Joint, soft tissue and bone injuries heal in many stages. One of the most exciting areas of research in orthopedic surgery and sports medicine involves making the most of the initial healing stages: inflammation and an increase in cells, or cell proliferation. Platelet rich plasma (PRP) treatment is becoming a more popular option for giving a biological boost to the healing process.
PRP is produced from a person’s own blood. It is a concentration of one type of cell, known as platelets, which circulate through the blood and are critical for blood clotting. Platelets and the liquid plasma portion of the blood contain many factors essential for cell recruitment, multiplication and specialization required for healing. After a blood sample is obtained from a patient, the blood is put into a centrifuge, a tool that separates the blood into its many components. Platelet rich plasma can then be collected and treated before it is delivered to an injured area of bone or soft tissue, such as a tendon or ligament.
PRP is administered to patients through an injection, and ultrasound guidance can assist in the precise placement of PRP. After the injection, a patient must avoid exercise for a short period of time before beginning a rehabilitation exercise program. Typically, patients will be restricted for 24 hours following the procedure.
PRP is a potent inhibitor of joint related inflammation. As such, many patients with inflammation of the joint (synovitis) may garner a benefit from PRP injection. In a small study involving knee osteoarthritis, PRP treatment was shown to be more effective than hyaluronic acid treatment (so called “gel” shots).
PRP can be used in the treatment of soft tissue injuries (muscle strains, tendon and ligament tears) as well. PRP has also resulted in positive clinical results when used in the treatment of rotator cuff tears and medial collateral ligament (MCL) injuries in the knee.
Overall, there are a limited number of published studies on the effectiveness of PRP treatment. However, there is increasing evidence that PRP is a better treatment option for many conditions that were typically treated with corticosteroids. In this regard PRP is a much safer therapy. Because PRP is created from a patient’s own blood, it is considered a relatively low-risk treatment with the potential to improve tissue healing or decreased inflammation.
More studies are needed to prove the effectiveness of PRP treatment and to research the best ways to standardize the treatment’s preparation.
PRP is given in the hopes of modulating the inflammatory response of soft tissue healing or joint inflammation. As such, consult with Dr. Williams as to the appropriateness of taking NSAIDs or other medication during your PRP treatment.
Typically, Dr. Williams recommends patients receive three injections spaced approximately two weeks apart as part of the complete PRP treatment.
Results will vary from patient to patient. However, most patients will experience a steady improvement of their symptoms approximately 6-8 weeks after the last injection.
Because each patients experiences pain differently, it is difficult to predict your experience. However, most patients tolerate the injections with a minimum amount of discomfort.
Injections always pose a risk of infection, even under sterile technique. Other possible risks include redness, soreness, change in sensation, short-term increased pain, bruising and swelling. Rarely, patients may transiently experience the sensation of light-headedness with either the peripheral blood draw or PRP injection.
a) You may take anti-inflammatory medications (like ibuprofen) for pain control.
b) The site should be iced for 15-20 minutes as needed for pain control.
c) Physical therapy (if indicated) will start 7-14 days after the procedure.
Typically, it is advised that you wait 24 hours from the time of the last injection to resume normal activity.
Most patients will have the injections performed in the same clinical area where you see Dr. Williams for an office visit.
Some patients may need an Ultrasound-guided injection. Those injections are performed in the Main hospital building in the Ultrasound department.
Insurances differ in terms of what is covered or not. It is always advisable to consult with your insurance company to review benefits and covered procedures. Because PRP is still not recognized as a standardize treatment option, insurance companies have not routinely covered the cost.
Dr. Williams will require direct payment for the procedure that can be arranged with the Billing Coordinator, Jasmine Zauberer. Please call 212-774-2609 to discuss payment options.