Tissue repair of tendons and other orthopedic injuries can be slow and incomplete despite following a good regimen of recovery. The negative impact of continued pain on athletes and other active men and women can be disruptive, depressing and frustrating! Sound familiar? Your blood has so many cells helping your body stay healthy and it’s amazing that something as simple as your blood can help go from suffering to having pain relief. Your body heals small wounds and injuries using repair cells in your own blood on a daily basis. Platelets in particular play a key role in that everyday wound healing processes. When you cut your finger with a knife, platelets come to the area to stop the bleeding and start a cascade of healing. With the scientific knowledge of how platelets create a healing atmosphere, doctors practicing integrative orthopedics around the world aim to harness that same benefit to help muscle, tendon, ligament and joint damage. Our focus is on repair and no cutting out tissue.
What is Platelet Rich Plasma?
Platelet Rich Plasma, PRP Therapy, is a revolutionary pain treatment therapy which involves injecting concentrated platelets from your own blood to stimulate the body to rebuild damaged tissue. The concentrated platelets found in PRP contain huge reservoirs of biologically active proteins, including growth factors that are vital to initiate and accelerate tissue repair and regeneration. These bioactive proteins initiate (or RE-initiate) connective tissue healing, bone and possibly joint surface regeneration and repair, promote development of new blood vessels, and stimulate the wound healing process. PRP Therapy harnesses that power of your own body to heal itself. After a simple in office blood draw the blood is separated into its individual components isolating the platelets which are then concentrated for injection back into the body. PRP is autologous (meaning comes from yourself), is non-invasive, requires little to no down-time and involves little to no risk of infection or complication.
Science and Safety of PRP
Since the late 1980s when scientists and physicians determined platelet concentrates can heal chronic ulcers, there have been many applications of platelets to treat a variety of medical conditions. PRP is used in dermatology, plastic surgery, orthopedics and other medical specialties. On PubMed, the scientific resource for all published clinical trials, there are more than 11,861 results sited about Platelet Rich Plasma. The PRP procedure is minimally invasive and done quickly in the office. There are minimal risks especially when the injection is done using ultrasound visualization.
PRP can be injected alone or in combination with other orthobiologic treatments to achieve optimal healing capacity. The safety and effectiveness of PRP has been widely studied for decades and solid evidence supports a PRP therapy for many conditions including as tennis elbow, hip tendonitis and knee arthritis. It is one of the best and safest option for an orthopedic problem that has failed to resolve with therapy, rest, modified activity and other conservative treatments. Some conditions also are not solved with orthopedic surgery.
What are the potential benefits of PRP Therapy?
You can see a significant improvement in symptoms as well as partial or full return of function. Pain relief benefits have been experienced as early as 2 weeks, but typically best results are experienced starting at 6-8 weeks. Healing takes time! I’ve seen patients continue to see benefit for months. The goals ultimately is to eliminate the need for more aggressive treatments such as long-term medication and/or invasive surgery.
Is PRP Therapy right for me?
If you suffer from knee arthritis or various joint or muscle non-healing injuries, you may be an ideal candidate for non-surgical regenerative options like PRP for pain relief. PRP Therapy is not always an option your surgeon may bring up. In experienced hands, PRP is safe, less aggressive and less expensive than surgery, with little to no down time. The reality is that not all orthopedic pain issues can be solved by surgery. PRP heals tissue with minimal or no scarring and it alleviates further degeneration of the tissues. If you have been advised that your next step is a joint replacement and you aren’t ready or do not want an aggressive surgery, schedule your consultation with Dr. Rolnik so you can move towards a pain-free, active lifestyle again!
What can be treated?
PRP injection treatments work best for damaged soft tissue (tendons, muscles and ligaments) supporting joints and arthritis including:
Osteoarthritis – knee, shoulder, hip ankle are most common
Rotator cuﬀ injuries including tendonitis or partial tears
Shoulder pain and instability
Tennis & golfer’s elbow
Hamstring and hip strains
Knee sprains and instability
Patellofemoral syndrome and patellar tendinosis
Achilles tendinosis & plantar fasciitis
How many treatments and how often is PRP Therapy?
