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PRP Therapy
What is PRP?
PRP, short for platelet-rich plasma, harnesses the remarkable regenerative potential inherent in your own blood's platelets. Platelets, renowned for their role in blood clotting, constitute a vital component of your blood composition. To provide some context, your blood consists of approximately 55% plasma, 45% red blood cells, and a mere 1% composed of white blood cells and platelets. Notably, platelets contain an array of essential proteins referred to as growth factors, which play a pivotal role in the intricate healing mechanisms activated during injuries.
The process of PRP involves the separation of these platelets and plasma from the remainder of the blood, yielding a high concentration of platelets within the plasma. This combination, aptly termed platelet-rich plasma, creates a potent elixir that acts as an accelerator for the body's natural recovery processes and serves as a catalyst for tissue repair. In essence, PRP taps into your body's innate healing powers to expedite recuperation and promote effective tissue regeneration.
How Does PRP Work?
When injury strikes, your body initiates a natural healing response, with platelets leading the charge as the first responders to the affected area. These remarkable blood components release vital signaling molecules known as cytokines, as well as essential healing proteins called growth factors. Cytokines, acting as small protein messengers, enable your cells to communicate effectively, optimizing the immune response and the healing process. Meanwhile, growth factors, the unsung heroes, roll up their sleeves and get to work, mending the damage.
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But there's more to the story. White blood cells, an integral part of your body's defense mechanism, are summoned to the site of injury. They, too, release growth factors, further enhancing the healing process.
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PRP takes this natural healing process to a higher level. By concentrating the platelets and growth factors found in your bloodstream to higher levels than your body can do on its own, a PRP injection delivers this potent mixture directly to the site of injury, supercharging your body's healing capabilities. It's like giving your body's repair crew a turbo boost, enabling faster recovery and targeted healing.
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What Can I Expect?
The PRP injection process begins with a straightforward blood draw. This blood sample is then carefully placed in a high-speed centrifuge, where it undergoes rapid spinning. During this centrifugation, platelets are meticulously separated from the other components of whole blood. The resulting concentrated mixture of platelets and white blood cells is then skillfully administered directly into the injured tissue.
To ensure precision and accuracy, we employ cutting-edge tools such as ultrasound and/or fluoroscopic guidance, allowing us to precisely target the injection site.
What Makes Us Different?
Specialized Expertise: With over a decade of dedicated experience in PRP injections, our commitment to excellence is unwavering. We actively contribute to research initiatives aimed at enhancing treatment outcomes, and we take pride in educating fellow physicians to advance patient care standards.
Customized Treatment Plans: We recognize that each individual is unique, and we approach their treatment as such. Leveraging our extensive experience, we meticulously tailor PRP solutions to specific needs, ensuring a bespoke and effective approach. From customizing the PRP solution to pinpointing the precise injection sites, personalization is our hallmark.
Cutting-Edge Technology: At the core of our procedures is state-of-the-art processing technology. This empowers us to deliver PRP solutions of unparalleled purity and concentration. Our utilization of advanced imaging technologies guarantees pinpoint precision during injections, leaving no room for doubt.
Quality Control: Your safety and the consistency of your treatment are paramount. We exclusively employ closed systems that eliminate any risk of cross-contamination. Our equipment, rigorously tested for reliability, assures you of consistent platelet concentration. We conduct thorough sample analysis to calculate platelet dosing, ensuring that your experience aligns with our high standards.
Comprehensive Evaluation: We understand that not every patient is a suitable candidate for PRP treatment. Our patient assessment process is comprehensive and may involve diagnostic tests and in-depth consultations to determine the most appropriate PRP treatment plan for your unique situation.
Multi-Disciplinary Approach: We recognize that recovery extends beyond the injection itself. We collaborate with rehabilitation experts and seasoned trainers specializing in regenerative medicine procedures to optimize your recovery and outcomes.
Research and Innovation: We're deeply engaged in pioneering research, conducting clinical studies on PRP, Bone Marrow, and Adipose treatments. Our commitment to innovation is underscored by our active participation in national conferences, where we share insights on regenerative medicine and serve as hands-on instructors, equipping other medical professionals with procedural expertise.
Patient-Centered Care: Your well-being is at the heart of our practice. We are dedicated to a patient-centric approach, characterized by a strong focus on patient education, diligent follow-up care, and unwavering support throughout your journey to recovery.
Proven Outcomes: With a track record of over a decade, we've witnessed numerous patients experience improved quality of life and heightened activity levels through our PRP procedures.
Transparency and Education: During consultations, we provide a comprehensive overview of the procedure, its benefits, potential risks, and anticipated outcomes. Our goal is to empower patients with the knowledge needed to make informed decisions about their treatment.
How Do I Prepare?
