Platelet rich plasma (PRP) therapy is a cutting-edge non-surgical technique that is now available for use as an in-office procedure. Years ago, it was thought that platelets functioned solely to form blood clots -- or, more specifically, to bind to each other at the sight of bleeding in order to form a "plug" to stop the flow of blood. Recent research has shown, however, that the platelet has a far greater role in the healing process than initially thought. When platelets aggregate at the sight of an injury, they not only form the plug to stem the bleeding but they also release growth factors. These growth factors, also known as cytokines, aid in the healing of injured tissues.
PRP Therapy: The Process
PRP therapy requires only a small amount of normal blood from the patient (approximately 20 cc's). This blood sample is placed into a centrifuge in the office and is spun for approximately fifteen minutes. The final product is a highly concentrated platelet rich gel, which, when applied to injured tissue, accelerates the normal healing process.
On the day of the treatment, the patient is seated in the exam chair and blood is taken from his or her arm. Once the PRP gel is ready for implantation, the area being treated is injected with local anesthesia after which there is no further discomfort from the procedure.
To insure the accuracy of the placement of the platelet rich gel a diagnostic ultrasound is used. Then a needle attached to a syringe containing the gel is guided by the ultrasound into the areas of injury. After the procedure, a simple Band-Aid is applied. Because there is no surgical incision involved there is little or no post procedural pain.
The Science
When the PRP gel is applied to the area of injury, the platelets are activated to produce proteins capable of stimulating cellular growth, proliferation and cellular differentiation called growth factors. By concentrating the number of platelets found in normal blood by 10 times, the concentration of growth factors in the area is equally enhanced. This is significant in terms of the healing process because growth factors are responsible for attracting stem cells that will eventually become new tendon, bone or fascia.
The procedure is very safe. Since the blood is drawn and processed immediately in the same facility there is no chance of contamination or blood from another patient. Also since the injection consist of blood from the same patient begin treated there is no chance of allergy or drug reactions. Additionally, platelets have a natural antibiotic quality so there is very little chance of infection.
Use
In my practice, by far the most common ailment treated with PRP is the painful heel condition known as plantar fasciitis. However, I have also successfully treated tendonitis, partial tendon ruptures and inflammatory bone conditions.
PRP versus Cortisone Injections
When PRP is compared to cortisone injections for inflammatory conditions there are many striking differences. Cortisone injections result in immediate pain relief. PRP injections do not act as quickly. PRP procedures take longer to deliver results because the growth factors take time to grow the new tissue. However, the platelets release the growth factors that attract the stem cells and then produce repaired "new" tissue. The cortisone reduces the inflammation immediately but actually causes tissue weakening and damage.
So the choice between cortisone and PRP comes down to fast relieve with potential tissue damage or actual new and repaired tissue that takes longer to relieve pain. This new innovative and cutting-edge technique is just the beginning of the new branch of science known as "orthobiologics". The day is fast approaching when medical science will be able to create new parts to cure the ailments and injuries that plague our bodies. "Protein Rich Plasma" is one of the modalities that are currently available to help the body accelerate the healing process and create new, repaired, healthy tissue.
PRP in the news:
The following articles on PRP are sited for your further reading on this subject:
Bruce Lashley, DPM Dr. Lashley is a podiatrist practicing in midtown Manhattan for the past 27 years. He specializes in the conservative and surgical management of the foot. He has been a participating sports enthusiast his entire life. As a health care provider Dr. Lashley wants to do all he can for his patients to keep them in the game. For more information on Dr. Lashley visit his web site. http://www.footdoctornyc.com/
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