Platelet Rich Plasma (PRP)

Platelet Rich Plasma (PRP) - Παρασκευή, 13 Μάρ 2015

An innovative treatment, for  Musculoskeletal Pathologies , PRP uses your own blood for healing muscle, tendon and ligament injuries. 

A common form of healing is scarring which affects function . Most of the Current therapies  treating sports Injuries  do not change the intrinsically poor healing properties. Given this situation, biologically based strategies involving the stimulation of cell activities through the delivery of Growth Factors have attracted considerable interest. 

Platelet Rich Plasma is derived by placing a small amount of your blood in a filtration system which separates red blood cells from platelets. The high concentration of platelets (containing a high level of Growth Factor) is then injected into the injured tissue which initiates the body’s natural healing response.

All the injections provided at European Sports Care Set up are  under Ultrasound Guided

After treatment cold therapy/icing of the affected area may be used.

Usually 2-3 injection are needed depending on the severity of the injury and the chronicity of the symptioms .


References
1. Sánchez M, Anitua E, Orive G, Mujika I, Andia I. Platelet-rich therapies in the treatment of orthopaedic sport injuries. Sports Med. 2009;39(5):345-54.
2. Woolf AD, Pfleyer B. Burdon of major musculoskeletal conditions. Bull World Health Organ. 2003;81:646–56.
3. Cassel EP, Finch CF, Stathakis VZ. Epidemiology of medically treated sport and active recreation injuries in the Latrobe Valley, Victoria, Australia. Br J Sports Med 20032; 37: 405-9.
4. Anitua M, Sánchez E, Nurden A, Nurden P, Orive G, And ́ıa I. New insights into and novel applications for platelet-rich fibrin therapies. Trends Biotechnol. 2006;24(5):227–34.
5. Praemer AF. Musculoskeletal conditions in the United States. 2nd ed. Rosemont: American Academy of Orthopaedic Surgeons; 1999.
6. Sampson S, Gerhardt M, Mandelbaum B. Platelet rich plasma injection grafts for musculoskeletal injuries: a review. Curr Rev Musculoskelet Med. 2008 Dec;1(3-4):165-74

Musculoskeletal Medicine

Platelet rich plasma injections (PRP injections) can be used in the treatment of many musculoskeletal injuries including that of tendons, muscles and joints. Typically 2 or more injections are required, separated by 1-4  weeks apart. This may vary depending on your injury.

Muscle and Tendon injuries can be treated with PRP

Muscles Injuries

  • Hamstring
  • Calf
  • Quadriceps

Tendon Injuries:

  • Tennis elbow (common extensor tendinosis)
  • Golfer’s elbow (medial epicondylitis)
  • Jumper’s knee (patellar tendinosis)
  • Achilles tendinosis
  • Plantar fasciitis
  • Hamstring tendons
  • Adductor tendons
  • Gluteal tendons

What other injuries can be treated with PRP?

  • Knee MCL tears
  • Knee osteoarthritis (9,10, 12-14)
  • Hip Osteoarthritis (11)
  • Acromioclavicular Injuries
How is PRP different?


PRP can potentially accelerate  healing and reduce injury time.

PRP with its concentration of growth factors stimulates the healing process (8).

 PRP focuses on restoring normal tissue composition while avoiding further degeneration.


References

  1. Sampson S, Gerhardt M, Mandelbaum B. Platelet rich plasma injection grafts for musculoskeletal injuries: a review. Curr Rev Musculoskelet Med. 2008 Dec;1(3-4):165-74.
  2. Antitua E, Andia I, Sanchez M, Azofra J, Del Mar Zalduendo M, De La Fuente M, et al. Autologous preparations rich in growth factors promote proliferation and induce VEGF and HGF productions by human tendon cells in culture. J Orthop Res. 2005;23:281–6.
  3. Fenwick SA, Hazlelman BL, Riley GP. The vasulature and its role in the damaged and healing tendon. Arthritis Res. 2002;4: 252–60.
  4. Hayem G. Tenology: a new frontier. Joint, Bone, Spine. Rev Rhum. 2001;68:19–25.
  5. Mishra A, Pavelko T. Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. Am J Sports Med. 2006;10(10):1–5.
  6. Jobe F, Ciccotti M. Lateral and medial epicondylitis of the elbow. J Am Acad Orthop Surg. 1994;2:1–8.
  7. Edwards SG, Calandruccio JH. Autologous blood injections for refractory lateral epicondylitis. Am J Hand Surg. 2003;28(2): 272–8.
  8. Sánchez M, Anitua E, Orive G, Mujika I, Andia I. Platelet-rich therapies in the treatment of orthopaedic sport injuries. Sports Med. 2009;39(5):345-54.
  9. Filardo G, Kon E, Pereira Ruiz MT, Vaccaro F, Guitaldi R, Di Martino A, Cenacchi A, Fornasari PM, Marcacci M. Platelet-rich plasma intra-articular injections for cartilage degeneration and osteoarthritis: single- versus double-spinning approach. Knee Surg Sports Traumatol Arthrosc. 2011 Dec 28.
  10. Kon E, Mandelbaum B, Buda R, Filardo G, Delcogliano M, Timoncini A, Fornasari PM, Giannini S, Marcacci M. Arthroscopy. Platelet-rich plasma intra-articular injection versus hyaluronic acid viscosupplementation as treatments for cartilage pathology: from early degeneration to osteoarthritis. 2011 Nov;27(11):1490-501.
  11. Sánchez M, Guadilla J, Fiz N, Andia I. Ultrasound-guided platelet-rich plasma injections for the treatment of osteoarthritis of the hip. Rheumatology (Oxford). 2012 Jan;51(1):144-50.
  12. Filardo G, Kon E, Buda R, Timoncini A, Di Martino A, Cenacchi A, Fornasari PM, Giannini S, Marcacci M. Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2011 Apr;19(4):528-35.
  13. Wang-Saegusa A, Cugat R, Ares O, Seijas R, Cuscó X, Garcia-Balletbó M. Infiltration of plasma rich in growth factors for osteoarthritis of the knee short-term effects on function and quality of life. Arch Orthop Trauma Surg. 2011 Mar;131(3):311-7.
  14. Kon E, Buda R, Filardo G, Di Martino A, Timoncini A, Cenacchi A, Fornasari PM, Giannini S, Marcacci M. Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc. 2010 Apr;18(4):472-9.

