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Weekend Doctor: About platelet-rich plasma (PRP) treatments

By Michael Stump, MD
Blanchard Valley Orthopedics & Sports Medicine

Many people suffer from chronic musculoskeletal conditions, such as tendinitis and osteoarthritis. While conservative treatments such as anti-inflammatory medications and rehabilitation can be effective in treating these conditions, sometimes they do not work. The next step in treatment of these conditions is often corticosteroid injections. These will often relieve symptoms quickly, but often do not have lasting results beyond six to eight weeks. In the past, if these conservative treatments were not effective, the next option was typically surgery.  However, today, there is a new treatment available that research has shown to be effective in treating chronic musculoskeletal conditions: platelet-rich plasma (PRP) that may be able to avoid or delay surgery and many of these conditions.

PRP is a term used to describe blood products that have an increased concentration of platelets. Platelets are typically thought of as cells that help clot blood, but they also have growth factors that are released in injured tissue to help stimulate the healing process. These growth factors in PRP are believed to be what makes PRP effective, resulting in enhanced or quicker healing. While this treatment is relatively new, and much research is still ongoing, there is high-quality evidence that PRP is effective at treating mild-to-moderate osteoarthritis of the knee, tennis elbow, rotator cuff tendinitis and hip tendinitis. There is also moderate-quality evidence that PRP is a good option for the treatment of hip osteoarthritis, patellar tendinitis (jumper’s knee) and plantar fasciitis. In addition to these diagnoses, PRP is also being studied for other types of tendinitis, osteoarthritis of other joints, acute ligament sprains and acute muscle strains or tears.

Your orthopedic or sports medicine provider can give you more information about PRP. They will discuss what research has learned about PRP for your condition, the risks and benefits of PRP injection, other treatment options and what to expect if you do choose to proceed with PRP. Before having a PRP injection, it is recommended to stop all anti-inflammatory medications, such as ibuprofen and naproxen, for one to two weeks before the injection and up to four weeks after the injection, because this can decrease the effectiveness of the PRP. It is also recommended to increase fluid intake for one to two days prior to the injection, to collect the blood necessary for the procedure. 

On the day of the procedure, the patient's blood is drawn through a needle stick in the arm and the blood is spun in a centrifuge to isolate the platelets. The platelets are then reinjected into the injured tissue or joint. Many physicians choose to use ultrasound during the injection so they can directly visualize where the PRP is being placed. It is common after a PRP injection for the pain to increase for several days, so often crutches or a sling may be helpful. The healing process after PRP injection is not a quick fix; it often takes two to six months before maximal improvement is seen. It is also common to prescribe physical therapy to help the healing process.

PRP is becoming increasingly common as a treatment for chronic musculoskeletal conditions. If you are interested in PRP as a treatment option, talk to your orthopedic or sports medicine provider for more information.