Platelet Rich Plasma

Injuries Treated

Chronic sports injuries

Degenerative Joint & Disc Disease

Chronic sprains and strains

Cervical, thoracic, and lumbar spine strains

Brain injuries

Arthritic Joints

Shoulder pain, hip pain, and knee pain

Ligament laxity or tears

Tendon and ligament injuries

Carpal Tunnel Syndrome

What is PRP?

“Prolotherapy is like planting seeds in a garden;

PRP therapy is planting seeds with fertilizer.”

Platelet rich plasma (PRP) therapy, like prolotherapy, is a method of injection designed to stimulate healing. “Platelet rich plasma” is defined as “autologous blood with concentrations of platelets above baseline levels,” “which contains at least seven growth factors.” Cell ratios in normal blood contain only 6% platelets, however, in PRP, there is a concentration of 94% platelets. Platelets contain a number of proteins, cytokines and other bioactive factors that initiate and regulate basic aspects of natural wound healing. Circulating platelets secrete growth factors, such as platelet-derived growth factor (stimulates cell replication, angiogenesis), vascular endothelial growth factor (angiogenesis), fibroblast growth factor (proliferation of myoblasts and angiogenesis), and insulin-like growth factor-1 (mediates growth and repair of skeletal muscle), among others. Enhanced healing is possible when platelet concentration is increased with PRP. Activated platelets “signal” to distant repair cells, including adult stem cells, to come to the injury site (see Figure 3). Increasing the volume of platelets accordingly increases the subsequent influx of repair and stem cells. Because the concentrated platelets are suspended in a small volume of plasma, the three plasma proteins fibrin, fibronectin, and vitronectin contribute to a repair matrix. You could compare dextrose prolotherapy and PRP this way: prolotherapy is like planting seeds in a garden; PRP therapy is planting seeds with fertilizer.

Alderman, 2015

Significant Improvement

Patients can see a significant improvement in symptoms as well as a remarkable return of function. This may eliminate the need for more aggressive treatments such as long-term medication or surgery. PRP is a supercharged form of prolotherapy. Results are dependent on the health of the patient, and their regenerative capabilities. For most healthy patients PRP reduces both the time and number of treatments when compared to traditional prolotherapy.*

*Results may vary; no guarantee of specific results

 

A Powerful Form of Regenerative Injection Therapy!

The concentrated platelets found in PRP include growth factors among the huge reservoirs of bioactive proteins that are vital to initiate and accelerate tissue repair and regeneration. These bioactive proteins can help increase stem cell production to initiate connective tissue healing, bone regeneration and repair; help promote development of new blood vessels; and help stimulate the wound healing process.

How it Works

A small amount of blood is taken from the patient. The blood is then placed in a centrifuge. The centrifuge spins and through a multi-functional process separates and concentrates a layer of platelets, mesynchymal stem cells and some white cells. This can increase the concentration of platelets and growth factors up to 400-600%.

When PRP is injected into the damaged area it stimulates the tendon or ligament to engage in collagen formation and thereby begins the healing cascade. As a result, new collagen begins to develop. The new collagen synthesis at the injury site quickly begins the repair process of large-to-micro tears of cartilage, tendons and ligaments. As this collagen matures, it replaces the damaged collagen fibrils to form a stronger bond to important areas of attachment.

There is little chance for rejection or allergic reaction because the substance is autologous, meaning it comes from the patient’s own body. The injection carries far less chance for infection than an incision and leaves no scar, and it takes only about 20 minutes, with a considerably shorter recovery time than after surgery.*

*Results may vary; no guarantee of specific results

I’m a disabled Vietnam Veteran and I have full medical care at the VA Hospital but they are not able to do what Dr. Hughes has been able to accomplish. He’s been able to reduce my pain medication by seventy five percent and the shots that he has given me in my lower back, due to degenerative disc disease, have increased my way of life.*

Mike

*Results may vary; no guarantee of specific results

Frequently Asked Questions

How Does PRP Compare With Cortisone Shots?

Studies have shown that cortisone injections actually weaken tissue and serve to further degenerate damaged cartilage. Cortisone shots may provide temporary relief and decrease inflammation, but generally does not provide long term healing. PRP therapy acts to heal and strengthen tendons and ligaments and in some cases thickening the tissue up to 40%.*

*Results may vary; no guarantee of specific results

Frequency of Treatments

While responses to treatment vary, most people will require 1 to 3 sets of injections of PRP. Each set of treatments is spaced 2 to 4 weeks apart.

Suggestions Following Treatment

You are restricted from the use of non-steroidal anti-inflammatory medications (NSAIDs) one week prior to the procedure and throughout the course of treatments. Initially the procedure may cause some localized soreness and discomfort. Patients rarely require some extra-strength Tylenol to help with the pain. Ice and heat may be applied to the area as needed.

