Plasma Rich Platelets (PRP)
PRP is the plasma fraction of whole blood, which has a platelet concentration above baseline. To be labeled as PRP, a platelet count of 4-5 times in excess of the baseline should be present in the platelet concentrate. Platelets contain granules that play a pivotal role in platelet function. There are approximately 50 to 80 α granules per formed platelet and contain more than 30 proteins including platelet-derived growth factor (PDGF), transforming growth factor (TGF-β, β1 and β2 isomers), platelet factor 4 (PF4), interleukin-1 (IL-1), platelet-derived angiogenesis factor (PDAF), VEGF, epidermal growth factor (EGF), platelet-derived endothelial growth factor (PDEGF), epithelial cell growth factor (ECGF), and insulin-like growth factor (IGF) etc. The properties of PRP are based on the production and release of these factors when the platelets are activated. Platelets begin secreting these proteins within 10 minutes of clotting. After initial release of growth factors, the platelets synthesize and secrete additional factors for the remaining days of their life span. It is these proteins and growth factors that give the PRP its healing potential. Obtaining PRP involves a routine blood draw performed in an office setting. The blood is then placed in a centrifuge where the products are separated from the red blood cells. Different mixtures and combinations of the PRP are utilized for different orthopedic applications. This treatment has been utilized in orthopedic practice for rotator cuff injuries, tennis and golfer’s elbow, Achilles tendonitis, patellar tendonitis, and osteoarthritis. Its indications, frequency, and activity modifications/rehabilitation varies with each condition and physician, and should be discussed with your treating doctor.
How is it Performed?
A nurse obtains small amount of blood that is drawn into a syringe. This sample then goes through centrifugation, a rapid spinning process that separates and concentrates the platelets and other beneficial growth factors from the blood. This concentrated portion is then injected into the painful joint or tissue. The entire PRP process is usually done in less than 30 minutes.
What are the Risks?
Because PRP uses your body’s own natural properties to treat your injury side effects are very uncommon. There can be an increase in pain and swelling 48-72 hours after the injection and pain immediately after the injection; however, part of this is the mechanism of the PRP working naturally.
Different applications have varying amounts of discomfort and activity restrictions. Anti-inflammatory medications such as Ibuprofen, Naproxen and Aspirin should not be used concurrently after receiving a PRP injection. These medicines may block the effects of the intended healing response facilitated by the post-injection inflammation. We ask that you refrain from taking them 1 week prior to the procedure and afterward at the instruction of your treating physician.