What is Platelet Rich Plasma (PRP)?
The PRP is a blood product concentration of the growth factors and other healing cells from the patient’s own blood.
What is the therapeutic mechanism of Platelet Rich Plasma?
The apheresis process separates the autologous blood into platelet rich plasma (PRP) and platelet poor plasma (PPP). The PPP is manually drawn off to leave PRP. This produces a product available for injection back into the patient. Included in the procedure are the venipuncture, preparation of the blood and centrifuge / separation / mixing / activation processes. This is needed to obtain a solution to stimulate the body to re-initiate the healing inflammatory processes.
How is PRP administered?
It is injected percutaneously (through the skin) into the intra-articular (inside the joint) space and into or around tendon and ligament tissues. A “peppering technique” with the needle is used to distribute the PRP at multiple sites along the injured tissue. Another method sometimes used is a percutaneous tenotomy procedure. After numbing the area with anesthetic (lidocaine), this technique uses direct needling of the injured tissue, prior to injecting the PRP into the tissue irritated by the tenotomy needling technique.
What tissue types are appropriate for treatment with PRP?
Acute and chronically injured tendons, ligaments, joint capsules and articular surfaces are positively impacted by treatment.
How many injections are given with each treatment?
Often a patient will receive 20-40 injections using the tenotomy technique described above. In addition, there are a corresponding number of superficial and deep anesthetic injections done to help alleviate the sensations from the tenotomy needling. Total injections may range from 40 to 80 with the deep therapeutic injections and anesthetic numbing injections are totaled.
How many injections are needed?
Typically 3-5 injection visits are anticipated depending on the injury. Some patients with minor issues may not require as many injections, while others with more extensive issues may require more than this average.
Do the injections hurt?
You will feel a small pinch to numb the sites for the injection with anesthetic (lidocaine), and then the PRP injections are typically very well tolerated by most patients.
Do I need to be put to sleep for the procedure?
No, only local anesthetic is used for the procedure. You will be awake and talking with the doctor throughout the procedure.
What is the recommended frequency of treatment for PRP?
The frequency of treatment is typically every 4-6 weeks ideally. Prior to initiating PRP injections, a thorough consultation and examination is performed, including possibly imaging tests (x-rays, musculoskeletal ultrasound, CT, MRI), for pre-procedure planning.
What is the expected length of treatment for PRP?
Typically it is 4-5 months, but could be longer in certain cases.
What are the objective signs of successful PRP treatment?
Decreased pain, decreased use of pain medications, increased functional activities should be seen as the patient improves.
What are the positive benefits of Platelet Rich Plasma (PRP) injections for you?
Benefits include improving the collagen content of the ligaments, tendons, and capsular tissues at the cervical facets, and improving the health of the joints or spine. Collagen acts to reinforce tissue making it more resilient and able to withstand more force through the structure. This allows higher levels of functional activity with less pain.
Will PRP cure my arthritis?
While there is no cure for osteoarthritis, PRP treatment of instability should help decrease the excess motion in the joints that can lead to worsening of arthritis. Treatment with PRP could slow the development or progression of arthritis and should make flares of the tissue less frequent. This treatment aims to treat the cause of the arthritic pain, instability in the joint or poor strength in the support structures, and is not just covering up the symptoms as is the aim of many commonly used arthritis “treatments”.