PLATELET RICH PLASMA (prp)
Unlock your body's healing power
What is PRP?
PRP (platelet rich plasma) is a concentrated sample of platelets that are taken from your own blood. Your blood has 3 main components: red blood cells (carry oxygen), white blood cells (fight infection) and platelets. Platelets help our tissues heal. When we have a cut and develop a scab, it is our platelets at work. These small cells release both anti-inflammatory molecules that fight inflammation and also growth factors, which promote tissue healing. These growth factors include vascular endothelial growth factor (VEGF), transforming growth factor beta (TGF-B), Insulin-like growth factor 1 (IGF-1) and platelet derived growth factor (PDGF) (1,2). These factors are important in tissue healing. By isolating and then concentrating your platelets, we can produce a very potent healing serum from your own blood.
How long has PRP been used?
For years, PRP has been used by ENT and plastic surgeons to promote graft healing after surgery and heal heavily damaged tissues from burn victims. In the world of sports medicine, its use has grown exponentially in the past 15 years as more people realize its potential healing power.
Is it safe?
Yes. Since PRP is produced from your own blood, the product itself is very safe. This has been shown consistently across the literature. The act of the needle injection itself carries a small risk of pain and infection, as does any injection in a doctor’s office.
What conditions can it treat?
PRP has been shown to be an effective treatment for many kinds of osteoarthritis, including knee and hip arthritis. It can substantially improve pain, reduce swelling and improve mobility. PRP is also very effective in treating most tendon problems, from inflamed tendons to partial tears.
Can a PRP injection speed up my recovery?
Yes! Multiple studies have demonstrated that a PRP injection can improve healing times and get you back in the game more quickly. A recent systematic review and meta-analysis compared PRP treatment to standard conservative therapy (physiotherapy, stretching, etc). The study concluded that PRP leads to both faster healing times and quicker return to play (3).
Are there different kinds of PRP?
Yes. PRP comes in different formulations – with platelet concentrations as low as 1.5x the normal amount, to greater than 10x baseline levels. Some PRP formulations have white blood cells, others do not. Some have higher levels of anti-inflammatory molecules like IL-1Ra (Interleukin-1 receptor antagonist). Others have higher levels of anabolic growth factors important for tissue healing.
Different conditions require different concentrations of each of the above. For example, most tendon problems benefit from the use of a white blood cell-rich PRP formulation (4). Your treating physician should be well acquainted with the research around PRP formulations and the indications for treating different conditions.
How long does it take to work?
The effects of a PRP injection can be felt within the first couple weeks. However, the full healing response continues for 3-6 months after an injection.
prp + arthritis
prp + Tendinopathy
Many different tendon and muscle problems can be treated effectively with PRP. See below for examples.
Eppley BL, et al. (2004). Platelet Quantification and Growth Factor Analysis from Platelet-Rich Plasma: Implications for Wound Healing. Plast Reconstr Surg. 114(6): 1502–1508.
Halpern et al. (2012). The Role of Platelet Rich Plasma in Inducing Musculoskeletal Tissue Healing. Hospital for Special Surgery. 8 (2) 137-145.
Sheth et al. (2017). Does Platelet-Rich Plasma Lead to Earlier Return to Sport When Compared With Conservative Treatment in Acute Muscle Injuries? A Systematic Review and Meta-analysis. Arthroscopy: The Journal of Arthroscopic and Related Surgery, 1-8.
Fitzpatrick, J., Bulsara, M., & Zheng, M. H. (2017). The Effectiveness of Platelet-Rich Plasma in the Treatment of Tendinopathy: A Meta-analysis of Randomized Controlled Clinical Trials. The American Journal of Sports Medicine, 45(1), 226–233.
Riboh, J. C., Saltzman, B. M., Yanke, A. B., Fortier, L., & Cole, B. J. (2016). Effect of Leukocyte Concentration on the Efficacy of Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis. The American Journal of Sports Medicine, 44(3), 792–800.
Smith, P. A. (2016). Intra-articular Autologous Conditioned Plasma Injections Provide Safe and Efficacious Treatment for Knee Osteoarthritis: An FDA-Sanctioned, Randomized, Double-blind, Placebo-controlled Clinical Trial. The American Journal of Sports Medicine, 44(4), 884–891.
Dallari, D., Stagni, C., Rani, N., Sabbioni, G., Pelotti, P., Torricelli, P., … Giavaresi, G. (2016). Ultrasound-Guided Injection of Platelet-Rich Plasma and Hyaluronic Acid, Separately and in Combination, for Hip Osteoarthritis: A Randomized Controlled Study. The American Journal of Sports Medicine, 44(3), 664–671.
Del Buono, A, Papalia, R, Khanduja, V, Denaro, V, Maffulli, N. Management of the greater trochanteric pain syndrome: a systematic review. Br Med Bull. 2012;102:115-131.
Long et al. Sonography of greater trochanteric pain syndrome and the rarity of primary bursitis. AJR Am J Roentgenol. 2013, Nov; 201 (5); 1083-6.
Barratt PA, Brookes N, Newson A. Conservative treatments for greater trochanteric pain syndrome: a systematic review. British Journal of Sports Medicine 2017;51:97-104.
Fitzpatrick, J., Bulsara, M. K., O’Donnell, J., McCrory, P. R., & Zheng, M. H. (2018). The Effectiveness of Platelet-Rich Plasma Injections in Gluteal Tendinopathy: A Randomized, Double-Blind Controlled Trial Comparing a Single Platelet-Rich Plasma Injection With a Single Corticosteroid Injection. The American Journal of Sports Medicine, 46(4), 933–939.
Fitzpatrick, J., Bulsara, M. K., O’Donnell, J., & Zheng, M. H. (2019). Leucocyte-Rich Platelet-Rich Plasma Treatment of Gluteus Medius and Minimus Tendinopathy: A Double-Blind Randomized Controlled Trial With 2-Year Follow-up. The American Journal of Sports Medicine, 47(5), 1130–1137.
Andriolo, L., Altamura, S. A., Reale, D., Candrian, C., Zaffagnini, S., & Filardo, G. (2019). Nonsurgical Treatments of Patellar Tendinopathy: Multiple Injections of Platelet-Rich Plasma Are a Suitable Option: A Systematic Review and Meta-analysis. The American Journal of Sports Medicine, 47(4), 1001–1018.
A Hamid, M. S., Mohamed Ali, M. R., Yusof, A., George, J., & Lee, L. P. C. (2014). Platelet-Rich Plasma Injections for the Treatment of Hamstring Injuries: A Randomized Controlled Trial. The American Journal of Sports Medicine, 42(10), 2410–2418.
Lhee S, Kim J, Jeon J, et al. (2016). Prospective randomized clinical study for the treatment of lateral epicondylitis; comparison among PRP (Platelet-Rich Plasma), prolotherapy, physiotherapy and ECSWT. British Journal of Sports Medicine, 50 (4).
Peerbooms, J. C., Sluimer, J., Bruijn, D. J., & Gosens, T. (2010). Positive Effect of an Autologous Platelet Concentrate in Lateral Epicondylitis in a Double-Blind Randomized Controlled Trial: Platelet-Rich Plasma Versus Corticosteroid Injection with a 1-Year Follow-up. The American Journal of Sports Medicine, 38(2), 255–262.
Gosens, T., Peerbooms, J. C., van Laar, W., & den Oudsten, B. L. (2011). Ongoing Positive Effect of Platelet-Rich Plasma Versus Corticosteroid Injection in Lateral Epicondylitis: A Double-Blind Randomized Controlled Trial With 2-year Follow-up. The American Journal of Sports Medicine, 39(6), 1200–1208.