Platelet-rich plasma (PRP) is a therapy which uses a component of a person’s own blood to treat their osteoarthritis. PRP is a safe treatment which often gives significant benefit to people suffering from osteoarthritis including improvements in stiffness, pain and mobility.
Growth Factors Promote Repair
PRP injections contain a high concentration of your own platelets. These platelets contain a large amount of growth factors, including platelet-derived growth factor (PDGF), transforming growth factor beta (TGF-β), insulin-like growth factor (IGF), epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF)1.
Table 1. Growth factors involved in tissue repair2.
|Growth Factor||Effect on Tissue Repair|
|EGF||Stimulates cellular proliferation|
|IGF||Mediates growth and repair of skeletal muscle|
|PDGF||Encourages proliferation of fibroblasts, enhances collagen synthesis|
|TFG-β||Stimulates fibroblast proliferation, formation of collagen, and extracellular matrix components|
These growth factors trigger tissue repair in our natural healing and recovery process. When a high concentration of these growth factors is introduced into the area of an injured or arthritic joint the healing process is jump-started.
How Is PRP Prepared?
Platelet-rich plasma is prepared by drawing and centrifuging a small sample of your own blood on the day of treatment. A centrifuge is a device which rapidly rotates, spinning a blood sample at a high speed causing it to separate into layers based on weight. After centrifugation the blood sample separates into a top layer of plasma which is transparent yellow in color (mostly water with some dissolved proteins) and a bottom thick, red layer (red blood cells). At the junction of the plasma and red blood cell layers sits a dense concentration of platelets. This platelet-rich layer of the plasma is the portion of the blood which is collected and used for injection.
How Is PRP Administered?
PRP is given by injection into the affected site or the site of injury. For example, in cases of tennis elbow the PRP injection is made at the site of the affected common extensor tendon on the elbow and in plantar fasciitis the injection is given at the site of the damaged plantar fascia insertion on the heel of the foot. In the case of osteoarthritis the “injury” includes two entire joint surfaces. An osteoarthritic joint is treated by injecting PRP into an affected joint space. Since a joint is a closed compartment the PRP fluid stays within the joint, coating the affected joint surfaces and exerting its effect on them through its rich concentration of growth factors.
Effectiveness Of PRP For Osteoarthritis
Many studies have been performed on platelet-rich plasma injections for osteoarthritis and the results have been near-unanimously positive, showing a reduction in pain and improvement in mobility among the people receiving the treatment. In total, 35 studies have investigated PRP as a treatment for osteoarthritis and all 35 of these studies have found that this treatment was beneficial3-37. Several of these studies compared PRP treatment to injections of hyaluronic acid and found that PRP is as good7, 11, 20 or better4, 6, 13, 14, 19, 24, 28, 35, 36, 37 for treating osteoarthritis.
PRP injection treatments are quite safe, having very little in the way of reported adverse effects38. While most treatments for pain involve a synthetic medication-based therapy, PRP simply uses a component of a person’s blood. PRP therefore carries very little risk of causing an allergic reaction. The most common adverse effect of PRP is discomfort at the site of treatment for 1-3 days. This is a common reaction as the mechanism of action of PRP involves a short-term inflammatory phase after treatment which can contribute to discomfort temporarily. As with any injection there is a small chance of infection. There is also a small chance of allergic reaction to the local anesthetic (numbing agent), which is used at the site of the injection.
What to Expect
PRP treatment can provide lasting results for people with osteoarthritis including reduced pain and improved mobility. Typically 3 treatments will be required to attain maximum benefit from PRP. PRP injections can be done 2-3 weeks apart without issue.
After PRP Treatment
PRP injections are a long-term solution for osteoarthritis. While this treatment gives long term benefit some people may experience discomfort following treatment for 1-3 days. In order to deal with the possible discomfort it is best to reduce physical activity after a PRP injection to avoid additional discomfort of the region which was treated. Applying ice to the affected area will not inhibit the effectiveness of the PRP treatment and may help if the treated area is achy or sore.
The treated body part should be rested on the day of treatment and if discomfort remains then 2-3 days of avoiding heavy activity may be required to assist in recovering. Anti-inflammatories such as aspirin, ibuprofen and naproxen in general should not be taken for 2-7 days after a PRP treatment as they could theoretically dampen its effectiveness. Generally acetaminophen (Tylenol) is preferable to anti-inflammatories in this short term to manage any discomfort or pain which may be present.
Who Should Not Have PRP?
People with thrombocytopenia (low platelets), active cancer, active infection and people on blood thinners are not candidates for PRP treatment.
Platelet-Rich Plasma Therapy in Halifax
If you are interested in having PRP treatment contact MacLeod Naturopathic at 902-820-2727 to book an initial consultation with Dr. MacLeod. If you would like to receive PRP treatment in Cape Breton you can contact Dr. MacLeod’s satellite practice in Port Hood at 902-227-5266.
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Last updated November 26, 2016