Working with a sports medicine doctor has given me the opportunity to observe the ins and outs of injection therapy for joints. Of the many injection therapies that are offered including steroid injections, hyaluronic acid injections, etc., the one that I found the most interesting is platelet-rich plasma (PRP) therapy. So what is PRP injection therapy all about?
PRP involves taking 30-60 mL of one’s own blood, centrifuging it, and extracting the platelet-rich plasma so that this may be injected back into the individual’s joint, mainly for damaged tendons. The platelet-rich plasma has a much greater concentration per volume of platelets than whole blood. This allows a small amount, several milliliters, to be injected into the area packing lots of platelet healing powers. Platelets main function is to help blood clot when vessels are damaged however, platelets also promote healing by secreting growth factors which stimulate cell growth and proliferation (Chen et al., 2019). The thought here is that when a tendon is damaged, the platelet-rich plasma will provide growth factors needed to grow and proliferate cells in hopes of healing the damage. Most patients coming in for platelet-rich plasma injections, in my experience, have exhausted all other forms of therapy and are giving it one last ditch effort before surgery. For the injection, a local anesthetic to numb the skin is used and the doctor should use ultrasound to ensure accuracy. Patients may feel a little sore afterward, but are able to return to activities as normal after the procedure.
Advantages include less inflammation and less immune response since the PRP is from the patient’s own blood (Chen et al.,2019). The procedure should also cause little to no pain, is much cheaper than surgery, and has a quick recovery time with no scar tissue. A disadvantage would include price. PRP is fairly pricey, can be up to $2000, and insurance companies generally do not cover the procedure. There are studies showing promising results that patients are having better outcomes after PRP injections (Chen et al., 2019).
I think for a lot of individuals dealing with joint point, they have tried all other options, they are tired of the pain, and so why not? There is very little risk in the procedure and if it works, awesome. If it doesn’t work, well you’re only $2000 in the hole, but at least not worse off. From my experience, I would say more patients have greater results with any injection, than without an injection and so maybe it's worth a try.
Chen, P., Huang, L., Ma, Y. et al. Intra-articular platelet-rich plasma injection for knee osteoarthritis: a summary of meta-analyses. J Orthop Surg Res 14, 385 (2019). https://doi-org.dml.regis.edu/.10.1186/s13018-019-1363-y
Monday, November 9, 2020
PRP Injections
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This was such an interesting read! I know that PRP injections are used for facial aesthetics. It has been a very popular and new type on injection/facial treatment that is being offered across many dermatology and plastic surgery center. Similar to the reason why they are used in joints is because they contain platelet-derived growth factors: epidermal growth factor, fibroblast growth factor, vascular endothelial growth factor, and so on. When injected, this stimulates angiogenesis, cell migration, cell proliferation and collagen deposition (Du et al.,2020). As you can imagine, its like a skin rejuvenating galore!
ReplyDeleteDu, R., & Lei, T. (2020). Effects of autologous platelet-rich plasma injections on facial skin rejuvenation. Experimental and therapeutic medicine, 19(4), 3024–3030. https://doi.org/10.3892/etm.2020.8531