How Soon Can I Go Back Regular Activities?

PRP therapy can help regenerate tendons and ligaments, but it is regenerative and therefore not a quick fix. This therapy is designed to stimulate the growth of new tissue, requiring time and rehabilitation. During the treatment program, most people are able to resume normal activities and exercise within the first few weeks.* Movement is essential for rehabilitation but repeating activities that created the problem is not advised. Many patients are active already and are more prone to getting back to the sports they enjoy a little too early. Please give yourself about 3 weeks before engaging in strenuous athletic events and be sure to ask Dr Hughes before going back into the activity that may have caused the condition.

*Results may vary; no guarantee of specific results

Is PRP Covered By My Insurance?

No, PRP is not covered by insurance. Also known as proliferation therapy, it’s considered experimental and investigational for all indications because there is inadequate evidence of its effectiveness. Your insurance may however, cover the cost of the initial consultation or if ultrasound imaging is needed for guidance.

How much does PRP cost?
The cost of PRP depends on the treated body area, complexity, and number of injections needed. Typical PRP procedures cost on average $1400 or more.

Scientific References

Akeda, K., Imanishi, T., Ohishi, K., Masuda, K., Uchida, A., Sakakibara; T., Kasai, Y., Sudo, A. (2012).Intradiscal Injection of Autologous Platelet-Rich-Plasma for the Treatment of Lumbar Disc Degeneration. Department of Orthopaedic Surgery and Spinal Surgery and Medical Engineering.

Alderman, D. (2015). The New Age of Prolotherapy. Practical Pain Management. 

American Academy of Orthopaedic Surgeons. (2014). Platelet-rich plasma treatment more effective than cortisone for severe hip bursitis. ScienceDaily. Retrieved February 24, 2016 from www.sciencedaily.com/releases/2014/03/140314093747.htm

DeNoon, D. (2010). Platelet-Rich Plasma Helps Tennis Elbow. Fitness & Exercise. Retrieved from WebMD February 24, 2016. http://www.webmd.com/fitness-exercise/20100310/platelet-rich-plasma-helps-tennis-elbow.

de Vos, R. J., Weir, A., van Schie, H. T. M., Bierma-Zeinstra, S. M. A., Verhaar, J. A. N., Weinans, H., & Tol, J. L. (2010). Platelet-Rich Plasma Injection for Chronic Achilles Tendinopathy. The Journal of the American Medical Association, 303(2), 144-149.

Filardo, G., Kon, E., Della Villa, S., Vincentelli, F., Fornasari, P. M., & Marcacci, M.(2010). Use of platelet-rich plasma for the treatment of refractory jumper’s knee. International Orthopaedics (SICOT), 34, 909–915.

Freitag, J. B., & Barnard, A. (2013). To evaluate the effect of combining photo-activation therapy with platelet-rich plasma injections for the novel treatment of osteoarthritis. BMJ case reports, 2013, bcr2012007463.

Gaweda, K., Tarczynska, M., & Krzyzanowski, W. (2010). Treatment of Achilles Tendinopathy with Platelet-Rich Plasma. International Journal of Sports Medicine.

Hauser, R. (2015). Platelet Rich Plasma Therapy for Knee Osteoarthritis. Retrieved from http://www.caringmedical.com/prolotherapy-news/platelet-rich-plasma-knee-osteoarthritis/.

Kon, E., Filardo, G., Delcogliano, M., Lo Presti, M., Russo, A., Bondi, A., Di Martino, A., Cenacchi, A., Fornasari, P. M., & Marcacci, A., (2008). Platelet-rich plasma: New clinical application A pilot study for treatment of jumper’s kneeInternational Orthopaedics (SICOT) International Orthopaedics, 34(6), 909-915.

Mei-Dan, O., Carmont, M. R. (2011). The role of platelet-rich plasma in rotator cuff repairSports Medicine and Arthroscopy Review,19(3), 244-250.

New York. (2013). Platelet-rich Plasma (PRP) Treatment Shows Potential for Knee Osteoarthritis. Hospital for Special Surgery.

Randelli, P., Arrigoni, P, Ragone, V., Aliprandi, A., Cabitza, P. (2011). Platelet rich plasma in arthroscopic rotator cuff repair: a prospective RCT study, 2-year follow-up. Journal of Shoulder and Elbow Surgery, 20(4), 518-528.

Sánchez, M., Anitua, E., Azofra, J., Aguirre, J. J., Andia, I., (2008). Intra-articular injection of an autologous preparation rich in growth factors for the treatment of knee OA: a retrospective cohort study. Clinical and Experimental Rheumatology.

See additional references here: Bonakdar, R. A. & Sukiennik, A. (2016). Integrative Pain Management. New York, NY: Oxford University Press.