Platelet Rich Plasma

Platelet rich plasma is composed of concentrated platelets which contain large reservoirs of bioactive proteins that are vital to initiate and accelerate tissue repair and regeneration. These bioactive proteins create and initiate connective tissue healing, bone regeneration and repair, promote development of new blood vessels and stimulate the wound healing process.

Platelet-Rich Plasma (PRP) therapy has been a part of surgical applications since the 1970s. Thanks to the recent technological surge, this non-surgical mode of treatment has also been used in the sports arena where it is being effectively used to mend ligaments and repair tendon injuries. Additionally the successful repair of the “normal” wear and tear of joints, ligaments, skin, tendons, blood vessels, and muscle tissues is an added benefit of this amazing regenerative therapy. 

How Does PRP Therapy Work?

To prepare PRP, a small amount of blood is taken from the patient. The blood is then placed in a centrifuge. The centrifuge spins and through a multi-functional process separates and concentrates a layer of platelets, other regenerative cells and some red and white cells. This increases the concentration of platelets and growth factors up to 400-600% When PRP is injected into the damaged area it stimulates collagen repair and thereby begins the healing cascade, resulting in new collegen development. The new collagen at the injury site quickly begins the repair process of damaged cartilage, tendons and ligaments. As this collagen matures it replaces the damaged collagen with stronger elemental collagen fibers and thereby repairing old injured tissue.  There is no chance for rejection or allergic reaction because the substance is autologous–meaning it comes from the patient’s own body. When compared to surgical treatment for damaged or torn tissue PRP injections carries far less chance for infection than surgery and actually reverses scar tissue instead of creating more of it. The procedure takes about 20 min to create PRP and together with the injection procedure takes about 45 minutes. Patients are encouraged to remain active during the recovery period (2-4 months) but refrain from activities that may reinjure the affected site.

PRP Regenerates Tendons & Ligaments

Tendons connect the muscle to the bone. Overuse or damage to the tendon over a long period of time causes the collagen fibers in the tendons to form small tears and be chronically inflamed, a condition called tendinitis. Damage to tendons most often occurs in the neck, knees, ankles, elbows, shoulders, and wrists.

Ligaments are composed of collagen fibers that hold one bone to another, stabilizing the joint and vertebral segments. When a ligament is damaged, it is no longer able to support the joint space or joint capsule, which often leads to pain symptoms. This instability will cause the muscles surrounding the area of damage to tighten and go into spasm. This generally leads to nerve compression and stiffness and pain. The instability causing the pain in your joints are not always found on MRI or x-rays. The most reliable way to know if ligaments and tendons are involved is through specific orthopedic exam and diagnostic ultrasound.

Tendons and ligaments have little to no blood supply and do not usually fully heal from the original injury. Repetitive and weight bearing activities or sudden trauma create micro tears to tendons and ligaments. Laxity in ligaments create joint degeneration leading to inflammation and thinning of the cartilage pad. Patients who experience chronic pain may not even remember when the injury occurred.

How Does PRP Compare With Cortisone Shots?

Studies have shown that cortisone injections actually weaken tissue and serve to further degenerate damaged cartilage. Cortisone shots may provide temporary relief and decrease inflammation, but generally does not provide long term healing. PRP therapy acts to heal and strengthen tendons and ligaments and in some cases thickening the tissue up to 40%.

How does PRP compare to MSC’s and placenta based products?

As you can see in the Predictive Biotech chart, the cytokine profile is more robust in placenta products than that found in the PRP. Also there are no MSC’s found in PRP. Therefore when treating with PRP repeated application are customary. The durability and longevity of the results from placenta products generally are greater than what is found with PRP.

As with all of the orthobiologic treatments, the health of the patient will influence the quality of the results. In addition it is very important that all patients closely follow the post treatment guidelines.

Treatment Plan

Cervical, thoracic and lumbar spine, degenerative disc disease, arthritic joints shoulder pain, hip pain, and knee pain, even the smaller joints of the body can all be treated effectively with PRP. After doing a complete history, specific orthopedic exam, ultrasound scans, and review of MRI or X-rays a report of findings and treatment recommendations will be given. Dr. Davison will determine whether prolotherapy, PRP or stem cell orthobiologics will be the most effective form of treatment for you. You will also receive a cost analysis comparing the respective treatment approaches.

Frequency of Treatments

While responses to treatment vary, most people will require a minimum of 2 and occasionally 3 to 6 sets of injections of PRP. Each set of treatments is spaced 2 to 4 weeks apart and may be up to 8 weeks apart.

Is PRP Right For My Condition?

If you have degenerative spine or joint disease, a tendon or ligament injury, laxity or tear and traditional methods have not provided relief then PRP therapy may be the solution. It will heal tissue with minimal or no scarring and alleviates further degeneration and builds new tissues.

What Can Be Treated?

Platelet Rich Plasma injections helps regenerate all areas of the body. This includes neck, middle and lower spine, sacroiliac, wrists, elbows, shoulders, hips, knees and ankles as well as tendons and ligaments all over the body. Our clinic treats patients with sports injuries, arthritic and degenerative joints and degenerative disc disease. More specific injuries including tennis elbow, carpal tunnel syndrome, scoliosis, ACL tears, shin splints, shoulder and rotator cuff tears, and plantar fascitis ( foot and heel pain) may all be effectively treated with PRP.

In scientific literature, reports of soft tissue injuries treated with PRP include: tendonopathies, tendonosis, acute and chronic muscle strains, muscle fibrosis, ligamentous sprains and joint capsular laxity, specifically in the extremities. PRP has also been utilized to treat intra-articular injuries such as arthritis, arthrofibrosis-frozen shoulder, articular cartilage defects, meniscal injury (knee cartilage), and chronic synovitis or joint inflammation.

What Are The Potential Benefits?

Patients can see a significant improvement in symptoms as well as a remarkable return of function. This may eliminate the need for more aggressive treatments such as long-term medication or surgery. PRP is a supercharged form of prolotherapy. Results are dependent on the health of the patient, and their overall level of health . For most healthy patients PRP reduces both the time and number of treatments when compared to traditional prolotherapy.

Suggestions Following Treatment

You are restricted from the use of opiate based pain medications, non-steroidal anti-inflammatory medications (NSAIDs)  one week prior to the procedure and refrain from cortisone injections for one month prior to treatments.

Patients occasionally require some pain medication following the treatments. This should only be needed for the first 24 to 36 hrs. We will recommend some very effective nutraceutical anti-inflammatories for pain and inflammation. These will not interfere with the collagen mending process and are generally very well tolerated. Heat may be applied to the area as needed. Consult the post treatment guidelines listed in the patient info section of this site.

How Soon Can I Go Back to Regular Activities?

PRP therapy helps regenerate tendons and ligaments but it is regenerative and therefore generally not a quick fix. This therapy is stimulating the growth of new tissue requiring time and rehabilitation. Dr. Davison can provide a DVD of specific movements that should be done daily to help with the recovery process. During the treatment program most people are able to resume normal activities and exercise within the first week following treatment. Movement is essential for rehabilitation but repeating activities that created the problem is not advised.

Many patients are active already and are more prone to getting back to the sports they enjoy a little too early. Please give yourself about 3 weeks before engaging in strenuous athletic events and be sure to ask Dr. Davison before going back into the activity that may have caused the condition.