PRP 1

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By Meggie Morley, DPT Student

In recent years the use of platelet rich plasma has been on the rise as a means of promoting healing in soft tissue structures such as tendons, muscles, ligaments and joints. With professional athletes such as Tiger Woods and Steph Curry receiving the injections as a method to promote healing, it may be useful to take a closer look at the possible effects and uses of PRP injections.

How it Works

Platelets are a component of the blood with the main function of promoting blood clotting. They also release numerous growth factors, including Platelet Derived Growth Factor (PDGF), which is a protein that helps regulate cell growth and division. PRP is made by collecting a blood sample from the patient, then centrifuging the blood to separate out the platelets.  The platelet rich plasma is then treated and injected into the patient, often with the use of ultrasound to guide the placement of the injection. PRP is made from the patient’s own blood, so there are very few side effects associated with the injections, however it is recommended to stop taking anti inflammatory medications before and after the injectionPRP 2

Article Review

In an article by Pandey et al., the effects of PRP were examined in patients who underwent arthroscopic rotator cuff repairs compared to subjects that underwent the same procedure without PRP.  The effectiveness of the treatment was measured by four different clinical scores and by ultrasound to view if there was a re-tear and the general vascularity of the rotator cuff. The results found that three of the four clinical scores demonstrated significantly better outcomes in the PRP group versus the control group at various follow up times. The other score (The American Shoulder and Elbow Surgeons Score) was comparable between the PRP and the control group at all follow-up visits. The incidence of re-tears was significantly lower in the PRP group, but only for large tears. The ultrasound also showed that there was significant vascularity at the repair site three months post operatively.

While this article showed positive outcomes for patients who received PRP, overall the evidence for the use of PRP in human subjects is still lacking. As with any medical procedure it is important to be informed and discuss your options with your physician.

FullSizeRender 9 Blog Post written by Meggie Morley, DPT.  At the time of posting Meggie was in her final clinical rotation with me at Catz Physical Therapy Institute.

References

Boswell SG, Cole BJ, Sundman EA, Karas V, Fortier LA. Platelet-rich plasma: a milieu of bioactive factors. Arthroscopy: The Journal of Arthroscopic & Related Surgery. 2012 Mar 31;28(3):429-39.

Kohen R, Warren R, Rodeo S. (2010, October 5). Platelet Rich Plasma (PRP) Treatment: An Overview. Retrieved from https://www.hss.edu/conditions_platelet-rich-plasma-prp.asp

Pandey V, Bandi A, Madi S, Agarwal L, Acharya KK, Maddukuri S, Sambhaji C, Willems WJ. Does application of moderately concentrated platelet-rich plasma improve clinical and structural outcome after arthroscopic repair of medium-sized to large rotator cuff tear? A randomized controlled trial. Journal of Shoulder and Elbow Surgery. 2016 Aug 31;25(8):1312-22.

Filardo G, Di Matteo B, Kon E, Merli G, Marcacci M. Platelet-rich plasma in tendon-related disorders: results and indications. Knee Surgery, Sports Traumatology, Arthroscopy. 2016:1-6.