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PRP Treatment (Platelet-rich Plasma)

Platelet Rich Plasma (PRP) For Joint Injections

We use Platelet-rich plasma (PRP) in our practice to treat tendon irritations, tendinitis, and bursitis around the shoulder, knee, elbow, and ankle joints.

PRP Blood DrawWe start by drawing a small amount of a patient’s blood, then spin it in an orthopedic centrifuge to isolate the PRP. The doctor then injects the PRP directly into the injured area, with the use of either ultrasound or fluoroscopy, where the growth factors can take action to help heal the damaged tissue.

The PRP has the benefit of stimulating the release of stem cells from vessel walls further augmenting repair. Stem cells are also being directly added to our cartilage regeneration efforts.

Tendinitis is an inflammation, degeneration or injury to the tendon, the structure in your body that connects muscle to bone. Tendinitis can lead to degeneration of the collagen fibers that make up the tendon. The chronic pain that develops with tendinitis has been successfully treated with soft tissue massage, stretching, icing, and careful exercises.

In the past, when tissues and joints were injured, the common treatment in similar circumstances was a cortisone injection. Cortisone is a steroid that inhibits protein metabolism so inflamed cells that are actively turning over are shut down. This effect reduces swelling and therefore pain. Unfortunately, it also reduces activity in normal cells and tissues, and leads to weakening of the tissues and occasional tendon ruptures. Joints that are repeatedly injected with cortisone show damage to the articular cartilage surfaces, which protect the ends of bones. Rather than work to actively heal the damaged tissue, a cortisone injection unfortunately only serves to mask the injury, allowing the athlete to continue to play, often causing more damage.

Steps for the joint injection procedure

1. Identifying the area of concern.

Using an ultrasound machine, we examine the area of concern to locate the damaged tissue.

2. Isolating and activating the magic from your blood.

First, the doctor draws about 2 teaspoons of blood. Using a centrifuge in our office, we isolate platelets from that blood (platelet rich plasma, or PRP), all within about 15 minutes. The platelets are then “activated” to release at least eight growth factors will be used to heal injured tissue. These growth factors work like magic to cause increased collagen and new blood flow.

3. Injecting the PRP into the joint.

Using numbing cream and a very small needle the doctor injects the Platlet Rich Plasma containing a high concentration of growth factors into the joint. These growth factors then activate multipotent stem cells already in the tissue, tricking them into “thinking” there’s been an injury. By creating an inflammatory response, the body sends more of it’s own healing elements to the area. The result is the generation of new, younger tissue to replace that which was torn or damaged.

What joint injuries can we treat with PRP?

Shoulders

Traditional options for patients suffering from many shoulder injuries include arthroscopic shoulder surgery to repair tears, or shoulder joint replacement. With both surgeries, months of rehab are required, and the patient must be aware of and prepared to take on the risks. As an alternative, PRP Injections can be performed with promising results for recovery without the need to undergo surgery.

Knees

Surgical options for those dealing with painful knee issues range from arthroscopic knee surgery to total knee joint replacement. Knee replacement is extremely traumatic and carries new-found risks of toxic wear particles entering the blood stream. Surgeries also often require months of painful rehab to regain strength and mobility. Most surgeries also accelerate the cascade of degeneration that leads to osteoarthritis. Depending on the severity of the knee injury, PRP may be a great alternative to surgery.

Ankles

Current surgical treatment options for common injuries and arthritis, include ankle arthroscopy to “clean up” damaged cartilage, fusion of ankle bones where cartilage has been lost, and tendon grafts screwed in place to strengthen loose connections between bones. All are painful and may not be effective in the long run. Depending on the severity of ankle injury, PRP may be a great alternative to surgery.

Elbows

If you are experiencing elbow pain, PRP is likely an excellent treatment option. In recent years, several studies have shown the effectiveness of platelet rich plasma in treating elbow tendon and ligament issues. In fact, these studies are so decisive that at this point in time, there are very few cases where surgery would be recommended for anything but the most severe elbow injuries.