While responses to treatment vary, many people will require only one PRP treatment per problem, however sometimes additional injections are needed. This will be determined at your consultation with Dr. Rolnik. Each PRP treatment is spaced approximately 4-6 weeks apart. Results are based on a host of factors, such as the severity of the injury/condition, the duration of damage, overall patient health, etc. There is no real limit to the number of treatments you can have, as there is little to no risk or side effects to PRP Therapy.
What happens during the PRP Therapy?
It is important to come well hydrated to your appointment. First your blood is drawn from your arm while you comfortably lay on the exam table. The blood is then placed in a specialized centrifuge in our lab. The centrifuge spins and separates the different components in your blood. The entire preparation process takes less than 30 minutes and increases the concentration of platelet and growth factors to stimulate an optimal healing response. Next, the affected area is cleaned and kept sterile. Dr. Rolnik then injects the PRP using ultrasound guidance to precisely target the diseased tissues. Some patients will benefit from several injections that day which will be reviewed prior to the procedure.
What can I do to maximize my results?
Prior to the injections, you are restricted from the use of non-steroid anti-inflammatory medications (NSAIDs) one week prior to and 8 weeks after the procedure. You may not have injectable or oral steroids (Cortisone, Prednisone, etc.) in the 4 weeks prior to PRP Therapy or 8 weeks afterwards. The healthier you are coming into your procedure the better your body is equipped to respond to the PRP treatment so we recommend following a Mediterranean whole foods diet before and after your injections. A healthy body heals better!
What can I expect after the procedure?
Initially, the procedure may cause some localized soreness and discomfort, usually lasting for 24-48 hours. The duration of discomfort varies on where the injections are given and how many injections are done at your procedure. Most patients only require some Extra-Strength Tylenol to help with the pain, though stronger prescription pain medication can be prescribed if necessary. Heat may be applied to the area as needed (ice initially is restricted as it has an anti-inflammatory effect that can limit the PRP benefit).
How soon can I go back to regular physical activities?
Each patient has a different situation and Dr. Rolnik will determine your particular plan of recovery, but generally speaking, after taking it easy with gentle exercise for the first few weeks (walking, swimming, etc.), you may gradually resume your normal activity, letting pain be your guide (meaning if it’s painful, don’t do it).
PRP Therapy helps regenerate tendons and ligaments but is not a quick fix- it takes time to recover. This therapy is stimulating the growth and repair of tissue and will continue over 6-9 months.
Is PRP the same as cortisone shots?
PRP is NOT the same as a cortisone injection. Studies have shown that cortisone injections may weaken tissue and lessen the healing capacity of tissue. While cortisone shots may provide temporary relief for a few weeks to months, they do not provide long term healing. PRP Therapy stimulates your own natural healing mechanisms to strengthening and repair diseased tissues especially for tendons/ligaments. PRP is both healing and strengthening.
Do I need a ride home?
Most patients can drive home after the procedure unless an injection is done on the right foot/ ankle as there may some discomfort after the treatment which may pose difficulty driving (since you use your right foot to drive!).
Does insurance cover this procedure?
No regenerative therapy is covered by standard insurance at this time despite evidence of great safety and success using your own cells. Many patients pay using an HSA or FSA card using pre-tax dollars. Your health is a priority and our patients choose to invest in their health and happiness. Insurance companies are slow to accept newer therapies in medicine and often they decide what they will and will not cover based on fiscal reasons as they monitor their bottom line. Our patients do not want to suffer anymore and are not willing to wait for insurance companies to change their policies.
To see if you are a candidate for PRP treatment, schedule your consultation with Dr. Rolnik to review you individual case and determine a solution for your pain.