During the past several years, much has been written about a preparation called platelet-rich plasma (PRP) and its potential effectiveness in the treatment of injuries.
Many famous athletes — golfer Tiger Woods, tennis star Rafael Nadal, and several others — have received PRP for various problems, such as sprained knees and chronic tendon injuries. These types of conditions have typically been treated with medications, physical therapy, or even surgery. Some athletes have credited PRP with their being able to return more quickly to competition.
What is platelet-rich plasma (PRP)?
Although blood is mainly a liquid (called plasma), it also contains small solid components (red cells, white cells, and platelets). The platelets are best known for their importance in clotting blood. However, platelets also contain hundreds of proteins called growth factors that are very important in the healing of injuries.
PRP is plasma with many more platelets than what is typically found in the blood. The concentration of platelets — and, thereby, the concentration of growth factors — can be 5 to 10 times greater (or richer) than usual.
To develop a PRP preparation, a sample of blood must first be drawn from a patient. The platelets are separated from other blood cells and their concentration is increased during a process called centrifugation. These platelets are then injected into the injured site.
How does PRP work?
Laboratory studies have shown that the increased concentration of growth factors in PRP can potentially speed up the healing process.
To speed healing, the injury site is treated with PRP preparation. This can be done in one of two ways:
PRP can be carefully injected into the injured area. For example, in Achilles tendonitis, a condition is commonly seen in runners and tennis players, the heel cord can become swollen, inflamed, and painful.
A mixture of PRP and local anesthetic can be injected directly into this inflamed tissue. Afterward, the pain at the area of injection may actually increase for the first week or two, and it may be several weeks before the patient feels a beneficial effect.
PRP may also be used to improve healing after surgery for some injuries. For example, an athlete with a completely torn heel cord may require surgery to repair the tendon. Healing of the torn tendon can possibly be improved by treating the injured area with PRP during surgery. This is done by preparing the PRP in a special way that allows it to actually be stitched into torn tissues.
What conditions are treated with PRP? Is it effective?
Research studies are currently being conducted to evaluate the effectiveness of PRP treatment. Recent research has shown that certain tendon problems can have improved outcomes with PRP injections.
Additionally, more and more literature is showing the significant effectiveness of PRP in the treatment of mild to moderate knee osteoarthritis. Factors that can influence the effectiveness of PRP treatment include:
- the area of the body being treated;
- the overall health of the patient;
- whether the injury is acute (such as from a fall) or chronic (an injury developing over time);
- the preparation of the PRP, including the cellular makeup of the material that is injected.
Chronic Tendon Injuries
According to the research studies currently reported, PRP is effective in the treatment of chronic tendon injuries, especially tennis elbow, a very common injury of the tendons on the outside of the elbow.
The use of PRP for other chronic tendon injuries — such as chronic Achilles tendonitis or inflammation of the patellar tendon at the knee (jumper’s knee) is promising. However, it is difficult to say at this time that PRP therapy is any more effective than traditional treatment of these problems.
Much of the publicity PRP therapy has received has been about the treatment of acute sports injuries, such as ligament and muscle injuries. PRP has been used to treat professional athletes with common sports injuries like pulled hamstring muscles in the thigh and knee sprains.
Surgery
More recently, PRP has been used during certain types of surgery to help tissues heal. Recent research has been dedicated to the benefit of PRP in meniscus healing after meniscus repair; however, these studies are only in their infancy.
Surgery to repair torn knee ligaments, especially the anterior cruciate ligament (ACL) is another area where PRP has been applied.
Knee Arthritis
More and more literature is showing the effectiveness of low-leukocyte PRP in treating low- to moderate-grade knee osteoarthritis. Some studies have shown that these results can last up to two years.
PRP for Hair Growth
Evidence for platelet-rich plasma is stronger for some types of hair loss than others. Most research on PRP for hair loss has focused on its use to treat androgenetic alopecia (AGA). Also known as hormone-related baldness, this is a condition that can affect both men and women.
In men with AGA, hair loss typically occurs on the top and front of the head. In women, thinning occurs on the top and crown of the head and often begins with the center hair part growing wider.
The evidence suggests that PRP may work best when it is combined with other treatments for AGA, such as topical minoxidil (Rogaine) or oral finasteride (Propecia), which is an anti-androgenic drug.
Conclusion
The risks associated with PRP are minimal: There may be increased pain at the injection site, but the incidence of other problems — infection, tissue damage, nerve injuries — appears to be no different from that associated with cortisone injections.
If you’re interested in anything else concerning PRP or you want to get started with your treatment, contact us to ask your questions for free.