PLATELET-RICH PLASMA INJECTIONS
Autologous platelet-rich plasma (PRP) injections were first used in 1987 in open heart surgery. Today, PRP injections have been safely used in many fields, including sports medicine, orthopaedics, cosmetics, fasciomaxillary and urology.
Blood contains plasma, red blood cells, white blood cells and platelets. Platelets are small discoid cells with a life span of about 7-10 days. Inside platelets contain granules, which contain clotting and growth factors. During the healing process, the platelets are activated and aggregate together. They then release the granules, which contain growth factors, which stimulate the inflammatory cascade and healing process.
Blood typically contains 6% platelets, whereas PRP has a significantly increased supra-physiological platelet concentration. Although this level can vary depending on the method of extraction and equipment, studies have shown that clinical benefit can be obtained if the PRP used has an increased platelet concentration of 4x greater than normal blood.
What injuries may be treated with PRP?
PRP injections can be used in the treatment of many musculoskeletal injuries including that of tendons, muscles and joints. Typically, two or more injections are required, separated by 4-6 weeks apart. This may vary dependant on your injury. This image shows ultrasound views demonstrating the healing of a supraspinatus injury using PRP injection.
Plantar fasciitis tear
Plantar fasciitis tear post PRP treatment
What medications do not work well with PRP?
If you take Coumadin, Heparin, Lovenox, Warfarin, Pradaxa, Debigatran, Orgaran, Innohep, Fragmin, Argatroban, Plavix, Effient, Prasugrel, ReoPro, Ticlid, Trental, Persantine, or any other blood thinner medication, please notify Dr Ibrahim. This medication must be discontinued prior to an injection and requires permission from the provider prescribing it.
In addition please inform Dr Ibrahim if you take aspirin or any aspirin related products, and all non-steroidal medications (e.g. Motrin, Advil, Naprosyn, Naproxen, Aleve, Indocin, Lodine, Orudis, Relafen, Daypro, Tolectin, Mobic, Torodol, Voltaren, Trilisate, Dolobid, Arthrotec, Ibuprofen, Diclofenac and Clinoril).
Visit www.prpinjection.com.au. This patient education website was developed by Dr Ameer Ibrahim and his colleagues. It includes a step-by-step guide to the procedure and links to medical research articles on platelet rich plasma injections.
Objectives: To compare three different ultrasound-guided injections for chronic tennis elbow.
Conclusions: Injections of corticosteroid cannot be recommended over polidocanol or autologous blood, because despite beneficial short-term effect there were inferior long-term effects. Whether polidocanol or autologous blood injections are effective is unknown, especially as their global effect profiles are not unlike previously reported for wait-and-see.
Platelet rich plasma versus steroid on lateral epicondylitis: meta-analysis of randomized clinical trials
Objectives: Lateral epicondylitis (LE) is a common tendinopathy for which an effective treatment is still unknown. The purpose of this meta-analysis was to compare the effectiveness of platelet rich plasma (PRP) vs steroid in reducing pain and improving function of the elbow in the treatment of LE.
Conclusions: This network meta-analysis provided additional information that PRP injection can improve pain and lower the risk of complications, whereas AB injection can improve pain, disabilities scores and pressure pain threshold but has a higher risk of complications.
The blood injections that might transform orthopedics