Platelet rich plasma (abbreviated PRP) is a treatment used for a variety of common orthopedic conditions. PRP is a concentration of platelet cells taken from your blood, and these platelets have growth factors that may help in the healing process of chronic injuries. Growth factors are chemicals that signal the body to initiate a healing response. By injecting PRP into areas of an injury, the hope is to stimulate and optimize your body's ability to heal the chronic conditions. PRP contains a high concentration of platelets, other blood cells important in healing, and growth factors.
PRP has been used in operating rooms for several decades to help with wound healing, and to stimulate bone formation in spinal fusion surgery. Recently, PRP has been used in outpatient settings for treatment of common overuse conditions including:
PRP injections can be done in a physician's office. The procedure takes about 30 minutes in order to withdraw the blood, spin the blood in the centrifuge, and inject the PRP into the injured area.
Finding a physician who provides PRP injections can be a challenge, but most commonly these are offered by orthopedic physicians who specialize in the care of chronic sports injuries.
PRP is obtained from the patient who is being treated. Blood is withdrawn from a vein in the patient's arm and the blood is placed in a centrifuge, a machine that spins at a high speed to separate the different types of blood cells. The physician extracts the platelet-rich portion of the blood, and injects this into the area of injury. There is not just platelets in the concentrated layer of the "spun" blood, but also other important growth factors, plasma, and some red blood cells.
PRP injections are given as soon as the blood has been spun and the platelets separated. Some physicians may choose to add an "activating agent," usually either thrombin or calcium chloride, while some inject just the platelets. Studies have shown that the tendons being injected can also activate the PRP, so the activating agent may not be necessary.
There is no clear science to justify a particular quantity of PRP and number of injections needed. Most physicians perform one injection, although sometimes PRP injections are given as a series of injections over a span of several weeks.
We know from laboratory studies that PRP can help increase certain growth factors that are important in the healing process. What we do not know is if this makes any difference in healing when PRP is injected into an injured part of the body.
Clinical studies that have been done so far do not clearly demonstrate if PRP is more effective than other treatments. While there are reports of cases of success, it is not known if these successes are better, or worse, than other standard treatments. Currently, investigations are underway to determine if PRP is more helpful than other treatments for chronic tendonitis.
PRP has been shown to have some beneficial effects for tennis elbow, Achilles injuries, and even knee arthritis. Unfortunately, these are relatively small studies that follow the patients for a relatively short duration. Because of this, most doctors, and definitely most insurance companies, consider PRP to be experimental. However, talk to any patient who has found success with PRP, and they will tell you about how successful this treatment can be! It is important to remember, the even though there are some success stories and small studies that show benefit, we really don't know if PRP is worth the expense of this treatment.
Side effectsare uncommon, but they are possible. Whenever a needle is inserted through the skin, infection can occur. The other more common side effect of PRP injections is an increase in inflammation and pain after the injection.
PRP injections are not recommended in individuals with bleeding disorders, those taking anti-coagulation medications (e.g.Coumadin), or those who have cancer, active infections, or are pregnant.
PRP injections are not covered by most insurance plans, so there is usually a fee for providing this service. If your insurance does not cover these injections, you can try to appeal to the insurance provider, but because there is little scientific evidence to support PRP use, the likelihood of coverage may be low.
Most physicians charge between $500 and $1,000 per injection, although I have also heard of fees up to $2,500. Fees for PRP injections vary widely, and you may be able to work out a payment with your physician. While there are many different costs to obtain PRP, most physician offices use disposable kits offered by some of the major orthopedic supply companies. These kits cost a few hundred dollars, so there is certainly flexibility in payment, and you should negotiate the best possible rate if you are paying out of pocket.
PRP injections have been a subject ofsignificant interest for orthopedic surgeons and for their patients. Trying to stimulate a healing response within the body can be a challenge, and PRP injections may be an effective way to achieve that goal. While there is some data to support the use of PRP injections in certain clinical situations, there is other datathat questions whether this is more beneficial than traditional treatment. There is little harm in PRP injections, and they are certainly a reasonable option, but the cost of these injections is often not covered by insurance plans. I think it is reasonable to consider a PRP injection, however it certainly should not be viewed as a mandatory treatment, and this should only be consideredwhenother simpler,and more proven treatments are attempted first.
What Are Platelet Rich Plasma (PRP) Injections?
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