Platelet Rich Plasma

The injection of PRP for musculoskeletal injuries is a new emerging technology that promises to optimize the healing potential of these injuries. The technique involves taking 10 cc of blood from the patient, centrifuging the blood to separate the plasma layer, and injecting that layer of plasma (3-4 cc) into the injured area. The process takes about 15 minutes. It is available at the sports medicine clinic at Carleton University, and costs $400 per injection.

Where is the evidence that this works?

Abstract from a paper by Mandelbaum: [1]

In Europe and the United States, there is an increasing prevalence of the use of autologous blood products to facilitate healing in a variety of applications.

Recently, we have learned more about specific growth factors, which play a crucial role in the healing process.

With that knowledge there is abundant enthusiasm in the application of concentrated platelets, which release a supra-maximal quantity of these growth factors to stimulate

recovery in non-healing injuries. For 20 years, the application of autologous PRP has been safely used and documented in many fields including; orthopedics, sports

medicine, dentistry, ENT, neurosurgery, ophthalmology, urology, wound healing, cosmetic, cardiothoracic, and maxillofacial surgery.

In summary, PRP provides a promising alternative to surgery by promoting safe and

natural healing. However, there are few controlled trials, and mostly anecdotal or case reports. Additionally the sample sizes are frequently small, limiting the generalization

of the findings. Recently, there is emerging literature on the beneficial effects of PRP for chronic non-healing tendon injuries including lateral epicondylitis and plantar

fasciitis and cartilage degeneration.

Abstract from a paper by Mishra: [2]

Tendon and muscle injuries are common in elite and weekend athletes. Treatment of these injuries in both groups is rapidly evolving. Sports medicine patients are demanding better and less invasive solutions for all types of musculoskeletal disorders. In this context, platelet-rich plasma (PRP) has emerged as a potential solution. PRP is a fraction of whole blood containing concentrated growth factors and proteins. These cytokines direct tissue healing through autocrine and paracrine effects. The number of basic science, animal, and human investigations of PRP for tendon and muscle injuries worldwide has risen sharply in recent years. These studies are helping clinicians better understand the mechanisms of PRP and are guiding novel treatment protocols.

References:

1. Sampson, S.G., M. Mandelbaum, B., Platelet rich plasma injection grafts for musculoskeletal injuries: a review. Curr Rev Musculoskelet Med, 2008. 1(3-4): p. 165-74.

2. Mishra, A. and T. Pavelko, Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. Am J Sports Med, 2006. 34(11): p. 1774-8.