Platelet Rich Plasma (PRP)

PRP is a Regenerative Injection Technique (RIT) used to regenerate and heal damaged ligaments, tendons, cartilage and joint structures.

 

Platelets are often thought of as clotting cells, causing blood to thicken and form scabs after injury;  however, platelets serve many other important functions.

These small cells are responsible for initiating the healing response which attracts white blood cells into injured areas to clean up damaged and dead cells, which often produce non-productive stagnant swelling and lead to chronic inflammation or tendonitis.  This chronic damage, once thought to be an active inflammatory problem is more appropriately referred to as tendonosis because of the lack of inflammation found.  This is the area that is prevented from healing because the swelling is non-productive and must be resolved in order for recovery to proceed.  Platelets injected into the area not only draw white blood cells in to clean up the area, but, they also release growth factors that are directly responsible for tissue regeneration.

 

For years, PRP has been used in surgical centers to improve the success of bone grafting, dental surgery and cosmetic surgery.  Today, PRP is considered the prime choice when joint pain involves damaged ligaments, tendons and / or cartilage.  All joints, ligaments and tendons are treatable whether the problem is acute or chronic.  Conditions such as tennis elbow, shoulder pain, wrist pain, ankle pain, chronic low back pain, unstable ACL/PCL (anterior / posterior cruciate ligament), pubic symphysis strains, Achilles tendonitis, rotator cuff tears, meniscal tears, osteoarthritis, and neck pain can respond to PRP therapy where other therapies have plateaued or failed.

 

Incomplete Healing of Joints Lead to Chronic Weakness and Pain

 

Inflammation over the short-term is a healthy and normal response by your body to heal an injured region in the body.  However, due to the limited blood supply to tendons and ligaments when they become injured they will heal very slowly, if at all.  Over time, these issues become chronic, leading to joint dysfunction and arthritis. 

 

 

What Exactly is PRP?

PRP is an injection technique that uses a concentrated plasma solution derived from your own blood.  This concentrated plasma solution consists of a high number of your own platelets and associative growth factors which work to heal various areas throughout the body.  These platelets release growth factors that are vital in initiating and accelerating tissue repair and regeneration.  The growth factors are a key to increase stem cell production that is vital to repair connective tissues such as tendons and ligaments, help bone regeneration, promote the formation of new blood vessels and stimulate the healing process.  The normal concentration of platelets in blood is between 150,000 and 400,000 per micro litre.  In PRP, where platelets have been concentrated, the count can exceed 2 million platelets per microlitre. 

 

Prepared and Concentrated Platelets (PRP) Derived from Your Own Body.

PRP Provides a Massive Influx of Platelets and Growth Factors to the Site of

Injury.

 

The specially prepared PRP solution derived from your own body is placed at the site of damage to the tendon or ligament.  Since platelets primarily control the healing cascade that occurs after an injury and when triggered, they release various types of growth factors which stimulate the migration of the body’s own stem cells to the site of injury.  The cells can then differentiate and promote healing of ligaments, tendons and cartilage.   Inflammation over the short term is a healthy and normal response by your body to heal an injured region in the body!  PRP used in this way amplifies the body’s natural healing mechanisms and cascades.  This can take place over several weeks.

 

PRP injections enhance blood flow, nutrient delivery, stem cell migration

and new collagen formation at the site of injury.

Over time, the tissue is remodelled resulting in thicker, stronger and more elastic tissue.

 

What Does PRP Do?

The PRP process concentrates fibrin, mesenchymal stem cells, and platelets so that each cubic millimeter of solution contains 1.5 to 2 million platelets, resulting in up to a five-fold increase in platelets and bioactive growth factors.  Because it is so concentrated, PRP acts as a potent tissue growth stimulant, amplifying the natural process of tissue repair and healing.  Studies show that PRP induces the production of new collagen by the fibroblasts, bone and cartilage cells at the site of the injection, rebuilding the joint cartilage and strengthening injured ligaments and tendons.  This new collagen is naturally incorporated directly into your existing cartilage and ligaments, making them thicker, stronger and more elastic. 

A marked pain reduction, increased joint stability, ligament and joint capsule strengthening occurs with this therapy.  Patients can enjoy long-lasting results with occasional maintenance sessions.   As pain levels decrease the quality of life, moods, sleep and energy increases.  This therapy can fully resolve acute and chronic pain and restore the vitality and well being back into your life.  

 

How Is PRP Made?

