Over the last several years, a lot of exciting work has been done in the area of uses of concentrated platelets taken from the patient’s own blood and treatment of chronic tendinitis. This informational sheet is being provided to inform you of what options exist for using platelet-rich plasma (PRP) in treatment of your orthopedic condition.
Platelets are the cells in our blood that assist in clotting. Platelets are full of growth factors which are chemicals that attract new vessel ingrowth, scar tissue, and healing cells. Much research has been done in animal studies showing that these growth factors can attract tendon cells, muscles cells, and can improve healing. By separating the platelets from the red cells and then concentrating them, it has been shown that this can be injected into the area of tendon degeneration in hopes of healing. The clinical studies that have been done are in fairly small series of patients, but have shown very good results. This would be used instead of cortisone that can damage tendons and ligaments.
The system that we use in the office involves taking one tube of blood and centrifuging the blood to separate red cells from the plasma. In doing so, the platelets in the plasma are then concentrated. This fluid is then withdrawn into a syringe and under sterile conditions is injected into your tendon either under local anesthesia or occasionally in a treatment room with sedation similar to what one receives when they have a colonoscopy. At the present time, most insurance companies are not paying for the procedure, however. We hope this will change as more studies are published.
There may be some pain following the procedure for a few days that require pain medication and occasionally narcotics. Rest is recommended for the first 48 hours. A course of very specific therapy is then begun to strengthen the muscles around the joint. Weightlifting and competitive sports are discouraged as this may inhibit and reduce healing. Most of the time, there is an improvement in the pain in the first 2-4 weeks. However, in patients with more significant tendinitis or partial tearing, a second injection may be necessary to further enhance the healing process. The entire healing process can take 6 months.
The risks of the procedure are quite low and primarily relate to discomfort taking the blood, pain during the procedure, and a small risk of infection from the injection. Because it is your own blood and tissue that are being used, there is no risk of infectious disease transmission nor is there a risk of further tendon degeneration as can be seen with cortisone. There is no guarantee however that this will be helpful to you and it should be understood that this is a procedure that, while exciting for which we are very hopeful will offer our patients a wonderful alternative to cortisone, has not yet had long-term clinical studies performed.
If you have further questions surrounding this, please do not hesitate to contact me and I look forward to being of service to you.
Lesley J Anderson MD