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 — Tiger Woods, tennis star Rafael Nadal, and several others — have received PRP for various problems. These include cartilage problems in the knee and tendon injuries. Some athletes have credited PRP with their being able to return more quickly to competition.
Even though PRP has received extensive publicity, there are still lingering questions about it, including:
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. Platelets also contain hundreds of proteins called growth factors which are very important in the healing of injuries.
PRP is plasma with many more platelets than what is typically found in 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, 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. Then the increased concentration of platelets is combined with the remaining blood.
Although it is not exactly clear how PRP works, 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 the PRP preparation. The PRP is carefully injected directly into the affected tissue or joint. Afterwards, 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.
Research studies are currently being conducted to evaluate the effectiveness of PRP treatment. At this time, the results of these studies are inconclusive.
At Axis Sports Medicine Specialists we are most interested in the treatment of knee cartilage injuries and arthritis. There have been several good quality studies which have suggested that this treatment may be effective at improving pain and function.
In some cases PRP may also be beneficial for chronic tendon injuries – like Achilles tendinopathy and tennis elbow. Again the evidence is mixed. One study on tennis elbow showed an 81% improvement in pain scores 6 months after injection.
Unfortunately it is still too soon to determine if this form of treatment will be any more effective than current treatment methods.
Treatment with platelet-rich plasma holds some promise. Currently, however, the research studies to back up the claims in the media are limited. PRP does appear to have a role in the treatment of cartilage injuries and some cases of tendinopathy. The medical community needs more scientific evidence before it can determine whether PRP therapy is truly effective in other conditions.
Even though the success of PRP therapy is still questionable, the risks associated with it 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 steroid (cortisone) injections.
If you are considering treatment with PRP, be sure to check your eligibility with your health insurance carrier. Few insurers, including the ACC, provide even partial reimbursement.