To minimize the risk of complications, it's advisable to avoid taking Aspirin or NSAIDs (such as ibuprofen, naproxen, diclofenac, meloxicam) for at least four days leading up to your procedure. Additionally, refraining from receiving a steroid injection for a minimum of four weeks prior to your appointment is recommended. Proper hydration is essential for the success of your procedure. In the 2-3 days preceding your appointment, we encourage you to stay well-hydrated by consuming a minimum of 60 ounces of water daily. Depending on the specific area you are having treated, it is advisable to arrange for an alternative means of transportation to and from your procedure. This measure ensures your safety and comfort, allowing you to focus solely on your treatment without concerns about driving.
Treatment Areas
1
Frozen Shoulder/Adhesive Capsulitis
PRP has shown to be better in at least 2 studies when compared to exercise alone (11,12)
2
Lateral Epicondylitis/Tennis Elbow
Multiple studies showing benefit when compared to cortisone injection (better and longer-lasting pain relief, heals and reorganizes tissue vs causing tissue degeneration) (13,14,15)
3
Achilles Tendonitis/Tendinosis
Patients receiving PRP post-surgically after achilles surgery had decreased time to regain range of motion, and return to their activities (16)
4
Patellar Tendinosis/Tendinitis/Jumper’s Knee
Safer than cortisone injection, and when combined with eccentric exercises, better healing than eccentric exercises or dry needling alone (17)
5
Shoulder Impingement
Studies showing improved pain relief, at least for the first 6 months when compared to cortisone injection – a safer alternative to a cortisone injection. (20, 21)
6
Plantar Fasciitis
PRP is more durable and effective than Cortisone injection in multiple studies (18,19)
7
Hip Bursitis
​Patients treated with PRP for hip bursitis had better outcomes and longer lasting relief compared to patients receiving cortisone injection (22)
8
Knee Arthritis
PRP injection was superior in short and long term pain relief when compared to hyaluronic acid injections (24)
References
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1. Hernigou P, Bouthors C, Bastard C, Flouzat Lachaniette CH, Rouard H, Dubory A. Subchondral bone or intra-articular injection of bone marrow concentrate mesenchymal stem cells in bilateral knee osteoarthritis: what better postpone knee arthroplasty at fifteen years? A randomized study. Int Orthop. 2021 Feb;45(2):391-399. doi: 10.1007/s00264-020-04687-7. Epub 2020 Jul 2. PMID: 32617651.
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2.Prodromos, Chadwick & Finkle, Susan. (2020). Autologous Biologic Treatment with Fat, Bone Marrow Aspirate and Platelet Rich Plasma Is an Effective Alternative to Total Knee Arthroplasty for Patients with Moderate Knee Arthrosis. Medicines. 7. 37. 10.3390/medicines7060037.
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3. Y.S. Kim, Y.J. Choi, S.W. Lee, O.R. Kwon, D.S. Suh, D.B. Heo, Y.G. Koh. Assessment of clinical and MRI outcomes after mesenchymal stem cell implantation in patients with knee osteoarthritis: a prospective study, Osteoarthritis and Cartilage, Volume 24, Issue 2, 2016, Pages 237-245, ISSN 1063-4584, https://doi.org/10.1016/j.joca.2015.08.009.
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4. Vangsness CT Jr, Farr J 2nd, Boyd J, Dellaero DT, Mills CR, LeRoux-Williams M. Adult human mesenchymal stem cells delivered via intra-articular injection to the knee following partial medial meniscectomy: a randomized, double-blind, controlled study. J Bone Joint Surg Am. 2014 Jan 15;96(2):90-8. doi: 10.2106/JBJS.M.00058. PMID: 24430407.
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5. Hernigou P, Flouzat Lachaniette CH, Delambre J, Zilber S, Duffiet P, Chevallier N, Rouard H. Biologic augmentation of rotator cuff repair with mesenchymal stem cells during arthroscopy improves healing and prevents further tears: a case-controlled study. Int Orthop. 2014 Sep;38(9):1811-8. doi: 10.1007/s00264-014-2391-1. Epub 2014 Jun 7. PMID: 24913770.
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6. Centeno C, Fausel Z, Stemper I, Azuike U, Dodson E. A Randomized Controlled Trial of the Treatment of Rotator Cuff Tears with Bone Marrow Concentrate and Platelet Products Compared to Exercise Therapy: A Midterm Analysis. Stem Cells Int. 2020;2020:5962354. Published 2020 Jan 30. doi:10.1155/2020/5962354
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7. Centeno CJ, Pitts JA, Al-Sayegh H, Freeman MD (2014) Efficacy and Safety of Bone Marrow Concentrate for Osteoarthritisof the Hip; Treatment Registry Results for 196 Patients. J Stem Cell Res Ther 4: 242. doi:10.4172/2157-7633.1000242
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8. Darrow M, Shaw B, Darrow B, Wisz S. Short-Term Outcomes of Treatment of Hip Osteoarthritis With 4 Bone Marrow Concentrate Injections: A Case Series. Clin Med Insights Case Rep. 2018;11:1179547618791574. Published 2018 Aug 10. doi:10.1177/1179547618791574
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9. Centeno CJ, Al-Sayegh H, Bashir J, Goodyear S, Freeman MD. A prospective multi-site registry study of a specific protocol of autologous bone marrow concentrate for the treatment of shoulder rotator cuff tears and osteoarthritis. J Pain Res. 2015;8:269-276. Published 2015 Jun 5. doi:10.2147/JPR.S80872
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10. Singh A, Gangwar DS, Singh S. Bone marrow injection: A novel treatment for tennis elbow. J Nat Sci Biol Med. 2014;5(2):389-391. doi:10.4103/0976-9668.136198
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11. Lin, Junhong. International Journal of Clinical Pharmacology and Therapeutics; Munich Vol. 56, Iss. 8, (Aug 2018): 366.
