Platelet rich plasma, otherwise referred to as PRP, has been a very hot topic in the last couple of years. Many professional athletes have utilized this novel biologic treatment to help them come back quicker from injuries. Tiger Woods was reported to have received PRP injections prior to all 4 majors in 2009. Two Pittsburg Steelers players, Hinds Ward and Troy Palamalu, received PRP injections to help them recover from injuries prior to the 2009 Super Bowl, and Rafael Nadal has been reported to use PRP in hopes of recovering from chronic patella tendonopathy. With all the professional athletes using and swearing by PRP, amateurs are asking for it.
So what is PRP? PRP is basically a portion of a patient’ blood with a higher proportion of platelets that is normal. It is obtained by drawing a blood sample from the patient and centrifuging the blood in order to separate the different components of the blood. This is possible as the different components have different weights. See the images below.
So why platelets? Platelets are one of the cells in your blood that play a vital role in blood clotting and in the healing process. Platelets contain granules that deliver growth factors, such as platelet derived growth factor and transforming growth factor, to sites of injury in order to facilitate a healing response.
PRP was first used in oral surgery and spinal surgery in the early 1990s. Their experience stimulated interest in the sports medicine world to experiment with utilizing PRP to treat very common and very difficult conditions such as lateral epicondylitis, patella tendonopathy and plantar fasciitis. All are conditions without a definitive cure. There has been more and more evidence to support the use of PRP in these conditions. There are several studies that have shown better than 90% success in the treatment of lateral epicondylitis (tennis elbow). There are also some promising studies on treatment of these other conditions (rotator cuff tears, hamstring tears, arthritis of the knee).
PRP is administered by injection to the affected area. After the blood is drawn and centrifuged, the Platelet Rich portion of the blood is drawn into a syringe. The area to be injected is anesthetized and the PRP is injected into the area. Many providers, including myself, utilize ultrasound guidance to be sure that the PRP is administered to the involved area.
Following the injection, patients are rehabilitated similar to the way we do the following surgery. Patients are given specific instructions based on the problem being treated.
Because the use of PRP is still in its infancy, most insurance companies consider it experimental and do not recognize it as a covered benefit. Thus, it is an out of pocket expense for patients. The cost varies widely depending on the physician administering it.
If you are wondering if you are a candidate for PRP therapy, I would be happy to evaluate your situation and discuss all of your options. Please call for an appointment.