Platelet Rich Plasma Injections

What is Platelet Rich Plasma (PRP)?

Platelet Rich Plasma (PRP) is a concentrate of platelets which, when injected in human tissue, can help to heal damage cells by stopping inflammation and promoting tissue regeneration.

PRP provides a promising alternative to surgery (or at least delays it) by promoting safe and natural healing without surgery.

Blood typically contains 6% platelets whereas PRP has a significantly increased supra-physiological platelet concentration, usually at least 4x greater. Some other blood elements may be present such as white cells.

PRP was first used in 1987 in open heart surgery. For 30 years, the application of autologous PRP has been safely used and documented in many fields including; orthopedics, sports medicine, dentistry, ENT, neurosurgery, ophthalmology, urology, wound healing, cosmetic, cardiothoracic, and maxillofacial surgery.

What Are Platelets?

Blood contains plasma, red cells, white cells and platelets. Platelets are small, discoid cells with a life span of about 7-10 days. Platelets contain inside clotting and growth factors. During the healing process, the platelets are activated and aggregate together. They then release these growth factors which can modulate the inflammatory cascade and stimulate the healing process.

When to use PRP?

Although PRP therapy is still considered an experimental therapy, its use has shown an experimental growth in the 5 years worldwide. Frequent uses of PRP therapy include:

  • Treatment of musculoskeletal conditions such as osteoarthritis of knees and hips, tendon injuries (Achilles, hamstrings, tennis elbow), trochanteric and subacromial/subdeltoid bursitis, muscular tear (hamstring, quads), joints and ligament sprain (ankle, knee). Also PRP therapy is being used intraoperatively by Orthopaedic surgeons to improve results in ACL repair and total hip/knee replacement
  • Aesthetic Medicine where it may help skin to regenerate and to maintain its radiance and elasticity
  • Diabetic and vascular ulcers treated with perilesional PRP therapy have shown a greater healing and regeneration cell rate
  • Hair loss caused by androgenic alopecia. Recent studies from 2014 have shown that PRP therapy helped hair growth in patients who had failed to previous treatments with minoxidil and finasteride. One of the conclusions of this study was that the “PRP injection is a simple, cost effective and feasible treatment option for androgenic alopecia, with high overall patient satisfaction”
  • Bone grafts in Oral-maxillofacial surgery and skin grafts in Plastic Surgery

PRP Injections – The Procedure

  • Assessment of the problem/injury – At the first appointment, the doctor usually takes a detailed clinical history of the patient’s injury or specific problem that may require PRP therapy, as well as any other medical conditions and current treatments that may be relevant. This will be followed by a thorough physical examination. Depending on the situation, additional tests such as a blood test or an x-ray/MRI to confirm the diagnosis and pinpoint the injury site for injection may be needed. Usually it is during this first consultation when a treatment plan with PRP is outlined and the procedure itself is explained and agreed
  • Blood collection – On the day of the PRP injection the doctor or nurse will take a blood sample from the patient’s arm, usually between 5 to 20 mls in a special sterile container. The amount of the sample depends on where the PRP will be injected. For example, the amount of blood taken for injection into the scalp for one study was 20 mls. This is slightly larger than one teaspoon
  • PRP injection – The patient’s own blood (autologous) will be then centrifuged (spun down) at a specific force and time in order to separate the different blood components into 2 different layers, the PRP layer and the red cell layer. Then the PRP layer will be drawn into a syringe and injected into the region of interest, namely intra-articularly into a knee for example or intra-dermally in the scalp, depending on the treatment discussed and desired

Is PRP Safe?

Because PRP therapy is an autologous therapy (the patient’s own blood components are injected in his own body) the probability of an allergic reaction is very unlikely which can occur when other substances such as steroids or hyaluronic acid  are used. Multiple studies have shown PRP therapy to be a safe and a well tolerated new therapy.

Even though there are potential side effects and complications inherent as to any medical procedure, only mild and self-limiting adverse effects in a small number of patients have been reported. One study reported mild pain and/or slight swelling, which resolved spontaneously within 24 to 48 hours. Other study reported local pain, stiffness, syncope, dizziness, headache, nausea, sweating, and tachycardia, all self-limited. There is also documented temporary mild worsening of pain in the knee joint after application of PRP which was spontaneously resolved after 2 days. Sporadic adverse effects of temporary mild rash, local numbness, and itching sensation were also reported. Pain can be prevented by the use of a local anaesthetic prior to the PRP injections. After the infiltration ice may be applied to ease the pain. The use of painkillers is also recommended to minimise discomfort, except the use of anti-inflammatories as these drug may alter the effect the regenerative effect of the PRP.

What is the Downtime with PRP Therapy?

Usually a couple of days of rest is recommended and activities such as yoga, running or the gym will be best to avoid. Also the use of anti-inflammatories or ice is not recommended as they could potentially affect the effectiveness of the PRP treatment.

How Much Does PRP Therapy Cost?

As PRP therapy is still an experimental treatment there is currently no Medicare rebate in Australia, hence it is a private fee only. For a detailed outline of the costs involved please call The Station, in Mornington, and a member of our team will be able to assist you with your questions.

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Bibliography

Lior Laver et al. PRP for Degenerative Cartilage Disease: A Systematic Review of Clinical Studies. Cartilage. 2017 Oct; 8(4): 341–364.

Sampson S, Gerhardt M, Mandelbaum B. Platelet rich plasma injection grafts for musculoskeletal injuries: a review. Curr Rev Musculoskelet Med. 2008 Dec;1(3-4):165-74.

Khatu SS, More YE, Gokhale NR, Chavhan DC, Bendsure N.Platelet-Rich Plasma in Androgenic Alopecia: Myth or an Effective Tool.

Journal of Cutaneous and Aesthetic Surgery. 2014 Apr-Jun; 7(2): 107-110

 

 

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