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Rehabilitating Injuries With Platelet-Rich Plasma (PRP) Injections

HIGHLIGHTS:

  • PRP injections cannot be used in conjunction with anesthetic injections, as 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)

Platelet-rich plasma (PRP) injections are a technique used by doctors in the treatment of joint, tendon and muscular injuries. Studies have found that using PRP to treat patients has been effective, while side effects have been minimal, due to the extracts being made from the patient’s own blood. Such high levels of safety and effectiveness in terms of injury treatment have convinced patients and athletes to turn to this method of treatment in greater numbers than ever.

Using PRP treatment

PRP is an acronym for platelet-rich plasma and this type of treatment involves injecting patients with platelets from their own blood which has undergone an extraction process resulting in a highly concentrated platelet substance. There are currently two main groups being used: one group which has a platelet concentration of around 5-10 times the normal amount found in the blood, and another group 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, ensuring it is suitable for medical treatment. Those platelets contain secretions which stimulate the body’s repair of any injured muscles while also supporting the recovery of surrounding tissue.

The effectiveness of this application of platelets was realized due to observations on how the body responds to flesh wounds or broken blood vessels, specifically with regard to how the platelets form a blockage to stem any blood loss. After this point, 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, with this method being most suited for use in treating injuries to tendons or muscles. PRP can be injected 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

Due to the fact that the platelets used in this treatment are sourced 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 for that matter. 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 due to this group of drugs leading to a decrease in PRP functioning efficiency.
  • PRP treatment is not covered by health insurance policies.

Treatment length, frequency of injections and potential results

  • The efficiency of the treatment depends entirely on the body part which has been injured. For instance, recovery times for muscular injuries will be shorter than the time required to recover from tendon injuries.
  • Patients with chronic complaints will require a longer course of treatment, while that treatment may also not be as effective as in cases of people receiving treatment 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 from one another with regard to both the length of time taken to treat the injury and the subsequent results.
  • PRP injections should be administered around 2-3 times per tendon or muscle injured, with each course of injections being around 7-10 days apart, depending on what the doctor considers appropriate.
  • Results of the treatment will become apparent from around 4-6 weeks onwards.

Method and steps involved for the injections

  1. Patients must not be dehydrated to any extent as this could lead to difficulties in terms of blood draw.
  2. Patients should refrain from taking any medication as directed by their doctor, especially anti-inflammatory and steroid-based drugs, for a period of around two weeks prior to the injections being administered.
  3. Patients will have their blood taken so that medical professionals can insert that blood into a special device designed to separate the platelets suitable for use in treatment. This process takes around 15 minutes.
  4. Any anti-inflammatory medication or steroid-based drugs should still be avoided once the injections have been administered. If any painful symptoms occur, pain relief medication or the application of ice should be used instead.

The difference between PRP and steroids

Steroids function by reducing inflammation, but this inflammation plays a vital role in the body’s self-repair process, meaning that even though steroids can alleviate the pain and swelling, the self-repairing process of the tendons or muscles involved will also be negatively affected. PRP, in contrast, functions by stimulating this self-repair process, enabling the affected tendons to make a full recovery by themselves, although this means that pain and inflammation are a distinct possibility.

Furthermore, treatment utilizing drugs or steroids can have serious long-term effects, whereas the fact that PRP is sourced from the patient’s own body means that any side effects and potential long-term physical impacts are minimized.


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