Platelet Rich Plasma (PRP) Injections : The Procedure

Ultrasound Guided is used to image the site of injury .There is no exposure to ionising radiation. It is the same technology used in pregnancy imaging.

Platelet Rich Plasma (PRP) Injections : Safety


This section address potential adverse effects and contraindications to platelet rich plasma (PRP) injections. The 2011 World Anti-Doping Code (WADA) has deemed all musculoskeletal PRP injections to be considered legal with no notification required. However, if you are an athlete and in a registered testing pool, always confirm with your practitioner the latest WADA regulations as they may have changed.

Side Effects

Platelet rich plasma (PRP) is prepared from autologous or the patient’s own blood so there is no risk of developing a growth of tumour or cancer (1). Adverse effects are rare but as with any injection there is always the small risk of infection or injury to nerves or blood vessels. Scar tissue formation and calcification at the injection site are also possible (2).

Is it painful?
It is usual that you may feel some pain during and following the injection. Our doctors prefer that you use paracetamol (e.g. Panadol) for pain relief.
If you experience persisting severe pain or an adverse reaction following the injection, please contact us.

References
1. Everts P, Knape J, Weirich G, Schonberger J, Hoffman J, Overdevest E, et al. Platelet-rich plasma and platelet gel: a review. JECT. 2006;38:174–87.
2. Sampson S, Gerhardt M, Mandelbaum B. Platelet rich plasma injection grafts for musculoskeletal injuries: a review. Curr Rev Musculoskelet Med. 2008 Dec;1(3-4):165-74.

When you should not have PRP

You should not have a PRP injection if you have the following (2):

  • Cancer or metastatic disease
  • An active infection
  • A low platelet count

You should also not have a PRP injection if you are pregnant or are breastfeeding. (2)


 

Medications to avoid before PRP

You should not have a PRP injection if you have used non-steroidal anti-inflammatory medications (NSAID’s) in the 7-10 days leading up to your appointment. If you are considering having this injection, please switch to another painkiller such as paracetamol or for other options, check with your local doctor or chemist.

WADA and PRP (Anti-Doping Requirements for Athletes)

The World Anti-Doping Authority (WADA) has deemed all musculoskeletal PRP injections for athletes legal to use with no notification required.(3)

Click here to view the official WADA 2011 statement on Platelet-Derived Preparations.

"Platelet-Derived Preparations
Platelet-derived preparations (commonly referred as PRP or blood spinning), prohibited in 2010 when administered by intra-muscular route, have been removed from the List for 2011 after consideration of the lack of current evidence concerning the use of these methods for purposes of performance enhancement. Current studies on platelet-derived preparations do not demonstrate a potential for performance enhancement beyond a potential therapeutic effect."

Before having an injection, always ask your doctor for the latest information on the WADA.

References
1. Everts P, Knape J, Weirich G, Schonberger J, Hoffman J, Overdevest E, et al. Platelet-rich plasma and platelet gel: a review. JECT. 2006;38:174–87.
2. Sampson S, Gerhardt M, Mandelbaum B. Platelet rich plasma injection grafts for musculoskeletal injuries: a review. Curr Rev Musculoskelet Med. 2008 Dec;1(3-4):165-74.
3. World Anti-Doping Agency [online]. Available from URL: http://www.wada-ama.org/en/Resources/Q-and-A/2011-Prohibited-List/ [Accessed July 21, 2011]

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