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Platelet-rich plasma PRP

Platelet-Rich Plasma (PRP) Therapy

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Blood Cells

Blood has many different types of cells, including:

  • Red blood cells:  cells that carry oxygen to the body.

  • White cells:  cells that fight infection.

  • Platelets:  cells that help blood clot and help the body heal from injury.

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Background on PRP

PRP is derived from your own blood by taking a sample of venous blood, placing it in a special tube, and spinning the blood in a centrifuge.  This separates whole blood into its components including red blood cells, platelets and plasma (the non-cellular fluid in blood).  The middle layer constitutes PRP, which contains highly concentrated platelets, the cells that promote blood clotting. These cells also contain a number of specialized chemicals called growth factors.  These include platelet derived growth factor, transforming growth factor beta, and vascular endothelial growth factor.  These factors interact with the local cells and send signals that initiate a variety of events such as cell division and migration.  The basic idea behind PRP injection is to deliver high concentrations of growth factors to an area of injury, with the hope of stimulating a healing response and reducing inflammation in the tissue.  To some extent, injection of whole blood will stimulate the same response, but to a lesser degree. PRP has been used since about 1987 to help promote healing in dental, orthopedic and plastic surgery procedures.  Over about the past 5 years, PRP has been recognized for its potential in treating both chronic and acute musculoskeletal injuries involving tendons, ligaments and muscles.  This procedure is gaining wide media attention as it has been used in professional athletes in attempts to return them to competition as soon as possible.

Potential Risks & Benefits

PRP has been injected for many musculoskeletal disorders, evidence supports the use of PRP in knee and hip arthritis, adhesive capsulitis, tendonitis, and even in select patients with low back pain.  Most PRP injections and current research focus on arthritis in the knees, hips and degenerate tendons. Because PRP is derived from your own blood (“autologous” transplantation), there is NO chance of having an allergic or immune reaction.  Indeed in the literature, side effects or complications of PRP injection are extremely rare.  The main risks include local infection (<1% chance) and pain at the site of injections. Injection of non-buffered PRP (which is acidic) tends to be very painful, thus we add a small amount of sodium citrate to the solution to neutralize the pH, which seems to alleviate much of the pain associated with the injection. In addition, we will anesthetize the area before PRP injection with long-acting local anesthetic.  <

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Pre-Procedure Planning And What To Expect During The Procedure

You should stop taking any non-steroidal anti inflammatory medications and we strongly recommend having someone else with you to drive you home.  In some cases, your referring physician may want you to be on crutches for 1-2 days after the injection and this should be arranged ahead of time.  Crutches are mainly useful if pain is severe when standing or walking after lower extremity injections.

The following steps will occur when you arrive at Solis:

  • Consultation with MD regarding the procedure.

  • MD will draw approximately 20cc of blood from an arm vein and place it in the centrifuge to concentrate the PRP.

  • Ultrasound of the affected area will be done to help localize areas of injury.

  • Under sterile technique, local anesthetic will be used to numb the skin and the area of injection, followed by PRP injection. 

  • Discharge home, the entire procedure typically taking about 1 hour.

What To Do And What NOT To Do After The Procedure

You may ice the area for 20 minutes every 2-3 hours for the first 24-48 hours after the procedure.  About 1 in 10 patients experience a “flare” reaction beginning the day after the procedure, manifested by intense pain.  If this occurs, begin taking the prescribed pain medication and notify Solis.  While some redness and swelling are common after the procedure, if any progressive swelling, redness, drainage or fever occurs, notify Solis and if unable to speak to Dr. Janz or Dr. Andrews that day, go to the emergency room.   


Activity level & follow up – for the day of the procedure and the day after, limit activity related to the injection site to activities of daily living.  Depending on the injection site and your referring physician, you may be on crutches for 1-2 days until pain is not increased with weight bearing.  Return to higher level activities such as running, cycling, golf, weight training, etc., will be directed by your physician at Solis.  It is expected that it will take up to 6-8 weeks to adequately assess your response to therapy.

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Further Reading

Dallari D, Stagni C et al “Ultrasound-Guided Injection of Platelet-Rich Plasma and Hyaluronic Acid, Separately and in Combination, for Hip Osteoarthritis”.  American Journal of Sports Medicine, 44 (3): 664-671, 2016.

Laver L, Marom N et al “PRP for Degenerative Cartilage Disease: A Systematic Review of Clinic Studies”.  Cartilage, 8 (4): 341-364, 2017.

Houck DA, Kraeutler MJ et al “Treatment of Lateral Epicondylitis with Autologous Blood, Platelet-Rich Plasma, or Corticosteroid Injections: A Systematic Review of Overlapping Meta-Analyses”.  Orthopaedic Journal of Sports Medicine 14;7 (3): 2019.

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