Platelet Rich Plasma Therapy

It is important to clarify what PRP therapy is, the current understanding of its mechanism of action, and evidence for its effectiveness in treating common sports injuries.

Platelet-rich plasma, also referred to as platelet-enriched plasma, platelet-rich concentrate, autologous platelet gel, and platelet releasate, is defined as a plasma fraction of autologous blood having platelet concentration above baseline, and prepared from blood drawn from the patient. Platelets are separated from other blood cells and then concentrated by centrifugation. The concentrated platelets are recombined with the remaining blood, and the platelet-rich blood is injected directly into the patient’s injured area. Despite its pervasive use, the clinical efficacy of PRP therapy and its precise mechanisms of action have yet to be clearly defined.

In addition to platelets, PRP contains a variety of growth factors, including transforming growth factor-β, platelet-derived growth factor, insulin-like growth factor-I, vascular endothelial growth factor, epidermal growth factor, and hepatocyte growth factor.  Many of these growth factors have been shown to enhance one or more phases of bone and soft tissue healing. Basic research suggests that PRP exerts its effects through many downstream events secondary to the degranulation of platelets releasing growth factors and other bioactive agents into the local environment, resulting in chemotaxis of inflammatory cells and activation and proliferation of local progenitor cells. It is believed that PRP can augment or stimulate healing by turning on the same biological processes that normally occur to initiate healing after musculoskeletal injury.

PRP is obtained via a high volume blood draw.  The average amount of blood drawn is 120cc, which is comparable to 1/5 of the amount for blood donation, so it’s a very safe amount to take. Your blood is then processed immediately using a centrifuge which separates the blood.  The blood is then passed back through another machine called a cell counter which isolates to portion of your blood called the Platelet Rich Plasma (PRP).

The PRP is the portion of your blood responsible for stimulating growth and healing.  You can think of the process of healing a cut to understand how PRP works.  First, platelets stick together in order for your body to form a clot and stop the bleeding.  Then the platelets send out special signals to tell your body to send stem cells to the area of damage.  Lastly, the stem cells are told what to grow into by the platelets, and you grow new blood vessels and new skin and heal the cut.  That’s essentially how PRP works to stimulate growth and healing of your chronic painful disorder as well.  And it works!

The PRP is then placed in a syringe and is ready to be injected. All injections are done under either ultrasound or x-ray guidance.  This assures that the intended structure is injected and treated accurately.  It also limits the risk of complications by assuring that un-intended structures (such as blood vessels and nerves) are avoided.