Autologous Blood Injection (ABI) and Platelet Rich Plasma (PRP) injections involve injecting a patients blood into a damaged part of the body.
Melbourne Radiology Clinic - Autologous Blood Injection (ABI) Patient & Post Procedure Information Sheet
Melbourne Radiology Clinic - Platelet Rich Plasma (PRP) Injection Patient & Post Procedure Information Sheet
Most commonly at Melbourne Radiology Clinic, this is done into a tendon for the treatment of tendinosis (the medical term for tendinitis), though other applications also include injecting ligaments, muscles and joints. Any tendon in the body may be injected with a patients blood products, with the most frequent clinical uses of ABI or PRP injections used for the plantar fascia (heel), Achilles (ankle), patellar (knee), gluteal (hip), hamstring (buttock), common extensor origin (tennis elbow or lateral epicondylitis) and common flexor origin (golfers elbow or medial epicondylitis). Approximately 80% of patients obtain complete or significant pain relief following this procedure.
PRP therapy has also recently found use in treating osteoarthritis. By injecting PRP into joints, it is felt that the healing factors may stimulate cartilage and surrounding soft tissue regeneration, as well as dampen the main symptoms associated with arthritis, that being pain and stiffness. Even if joint surgery, such as joint replacement, is delayed for a year or two, then this is considered a win.
Blood contains many nutrients and substances which are thought to promote healing. Platelets are tiny cells in blood which stick to each other when we cut ourselves to result in the formation of a clot to stop any further bleeding. Platelets contain many powerful growth factors, in particular PDGF (Platelet Derived Growth Factor) which has been shown to promote healing of many types of tissues, including bone, teeth, skin and the tissue lining our eyes. PDGF also promotes healing of tendons which are damaged due to excessive use and/or the ageing process.
Patients who suffer from tendinosis usually require a correct diagnosis prior to any procedure. This usually involves an ultrasound and/or an MRI (Magnetic Resonance Imaging) scan. Following diagnosis and if not already done so, the initial line of treatment is to undergo a period of rehabilitation for 6 weeks supervised by a suitable health care provider. This might be your rehabilitation physician, physiotherapist, podiatrist, chiropractor or osteopath to name a few. If pain persists, then the patient is a candidate for an ABI or PRP injection.
The procedure of ABI takes approximately 5 minutes and involves the use of an ultrasound machine to guide the needle into the correct location and safely.
First the skin is cleansed and prepared. Local anaesthetic is then injected into the skin overlying the tendon. Blood withdrawn from one of the arm veins is then injected directly into the tendon. The amount of blood injected depends on the size of the tendon. The procedure is at this point over and the needle injection site is then dressed with a small bandage.
A PRP injection is similar to an ABI, with the only difference being that a larger amount of blood is withdrawn from an arm vein. The blood is then placed into a tube, which in turn is placed into a machine called a centrifuge, which spins many thousand times a minute. The blood is left to spin for 15 minutes. At this point, the cells in the blood have separated from the fluid component of blood (plasma) into the three main cell types: red blood cells, white blood cells and platelets. The platelets are then selectively removed and used for injection. In this way, the theoretical benefit is that a greater concentration of platelets is delivered into the damaged body part than if whole blood was given alone (approximately 8-10 times greater concentration). There is, however, no scientific research documenting this benefit at the time of writing.
Following the procedure you will be provided with clear, written instructions on when to re-commence your rehabilitation. [See the PDF information sheets above]. If your pain persists after 4 weeks following injection, then a repeat injection is strongly recommended. If your pain remains unchanged following a second injection then no further ABI/PRP injection will be offered and you may instead be offered an alternative injection that is available, or otherwise you may wish to pursue surgery. A third injection is rarely offered.
As with all medical procedures, there are risks. The staff at Melbourne Radiology Clinic have performed this procedure hundreds of time with the only complication being a single minor skin infection which was successfully treated with antibiotics. An infection of the deep soft tissues is also a risk. No recorded tendon ruptures have been documented in the scientific literature, nor has this been our experience to date. Patients consistently report a flare up of their pain in the first week following the procedure, however in most cases, this is controlled with some paracetamol and/or an anti-inflammatory medication. Codeine is rarely required.
A radiologist, a medical doctor specialised in interpreting medical images for the purposes of providing a diagnosis, will then provide a formal written report to your referring doctor or health care professional detailing the procedure and providing some recommendation for your after-care. If medically urgent, or you have an appointment immediately after the scan to be seen by your doctor or health care provider, Melbourne Radiology Clinic will instantly have this report ready. Otherwise, the report will be received by your doctor or health care provider within the next 24 hours.
Whilst every effort is made to keep your appointment time, the special needs of complex cases, elderly and frail patients can cause unexpected delays. Your consideration and patience in these circumstances is appreciated.
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