with primary and secondary knee osteoarthritis. Each patient received three injections of PRP at approximately 4-week intervals. No adverse events were reported by 52-week follow-up. Participants in the study demonstrated significant and almost linear improvements in pain and symptom relief on the Knee Injury and Osteoarthritis Outcome Scores, as well as improvements on the Brittberg-Peterson Visual Pain Visual Analog Scale. In addition, a majority of patients expressed a favorable outcome at 12 months after treatment.

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