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Rehabilitating Injuries With Platelet-Rich Plasma (PRP) Injections

HIGHLIGHTS:

  • PRP injections cannot be used in conjunction with anesthetic injections. The acidity and alkalinity present in the anesthetic can negatively impact PRP function. Hence, patients must be prepared to endure the pain or discomfort resulting from PRP injections.
  • PRP treatment for those with chronic conditions takes longer and is often not as effective. PRP is rather for those who sought out treatment immediately after their injury occurred.

 

Platelet-Rich Plasma (PRP)

Doctors use Platelet-rich plasma (PRP) injections in the treatment of joint, tendon and muscular injuries. Studies have found that using PRP to treat patients is effective and has minimal side effects. This is because the extracts are made from the patient’s own blood. This level of safety and effectiveness for injury treatment have convinced more and more patients and athletes to turn to this treatment method.

Using PRP treatment

PRP is an acronym for platelet-rich plasma. This type of treatment involves injecting patients with platelets from their own blood. The blood is extracted through a process to gain the highly concentrated platelet substance. Doctors currently use two main groups of platelets: one group which has a concentration of around 5-10 times the normal amount found in the blood, and another which has a concentration of around 2-3 times the usual amount.

The aim of this treatment is to utilize platelet plasma that has undergone a process to increase its platelet concentration. Those platelets contain secretions which stimulate the body’s repair of any injured muscles while also supporting the surrounding tissue’s recovery. This makes it suitable for medical treatment.

Doctors realized the effectiveness of this application of platelets after observing the body responds to flesh wounds or broken blood vessels. What was especially observed was that the platelets form blockages to stem any blood loss. After that, those platelets stimulate white blood cells or other cells into making tissue repairs at the injury or tear site.

Orthopedic treatments for injuries also rely on this key principle, and is most suited in treating tendons or muscle injuries. In these cases, doctors inject PRP into the injured area, such as a torn muscle, to repair that muscle.

Injuries that can be treated with PRP injections

  • Various forms of tendon injury, including tendinitis in the elbow, also known as tennis elbow, and rotator cuff tendinitis
  • Osteoarthritis
  • Injuries resulting from surgery, such as after anterior cruciate ligament surgery, tendon repair surgery or any other forms of joint surgery

Drawbacks and potential side effects of PRP treatment

Since doctors source the platelets for treatment from the patient’s own blood, there are no risks of tumors developing in the affected tissue. Nor are there any other physical side effects. However, the following are some of the potential drawbacks of this kind of treatment:

  • PRP injections cannot be used alongside anesthetic because the acidity and alkalinity present can negatively impact PRP efficiency. Thus, patients should be prepared to endure the pain or discomfort resulting from receiving PRP injections.
  • Patients must refrain from taking any anti-inflammatory or steroid-based drugs for two or more weeks prior to PRP injections. This is because this group of drugs can lead to a decrease in PRP functioning efficiency.
  • Health insurance policies do not cover PRP treatments. 

Treatment length, frequency of injections and potential results

  • Treatment efficiency depends entirely on which body part is injured. For instance, recovery times for muscular injuries will be shorter than for tendon injuries.
  • Patients with chronic complaints will require a longer course of treatment. Moreover, the treatment may not be as effective as in cases where it is given immediately after an injury has been sustained.
  • The size of the injured joint also plays a part. For example, treatment for tennis elbow and treatment for rotator cuff tendonitis will differ. In other words, the time taken to treat the injury and the subsequent results will vary. 
  • Doctors will administer PRP injections around 2-3 times per tendon or muscle injured. Each course of injections is given 7-10 days apart, depending on the interval the doctor considers appropriate.
  • Results of the treatment will become apparent from around 4-6 weeks onwards.

Preparation and procedure for the injections

  1. A patient must not be dehydrated to any extent as this could lead to difficulties when drawing blood.
  2. Refrain from taking any medication as directed by the doctor for a period of two weeks prior to the injections. Especially avoid anti-inflammatory and steroid-based drugs.
  3. First, a medical staff will take the patient’s blood to insert into a special device. This device is specifically designed to separate the suitable platelets. The process takes around 15 minutes.
  4. Even after the injections have been administered, continue to avoid anti-inflammatory medication or steroid-based drugs. If any painful symptoms occur, use pain relief medication or apply ice instead.

The difference between PRP and steroids

Steroids reduce inflammation, which plays a vital role in the body’s self-repair process. This means that even though steroids can alleviate the pain and swelling, it also negatively affects the self-repairing process of the tendons or muscles. PRP, in contrast, functions by stimulating the self-repair process. This enables the affected tendons to make a full recovery by themselves. However, this also means that pain and inflammation are a distinct possibility.

Furthermore, drugs or steroids can have serious long-term effects. Contrarily,  since PRP is sourced from the patient’s own body, any side effects and potential long-term physical impacts are minimized.


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Associate Professor Cholawish Chanlalit, M.D. Summary: Orthopedics Orthopedics