The initial part of the procedure involves a blood draw from your vein.   This blood is then spun down to separate the red and white blood cells from the platelets and plasma, to create your PRP.   The concentrated platelet solution (PRP) is then injected into the treatment area, under ultrasound guidance, to assure the solution reaches the targeted region(s).  The duration of the entire procedure is 45-60 minutes.

 

What types of conditions are treated with PRP?

Based on current research, soft tissue injuries are the most responsive to PRP.  This includes tendonitis, tendinosis, tendon tears, ligament sprains or tears, loose ligaments, and muscle tears.  PRP has also been effective at treating cartilage degeneration such as arthritis as well as labrum tears in joints.

 

What are some common diagnoses treated with PRP?

SHOULDER:  Rotator cuff tendinitis or tear, rotator cuff impingement syndrome or bursitis, bicipital tendinitis, labrum tear, arthritis, instability
ELBOW/WRIST/HAND:  Tennis elbow, golfer’s elbow, DeQuervaine’s Tenosynovitis, trigger finger, arthritis, other wrist or finger tendonitis
HIP:  Iliotibial band tendinitis (ITB Syndrome), psoas tendinitis and bursitis, greater trochanteric bursitis, labrum tears, arthritis, sacroiliac joint dysfunction
KNEE:  Patellar tendinitis, partially torn or strained major ligaments of knee (ACL/LCL/MCL), meniscus tears, chondromalacia, arthritis, instability
ANKLE:  Achilles tendinitis, peroneal tendinitis, ankle sprain, instability ,other foot or ankle tendinitis
SPINE: Whiplash injury, back pain, rib problems, ligament sprain, instability, arthritis

 

Cartilage, Tendon and Ligament Injury (partial tears), Sports Injuries, Tendonitis, Arthritis, Degenerative or Herniated Discs, Fibromyalgia, Headaches, Sciatica, Dislocations, Tempromandibular Joint Syndrom (TMJ), Whiplash Injury, Neck Pain, Back Pain, Elbow Pain, Shoulder Pain, Rotator Cuff Syndrome, Knee Pain, Meniscus Tear, Hyper-mobile (loose) Joints, Yoga Over Stretching Injuries, Post Injury / Trauma Pain, Pain or Injury that has been unresponsive to other therapy or surgery.

 

Is PRP curative or just a band-aide?

Unlike Cortisone shots, PRP actually heals the injured region.

 

How Does PRP Compare to Regular Dextrose Prolotherapy?

Compared to dextrose prolotherapy, clinical and anecdotal experience has demonstrated that using PRP as the regenerative injection method creates a much more profound healing effect and results in increased healing with less treatments when compared to dextrose (sugar) prolotherapy.  Prolotherapy, in itself, is a very effective and useful therapy.  PRP is especially useful when regular prolotherapy has provided positive results, but recovery has not been ideal.  In these cases PRP is often the treatment that will resolve these less responsive or more injured areas.

 

How Often is PRP Done?

Typically, most will require 2-6 sessions with a 4-8 week frequency.  Improvements are usually noted 3 weeks after treatment.  More serious injuries or those with pre-existing health issue will likely require longer course of treatment.  

If you are a slow healer, the recovery will be slower.  Dr. Sraw prescribes individually specific PRP Therapy protocols for optimal results, which vary depending on individual needs,  hormone status, immune status and severity of injury.   Optimal nutrition, supplementation, stress management, adequate sleep are all factors that influence healing, as well.  Dr Sraw will guide you through the process to make sure you are able to maximally benefit.    

 

Optimize Your Success with PRP

To optimize your treatment program, further testing or additional augmentative therapies may be recommended.  This may include any of the following:

Labwork – blood chemistry
Hormone Testing
Applied Kinesiology Testing
Manual Therapy – like massage, physiotherapy, chiropractic
Trigger Point Therapy
Acupuncture
Laser Therapy
Supplementation

 

Your Next Steps

Step 1

History

Your initial session is your opportunity to share your health goals, and for Dr. Sraw to gather vital information that will help determine the root cause of your concerns and to determine the best treatment plan for you.

A complete medical and lifestyle history regarding the details of your current and past health concerns, lifestyle and current medication and supplementation is taken during your initial session.

Step 2

Further Testing

As need be, Dr. Sraw will suggest further testing be conducted to uncover any questions remaining by the end of the first session.  Tests you have completed from the past may be requested, as well.

Step 3

Examination

Your initial session will include a physical examination.  The area of pain and surrounding areas will be examined.  Assessment may include gait assessment, orthopaedic testing and/or applied kinesiology.  Dr. Sraw may also use ultrasound to assess the injured tissue(s).