The use of biologic solutions such as platelet-rich plasma (PRP), stem cells, or growth factors is becoming more common in modern orthopaedic practice, in part due to a growing body of research and increasing market demand for alternative methods of nonsurgical management of musculoskeletal conditions.
PRP is a newer modality of treatment for the management of many orthopaedic conditions, including those in the hip and knee. RBC (red blood cells), WBC (white blood cells), plasma, and platelets are the major components of blood. Platelets are small discoid blood cells with granules containing clotting and growth factors which are released during the healing process. On activation, the platelets accelerate the inflammatory cascade as well as healing by the release of the granules containing growth factors.
A normal blood specimen contains only 6% platelets whereas platelet rich plasma (PRP) contains a much higher concentration of platelets (typically at least 4-6x higher). A PRP injection is generally recommended in the treatment of tendon or muscle injuries with a success rate of about 70% to 80%. Four to six weeks may be required for complete healing. Recent research has also shown benefit in improving pain and function, and even slowing progression of disease, in patients suffering from arthritis.
Insurance providers are currently reimbursing for PRP injections. At present, PRP injections are billed as a direct out-of-pocket cost to the patient. To discuss pricing, please contact our office.
Special precautions are required in individuals with low platelet count, bleeding disorders, individuals allergic to local anesthetic agents, those with active infections, and women who are pregnant or breast feeding.
The American Academy of Orthopaedic Surgeons recommends patients adhere to the following pre-injection guidelines:
The procedure is done in the office just like any other injection. With sterile technique, our staff will first draw 15 ml of blood from a vein in your arm. The blood will be centrifuged or spun to separate the platelets from other blood components. The entire process takes about 10 minutes. The platelet rich portion of the blood is then extracted. The affected part of the body is anesthetized and PRP is injected into the affected area under ultrasound guidance, and a small bandage is placed.
After the procedure
Following the procedure, you can resume your daily routine activities but avoid strenuous activities such as heavy exercise or lifting.
You may experience some pain during the injection which may last for a couple of days. Cold compresses and pain medication may be prescribed for pain relief. Anti-inflammatory medications are generally to be avoided for up to 48 hours after the injection, as they can affect the platelet function.
Risks and complications are rare but can include infection, nerve or blood vessel injury, scar tissue formation, and calcification at the injection site following a PRP injection.
Risks and Complications
Reported adverse effects are not different from those of normal venipuncture or injections at the same body locations. PRP injections, however, are frequently more painful than other injections due to the viscosity of the solution.
Call Dr. Cooper immediately in case of persistent pain or the development of any adverse reaction after the injection.