Platelet rich plasma (PRP) is a concentration of platelets from your blood which is injected into your body to help healing in specific conditions.
History of PRP
PRP was first used in the 1970s for people with low platelet counts. In the 1980s it was used in cardiovascular surgery and maxillofacial surgery. In 1998 it was first used with a bone graft so implants lasted longer.
Current recommended usage
PRP is currently recommended for the following conditions.
- Lateral epicondylitis
- Patellar tendinopathy
- Achilles tendinopathy
- Rotator cuff tendinopathy and partial rotator cuff tears
- Plantar fasciitis
- Knee and hip osteoarthritis
- Ankle arthritis
- Hand and foot arthritis
- UCL injuries
- Gluteus medius tendinopathy
- Hamstring injuries
I've treated each of these conditions multiple times with PRP and have a significant success rate.
How is PRP prepared?
- We draw 50 ccs of blood, or about 1/8 of how much is donated during a blood donation.
- Blood spun in a centrifuge, which separates out parts of it.
- Blood filtered to remove red blood cells.
- Blood spun in centrifuge again to concentrate platelets and plasma.
The EmCyte system I use is calibrated to produce platelets at six to ten times your normal concentration, which studies have shown is the number that works best for PRP.
How long do results take?
PRP is not a steroid and will not give automatic relief. It usually takes 8-12 weeks to experience the full effect from PRP.
I usually see patients six weeks after the procedure to make sure everything is going well, and there is usually minimal improvement. However at 8-12 weeks, there is reduced pain and increased function.
What else should I know about PRP?
- Not everyone experiences relief from PRP. If you don’t get relief from one PRP shot, the odds that you will get relief from future PRP shots are low.
- A PRP shot hurts since fluid is being injected into a joint that is not used to having fluid in it.
- PRP does not regrow cartilage, bone or tendon. It is an anti-inflammatory and is an adjunct to conservative therapy. If you don’t do PRP while doing other modifications like physical therapy and maintaining a healthy weight, it won’t work. If you have bone-on-bone arthritis, PRP will not help new cartilage appear. You will still need a joint replacement.
- Insurance does not cover PRP.
- I use ultrasound to view where I am placing the PRP needle, which allows me to guide my injections into a very confined small space and be extremely precise with my injections.
Frequently asked questions
I've had a shoulder replacement on one shoulder. Will getting PRP on the other shoulder delay surgery?
PRP is an anti-inflammatory, so it decreases the inflammatory process that leads to shoulder arthritis. It may provide pain relief and delay surgery, but your doctor will have more details about your specific issue.
Is PRP effective if the patient has a low platelet count?
Yes, PRP can still be helpful even if a patient has a low platelet count. Ideally the concentrated platelets will be near the million count, but even lower amounts can be helpful.
Is anything added to the plasma before it is injected?
No, I do not add anything to the plasma before it is injected. It is all natural, and I have not found that adding anything helps the injection work better.
Are there age restrictions on PRP?
No, there are no age restrictions. I’ve had it work well on teen athletes and on people in their 80s and 90s.
Are there any contraindications or side effects?
Active cancer is a contraindication – we don’t want to accidentally spread the cancer. Bleeding disorders are another contraindication, as the person may not have enough platelets. There is a very low risk of infection since there are no activation agents and we use sterile techniques.