Wednesday, June 19, 2013

Platelet Rich Plasma. Understanding PRP's Role in Sports Medicine

Platelet rich plasma, or PRP, has gained increasing use in treating musculoskeletal injuries in the past decade. Several high profile uses in professional athletes have led to its widespread application in the general public, and an explosion of research into its utility. Today’s entry will hopefully provide an understanding of where we stand with PRP, its function, and the role for its use in treating sports medicine injuries today.

What is PRP?

PRP at its most basic form is any blood product with a concentration of platelets above normal concentration. Platelets are a cellular component of blood that have a role in tissue healing and blood clotting. It’s their role in tissue healing that has spawned its use in a range of therapeutic applications including sports medicine. By increasing the concentration of platelets, PRP systems also increase the concentration of the important growth factors these cells release, providing a product shown to enhance healing of musculoskeletal tissue.


PRP is obtained with a simple blood draw, often in your physician office. It is then processed in a centrifuge to concentrate platelet cells and separate out other cells and fluids. It is then injected in the injured tissue or joint after a local anesthetic is applied. A short period of rest is often recommended to minimize the chances of pain at the injection site and to allow the healing process to begin.





What do we treat with PRP?

A number of clinical studies have been released in recent years looking at PRP’s utility in a range of conditions, from arthritis to acute muscle and ligament injuries to chronic conditions like tendonitis and plantar fasciitis. Further studies have looked into its role in augmenting surgical repair of the structures such as the rotator cuff, achilles tendon, and anterior cruciate ligament. Broadly speaking, these studies would indicate that PRP’s efficacy is best classified as mixed. Many of these studies are relatively small and often conflict with one another. The clearest benefit for the use of PRP has been its use in treating lateral epicondylitis, or tennis elbow, plantar fasciitis, and osteoarthritis of the knee. Its usefulness in treating acute injuries, patellar tendonitis, hip bursitis, and in augmenting surgical repairs is mixed at best, and in the case of rotator cuff repair may even be detrimental to healing.






Should I get a PRP injection?

That is often the question most patients want answered. The clearest answer is to talk to your physician. He or she should be able to discuss PRP’s use in your specific condition. Often other remedies such as physical therapy, rest, or braces can offer a more reliable cure. However, certain conditions do appear to be better candidates for PRP, and I have found it to be very useful for the patient who has tried and failed more traditional approaches such as steroid injections, prolonged physical therapy, and rest. An individualized approach to these conditions is certainly the best medicine.