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If you have been following the recent trends in sport injury treatment or are an athlete yourself, you may have heard reference to PRP.  The abbreviation stands for platelet-rich plasma.  So what exactly does PRP do and how is it effective for healing?

Plasma is a component of blood.  The plasma in blood contains proteins called growth factors that assist with healing. PRP is plasma with a higher concentration of platelets than what is naturally found in blood.  When someone is being prepped to receive PRP injections, that individual’s blood is drawn and platelets are separated from other blood cells in order to produce PRP.  The resulting substance is then injected in the area that requires healing in order to speed the healing process.

This description of the effects of PRP makes it seem like a “cure-all” for healing nearly any ailment of the body.  So what’s the catch?  PRP is still an experimental treatment; therefore, the procedure is typically not covered by insurance and instead conducted at a self-pay rate.  Also, not all of the effects are known.  Stimulating growth in a particular area with PRP may have the potential to trigger the growth of cancer cells, but the validity of this theory is untested and unknown.  Additionally, PRP has been shown to be ineffective for certain conditions.  The discrepancy in effective treatment may be due to the area of the body being effected, the age of the individual receiving the injections, the type of injury (ex. acute or chronic), and the protocol used by the doctor for performing the injections (ex. number of injections in a series).  PRP may even be inhibitory for certain conditions like bone healing due to the nature of bone healing being different from that of muscles and tendons.  A decrease in the healing effects may also occur if the body feels that it is being overstimulated by healing factors and, in turn, shuts off certain healing processes. 

Then what conditions are treated with PRP and where has it been effective?  PRP has been shown to be effective in the treatment of chronic tendon injuries, especially lateral epicondylitis (tennis elbow).  Its effectiveness on chronic Achilles tendonitis or patellar tendonitis has demonstrated some positive trends, but it is unclear if PRP is more effective than traditional treatments.  Despite the publicity and trend toward using PRP for sport related injuries, there is no definitive proof that these injections provide any change or enhancement in the healing process for acute (recent) injuries to muscles and ligaments.  However, the treatment continues to be utilized for acute sport injuries and the research continues.  PRP has been used to assist with healing in surgeries for rotator cuffs and knee ligament repairs, knee arthritis, and fractures; however, the evidence is either inconclusive or demonstrates little to no changes in the rate of tissue healing.  One Italian study even showed an inhibitory effect when used for treatment of a rotator cuff injury.

It is important to note that if someone chooses to receive PRP injections for his/her particular condition, the injection itself will not cause immediate relief of symptoms like one would expect from cortisone.  There will likely be pain at the injection site, the area should then be immobilized for approximately 7-10 days, ice and anti-inflammatories should be avoided, and return to sport (if that is the intention) should be slow.  As stated previously, PRP injections are still being researched.  As more studies are done, there will be more evidence to rely on in order to determine the effectiveness of this particular treatment.

Resources:

http://orthoinfo.aaos.org/topic.cfm?topic=A00648

Platelet Rich Plasma (PRP) – Lecture by Christopher T. Donaldson, MD at Saint Francis University

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