PLATELET RICH INJECTIONS
(PRP & PRF)
What is PRP?
PRP stands for Platelet Rich Plasma. Plasma is the fluid portion of blood that contains cellular components such as red cells, white blood cells, and platelets. Human platelets play a crucial role in clot formation; they are also very involved in injury healing. Your blood platelets contain potent growth factors necessary to begin tissue repair and regeneration at the injury site. Concentrated platelets contain large reservoirs of growth factors that can greatly and naturally accelerate the normal healing process. The use of concentrated growth factors is considered by many to be an exciting and new cutting-edge therapy that can stimulate tissue repair and regenerate weakened torn or damaged ligaments, ligaments, and joints. Platelet Rich Plasma Treatments (also known as PRP Injections, PRP Therapy, or PRP Prolotherapy) are treatments for acute or chronic musculoskeletal injury or pain that can help you avoid the pain, complications, and recovery time associated with joint surgery. The PRP treatment solution is derived from your own blood. A small amount of your own blood is drawn, and after filtering out the rest of the cells and plasma, a small number of platelets remain. This highly concentrated number of platelets, from 7 to 10 times that of normal blood, can be injected into the damaged areas and catalyze new soft-tissue growth.
The use of concentrated growth factors is considered by many to be a new cutting-edge therapy that can stimulate tissue repair and regenerate weakened torn or damaged ligaments, tendons, and joints.
PRP is a non-surgical treatment for healing soft tissue. The solution is injected into the affected region to stimulate and enhance healing.
What is PRF?
PRF stands for Platelet Rich Fibrin. Like PRP, PRF is a natural, blood-derived regenerative treatment with very similar benefits. This difference between the two is how they are spun in the centrifuge. PRP is spun faster and requires a non-clotting additive, whereas PRF is spun slower and does not have a non-clotting additive. With PRF, the lower speed stops the blood layers from separating as aggressively. This allows white blood cells, stem cells, and a natural fibrin matrix to remain in the final product. The matrix of fibrin acts as a structural scaffold that entraps the platelets, allowing for a slower sustained release of growth factors. The fibrin matrix also allows the platelets and other cells to “stick” to a targeted site. PRF and PRP have many similarities with each excelling at different types and sites of injuries.
What conditions respond well to PRP?
Weakened torn or damaged ligaments, tendons, muscle tears, menisci, or labrums are the most common soft tissue structures treated. PRP has also been effective in treating arthritis.
Common areas treated:
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Knees: meniscus, ACL, MCL LCL, arthritis, kneecap instability
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Shoulder: Rotator Cuff Tears, labrum tears, tenositis
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Hip: labrum, tenositis, bursitis
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Low Back: Facet joints, arthritis, Sacro-Iliac dysfunction
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Ankle/Foot: Achilles dysfunction, tendonitis, arthritis, ankle sprains
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Wrist/Hand finger/joint tendinitis, ligament tears, arthritis, carpal tunnel
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Elbow: Tennis elbow (later epicondylitis, golfers elbow (medial epicondylitis)
How does PRP heal the area?
PRP heals the injured region. Unlike pharmaceutical medications, like ibuprofen or cortisone, which may just take the pain away but cannot heal the injury.
Platelets are packed with growth and healing factors, platelets initiate repair and can attract the assistance of stem cells furthering the results in healing injured tissues. Growth Factors are released from large quantities of activated platelets at the site of injury. This leads to a reaction that initiates a healing cascade. Growth factors stimulate and promote healing of weakened, torn, or damaged soft tissue such as tendons, ligaments, meniscus, or labrum.
What to expect?
PRP involves an initial blood draw from the patient, similar to donating blood. The volume of blood drawn is determined on the treatment sites and amount of PRP desired for the injection. Once the blood is drawn it is separated into individual layers through a process called centrifugation, which takes approximately 15-20 minutes. The PRP layer is then extracted and injected into the treatment site.
Patients typically tolerate the procedure well, although post-injection soreness is sometimes experienced. Each area of the body treated can have a different amount of soreness following the injection.
Two to four treatments are needed depending on the degree of injury and how long the injury has been there. Treatments are typically performed every 4-6 weeks if indicated.
For the first 48 hours, swelling and mild discomfort are typical in the injected area. By day 3, these symptoms will begin to resolve substantially.
Minimal side effects have been observed with treatment. Any stiffness or discomfort reported after PRP should resolve with time.
How long does it take to work?
Most patients notice some element of improvement by 2-6 weeks after PRP treatment. Symptom improvement is slow and subtle as days and weeks pass, with the usual reports of original pain being lessened over time. Increased endurance and strength are typically reported.
