Platelet Rich Plasma Therapy (PRP)

What is Platelet Rich Plasma (PRP) Therapy?
Platelet-rich plasma (PRP) therapy is an injection that utilizes a highly concentrated solution of platelets and growth factors extracted from the patient’s own blood that helps increase the body’s healing process biologically. PRP is thought to actually repair your damaged tissue, as well as slow down further wear and tear of your cartilage.

Am I a candidate for Platelet Rich Plasma Therapy?
There are numerous conditions that have been shown to benefit from PRP. For instance, bursitis, tendonitis, arthritis and various ligament injuries. More recently, PRP therapy has been used in cosmetic procedures and even thinning or balding hair. There are very few medical conditions where PRP is contraindicated, such as patients who have a medical condition that could worsen or spread with injections, for instance an active infection, a metastatic disease and certain blood and bleeding disorders. Patients who undergoing anticoagulation therapy and cannot temporarily suspend treatment as well as patients who are anemic. Pregnant patients are also not candidates for PRP therapy.

How long does Platelet Rich Plasma Therapy take?
The entire process takes about 40 minutes to an hour depending on the injection site being treated and the ease of drawing the blood. Following the procedure, patients typically spend an additional 10 to 30 minutes in the recovery room depending on the region treated.

How is Platelet Rich Plasma Therapy performed?
The procedure starts with a blood draw of between 30-60mls of blood drawn typically from the arm similar to a regular blood draw for routine lab work. Once the blood is drawn, a bandage is placed and the patient can wait in the waiting room as the blood is processed. The blood sample is then placed in a centrifuge, which separates the blood into its basic components. From this sample, the platelet-rich plasma is carefully extracted from the rest of the blood. The remainder of the blood is discarded and the PRP extraction is then ready for injection. The patient is brought into the procedure suite and placed either seated, lying on their back, on their stomach or on their side depending on the area being injected. The needle placement and the injection itself is performed under direct visualization using a combination of fluoroscopy and/or ultrasound depending on the area being injected. The use of these visual aides ensure that the PRP solution is injected in the exact location we are treating. A sterilizing solution is used to clean the skin overlying the target site and local anesthetic is used to numb the skin and underlying superficial tissues. A small needle is then directed with the assistance of the live guidance into the treatment area. The PRP solution is then injected into the injured area, which may include tendons, bursa, joints, nerves, ligaments, spinal discs, and many other injured tissues.

Will Platelet Rich Plasma Therapy hurt?
The procedure involves inserting a needle through skin and deeper tissues which can sometimes be painful. We do numb the skin and deeper tissues with a local anesthetic using a very thin needle before inserting the procedure needle. Once numbed, placing the procedure needle often feels like more of a strong pressure and pinching than a sharp pain. Some patients choose to receive intravenous sedation that can make the procedure easier to tolerate.

Will I be “put out” for Platelet Rich Plasma Therapy?
This procedure is typically done under local anesthesia only, or with small doses of IV medications providing light sedation. The sedation can make the procedure more tolerable for some patients. The amount of sedation given generally depends upon the patient.

What should I expect after Platelet Rich Plasma Therapy?
The treated area can be numb for about an hour. It is normal to have a significant increase in pain and stiffness in the area for the few days following the injection. It typically takes at least four weeks until patients notice improvement with pain and function, and four to six months for maximal benefit.

What should I do after the Platelet Rich Plasma Therapy?
After the numbness wears off, you may move the affected area, but avoid activities that cause increased pain. It is best not to take any anti-inflammatory medicine for at least four weeks following the procedure. For pain, take acetaminophen (Tylenol) or medicine prescribed by your doctor. For the first 24 hours, ice only if needed for 10 to 20 minutes every two to three hours. After one to two weeks, you can resume physical therapy as directed by your physician.

Can I go back to work the next day?
Although there is typically increased pain at the treated site for the first few days, most patients are able to go back to work the next day.
How many PRP injections do I need to have?
This treatment is not a “quick fix” and is designed to promote long-term healing of the injured tissue. The regeneration of collagen takes four to six months and may require multiple injections. For most cases, one to three injections are required at 4 to 6 week intervals. Pain and function recovery will be assessed 4 weeks after the injection to determine further therapy needs.

What are the risks and side effects?
Research and clinical data show that PRP injections are extremely safe, with minimal risk for any adverse reaction or complication. There is little chance for rejection or allergic reaction because the substance is autologous (your own blood). The injection carries far less chance for infection than an incision and leaves no scar and it takes only about 20 minutes, with a considerable shorter recovery time than required after surgery.

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