by Evie Ullman, DPT
Platelet Rich Plasma, also known as PRP, is derived from the patient’s own blood and injected into the site of injury. It is used by orthopedists to treat tendonitis, ligament sprains, cartilage injuries and muscle strains.
Blood is made up of four main components: red blood cells, white blood cells, platelets and plasma. Platelets play a key role in the healing process because they release the growth factors necessary for healing damaged tissue. Plasma is merely the liquid component of blood that carries the red and white cells and platelets.
For PRP therapy, a blood sample is taken from the patient and placed in a centrifuge, where it spins and separates out the platelets. The end result is a few milliliters of plasma loaded with platelets. It is typically injected under ultrasound guidance. The entire process can be viewed here: Platelet Rich Plasma Therapy.
So, does it work? We don’t really know yet. Research is favorable, but inconclusive. I was able to find one systematic review of studies done on PRP. (A Systematic Review of the Use of Platelet-Rich Plasma in Sports Medicine as a New Treatment for Tendon and Ligament Injuries, by Taylor, Drew W MS; Petrera, Massimo MD; Hendry, Mike BScH; Theodoropoulos, John S MD in: Clinical Journal of Sport Medicine, July 2011, v. 21 issue 24).
This review reported that there are only 3 total randomized clinical trials done so far. The studies indicated that PRP may accelerate injury recovery and prevent recurrence. The important thing to note is that PRP has no adverse side effects except for those associated with an injection (temporary pain and swelling at injection side and risk of infection). It is “all natural” because it comes from your own blood. Cortisone is used frequently to treat inflammation for some of the same types of injuries, sometimes quickly with great results, but it is known to cause eventual tissue breakdown if used too much.
I had a PRP injection in my right elbow at the end of January 2012 for recurrent, very painful lateral epicondylitis, aka “tennis elbow.” I’ve been struggling with this injury on and off for 3 years, treating it with cortisone shots which would work for months at a time, but the last shot I had in October did nothing for me. An MRI scan showed a small interstitial tear in my common extensor tendon. I wanted to see if I could get it to heal without surgery, so I sought out PRP. Today, I am 5 weeks post injection. Is it healing? Yes, I think so. I am feeling about 50-60% better at this point. But I am not sure if it is due to the injection or relative rest, activity modification and performing my PT home exercises diligently. I like to consider the injection a conservative way to help accelerate the natural healing process. Very bad tendonitis can take 2, 3, even 6 months to heal. At this point, I am willing to wait it out and see.
PRP is not covered by insurance. Patients can expect to pay $500 to $1,000 per injection. (I was lucky enough to get an injection at a discounted price because I work in the industry, but still, not cheap). Ask your PT where you can go for a PRP injection in the Boston Area.
Dr. Ullman is a Physical Therapist at Boston Sports Medicine