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12. Kothari SY, Srikumar V, Singh N. Comparative Efficacy of Platelet Rich Plasma Injection, Corticosteroid Injection and Ultrasonic Therapy in the Treatment of Periarthritis Shoulder. J Clin Diagn Res. 2017;11(5):RC15-RC18. doi:10.7860/JCDR/2017/17060.9895
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13. Peerbooms JC, (2010) Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-Year follow-up. http://www.ncbi.nlm.nih.gov/pubmed/20448192
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14. Gosens T, et al. (2011) Ongoing positive effect of platelet-rich plasma versus corticosteroid injection in lateral epicondylitis: a double-blind randomized controlled trial with 2-year follow-up. http://www.ncbi.nlm.nih.gov/pubmed/21422467
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15. Mishra A, et al. (2014) Efficacy of platelet-rich plasma for chronic tennis elbow: a double-blind, prospective, multicenter, randomized controlled trial of 230 patients. http://www.ncbi.nlm.nih.gov/pubmed/23825183
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16. Sanchez M, et al. (2007) Comparison of surgically repaired Achilles tendon tears using platelet rich fibrin matrices. http://www.ncbi.nlm.nih.gov/pubmed/17099241
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17. Dragoo JL, Wasterlain AS, Braun HJ, Nead KT. Platelet-Rich Plasma as a Treatment for Patellar Tendinopathy: A Double-Blind, Randomized Controlled Trial. The American Journal of Sports Medicine. 2014;42(3):610-618. doi:10.1177/0363546513518416
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18. AkÅŸahin, ErtuÄŸrul, et al. “The comparison of the effect of corticosteroids and platelet-rich plasma (PRP) for the treatment of plantar fasciitis.” Archives of orthopaedic and trauma surgery 132.6 (2012): 781-785.
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19. Ragab, Ehab Mohamed Selem, and Ahmed Mohamed Ahmed Othman. “Platelets rich plasma for treatment of chronic plantar fasciitis.” Archives of orthopaedic and trauma surgery 132.8 (2012): 1065-1070.
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20. Doaa H. Ibrahim, Nagat M. El-Gazzar, Hanan M. El-Saadany, Radwa M. El-Khouly, Ultrasound-guided injection of platelet rich plasma versus corticosteroid for treatment of rotator cuff tendinopathy: Effect on shoulder pain, disability, range of motion and ultrasonographic findings. The Egyptian Rheumatologist, Volume 41, Issue 2, 2019, Pages 157-161, ISSN 1110-1164, https://doi.org/10.1016/j.ejr.2018.06.004.
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21. Dadgostar, H., Fahimipour, F., Pahlevan Sabagh, A. et al. Corticosteroids or platelet-rich plasma injections for rotator cuff tendinopathy: a randomized clinical trial study. J Orthop Surg Res 16, 333 (2021). https://doi.org/10.1186/s13018-021-02470-x
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22. Begkas D, Chatzopoulos ST, Touzopoulos P, Balanika A, Pastroudis A. Ultrasound-guided Platelet-rich Plasma Application Versus Corticosteroid Injections for the Treatment of Greater Trochanteric Pain Syndrome: A Prospective Controlled Randomized Comparative Clinical Study. Cureus. 2020;12(1):e6583. Published 2020 Jan 7. doi:10.7759/cureus.6583
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23. ROSÁRIO, DAVI ARAÚJO VEIGA et al. COMPARISON BETWEEN CONCENTRATED BONE MARROW ASPIRATE AND CORTICOID IN GLUTEAL TENDINOPATHY. Acta Ortopédica Brasileira [online]. 2021, v. 29, n. 1 [Accessed 1 December 2021] , pp. 26-29. Available from: <https://doi.org/10.1590/1413-785220212901236828>. Epub 10 Mar 2021. ISSN 1809-4406. https://doi.org/10.1590/1413-785220212901236828.
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24. Tang, J.Z., Nie, M.J., Zhao, J.Z. et al. Platelet-rich plasma versus hyaluronic acid in the treatment of knee osteoarthritis: a meta-analysis. J Orthop Surg Res 15, 403 (2020). https://doi.org/10.1186/s13018-020-01919-9