What is Platelet Rich Plasma?
PRP injections are a new medical technology used in the treatment of many musculoskeletal injuries, including that of tendons, muscles and joints.
Soft tissue injuries which include ligament and tendons represent up to 45% of all musculoskeletal injuries.
Blood contains plasma, red blood cells or erythrocytes, white blood cells and platelets. Platelets are small disc shaped cells. Platelets are a specialized type of blood cell involved in injury healing. Platelets also contain large reservoirs of natural growth factors.
- Platelet-derived growth factors – PDGFaa, PDGFab, PDGFbb
- Transforming growth factors – TGFb1, TGFb2
- Vascular endothelial growth factors – VEGF
- Epithelial growth factors – EGF
This concentrate also contains 3 proteins in the blood to act as cell adhesion molecules: fibrin, fibronectin, and vitronectin.
Clinical data has shown that the concentration of growth factors may help optimized conditions for healing.
During the healing process, the platelets are activated and aggregate together. They then release the granules which contain growth factors which stimulate the inflammatory cascade and healing process.
Blood typically contains 6% platelets whereas PRP has a significantly increased platelet concentration. This level can vary depending on the commercial concentration kit that is being used.
How is platelet rich plasma derived and how is it injected?
As your own (autologous) blood is used, it is first collected by venesection, the same procedure used in blood tests or blood donations (but using a much smaller needle). 20 – 60 cc of blood is taken (500 cc) is taken in blood bank donations.
This blood will then be spun down in a centrifuge to separate the components. The process takes 15 minutes. The platelet rich plasma (PRP) is then harvested and there are a variety of different ways this can be done. At DiagnostiCare we use a commercially available kit which optomises the concentration of platelets and growth factors.
Depending on your injury, up to 2-8mL of PRP will then be concentrated from the centrifuged blood.
Usually 2 or more injections are required, separated by 4-6 weeks apart. This may vary depending on the injury, you are being treated for.
You should not have a PRP injection if you have used non-steroidal anti-inflammatory medications (NSAID’s – examples include Neurofen, Voltarin, Mobic) in the 7-10 days leading up to your appointment. If you are considering having this injection, please change to an alternative painkiller such as paracetamol, or for other options, check with your local doctor or chemist.
Following administration of local anaesthetic, ultrasound guidance is used to ensure accurate placement of the platelet rich plasma.
Is Platelet Rich Plasma Safe?
Since Platelet Rich Plasma is Autologous (from the patient) there is no chance of rejection with minimal chance of adverse effects.
What are the contra-indications?
You should not have a PRP injection if you have the following:
- Cancer or metastatic disease
- An active infection
- A low platelet count
You should also not have a PRP injection if you are pregnant or are breastfeeding.
What are the adverse effects?
Platelet rich plasma (PRP) is prepared from the patient’s own blood so there is no risk of developing allergies or cancer.
Adverse effects are rare but as with any injection there is always the small risk of infection or injury to nerves or blood vessels. This is minimised with the use of ultrasound guidance. Scar tissue formation and calcification at the injection site are also possible.
Very rarely, allergy is experienced to local anaesthetic such as lignocaine or bupivacaine, which may be used prior to injecting the platelets. This is the same local anaesthetic used by doctors and dentists in the community.
Please inform your doctor if you have any known allergies to medications, particularly in relation to local anaesthetics.
Is it painful?
It is usually the case that you may feel some pain during as well as after the injection.
For post injection pain relief, you should use paracetamol (e.g. Panadol) for pain relief or paracetamol combined with codeine (e.g. Panadeine) should you require something a bit stronger.
If you experience persisting severe pain or an adverse reaction following the injection, please contact us.