PRP – PLATELET-RICH PLASMA

Introduction

Platelet-Rich Plasma (PRP) injection is a medical procedure used for a wide range of musculoskeletal problems. PRP is a blood sample formulated to obtain a high concentration of platelets. The treatment improves the body’s natural ability to self-cure. It is applied to fasten healing and shorten the recovery time after acute and chronic soft tissue problems. The treatment technique has been relatively recently used to treat musculoskeletal problems, but due to its very good results, it is rapidly gaining popularity. PRP is successfully used to treat tennis elbow, golfer’s elbow, plantar fasciitis, Achilles tendinopathy and others.

Platelets are blood components whose main function is to participate in the process of blood clotting, e.g. after an injury. In addition to clotting factors, platelets release the so-called growth factors to start the natural process of healing. Injection of PRP at the site of musculoskeletal system damage stimulates and speeds up the natural processes of healing. This is especially important in the areas of poor blood supply (for example, tendons), because the procedure enables more effective delivery of the substances necessary for self-healing. Other treatments for chronic tendon problems do not necessarily improve the healing capacity of the tendon in the same way as PRP. In addition, PRP injections are devoid of many potential side effects of steroid injections or the long-term use of non-steroidal anti-inflammatory drugs (NSAIDs).

Course

Platelet-rich plasma treatment is divided into two steps: preparing platelet-rich plasma for injection, and injecting the preparation into the desired area. First, blood is collected and placed in a machine called a centrifuge. A centrifuge separates blood into layers, making it possible to collect the layer containing PRP. After the blood is collected and properly treated, PRP is ready. The preparation can be injected up to 30 minutes later. A doctor can use an ultrasound probe to place the needle directly in the desired area. General anaesthesia is not necessary.

What can go wrong?

There have been very few reports on complications and side effects of the procedure. Whenever an injection is given, there is a risk of an infection. A small number of patients reported pain, redness and swelling at the injection site, but these symptoms did not last long. Because the material injected during the procedure is mostly the patient’s blood content, there is no fear of transmission of bacteria or viruses (e.g. HIV). With other types of injection therapy, scarring and calcification may appear at the site of injection. This has not yet been reported with PRP injections, but it is theoretically possible. Allergic reactions are also likely but rare and are associated with the administration of a local aesthetic. The most dangerous complication is when a needle penetrates a blood vessel or a nerve, but with ultrasound visualization the risk of this complication is very small.

What happens after the procedure?

Immediately after the procedure, the patient is monitored. There may be some discomfort at the site of injection lasting from a few days to a week. The patient may feel even worse than before the surgery. This is because a local inflammatory response has just been triggered. However, worsening of the condition usually does not last long. After returning home, ice can be applied at the site of injection, you can raise your leg or arm, and reduce the activity to a comfortable level. Recommendations to limit activity vary depending on the area being treated. It is not recommended to use anti-inflammatory drugs (one week before the procedure and about 4 weeks after) because they may reduce the positive effect of the treatment.

The most surprising is the speed of recovery after the administration of platelet-rich plasma. This time is influenced by many factors, also independent of the patient and doctor. Sometimes, PRP allows to recover in half the time, without side effects, such as scars and adhesions.

In the Szpital Zakonu Bonifratrów, PRP is introduced by a team of specialists in orthopaedics and traumatology:

Stanisław Szymanik, MD – Head of the Diagnostic and Treatment Department

Michał Latos, MD

Michał Starmach, MD