What is PRP?
PRP stands for Platelet Rich Plasma. It is an advanced therapy that applies a patient’s own natural healing mechanisms from platelets to heal injured tendons and ligaments supporting the joints. Joints become painful and non-healing when the body’s natural healing mechanism gets short circuited, whether with repetitive injury, poor nutrition, or use of anti-inflammatories. PRP can accelerate the ongoing but slowed healing in acute injuries or restart stalled healing in chronic injuries.
How does PRP work?
When a joint is injured, the ligaments and tendons are stretched. The first cells to start the healing process are the platelets. They move into the damaged tissue and start to plug the bleeding at the tears. They then release growth factors which start the healing cascade. These growth factors call in new cells and cause new blood vessels to form in the tendons and ligaments. Eventually, stem cells remodel the tissues and lay down new collagen and fibroblasts. When patients have chronic injuries, somewhere this healing process got short circuited. Dr. Brooks injects the PRP into the injured ligaments and tendons which restarts the healing process at the sites that need it.
How does this compare to cortisone (steroid) injections?
Overuse or damage to the tendon over a long period causes the collagen fibers in the tendon to form small tears, a condition called tendinosis. This is different from tendonitis. Tendonitis is due to an inflamed tendon, usually over a short period of time. Steroid injections have an anti-inflammatory effect and typically make tendonitis better. In tendinosis, there are no microscopic signs of inflammation and steroid injections typically do not resolve symptoms. PRP helps heal those tendons or ligaments that have not responded well to steroid injections.
Which joints can be treated?
PRP is mainly used for chronic tendon or ligament injuries, but acute injuries can be treated. Dr. Brooks typically treats plantar fascia, ankles, Achilles tendons, knees, hamstring tendons, wrists, elbows, and shoulders.
Where is the procedure done?
In our office at North Cypress Medical Center.
How much time does the procedure take?
The PRP process takes about 30-45 minutes in the office. It starts with drawing some blood from the patient. It is then placed in a special separator cup which goes into a tabletop centrifuge and is spun for 15 minutes. During that 15 minutes, the ligaments and tendons of the joint are anesthetized with local anesthetic. After 15 minutes, the PRP has been separated and concentrated by the centrifuge. It is then injected into the joint to be treated under musculoskeletal ultrasound guidance.
How many treatments are required?
Typically requires an average of 1-2 injections per affected area.
When can I return to regular activity?
It varies depending on the area injected, but typically it entails 1-2 weeks of light activity immediately after injection. After that, you start physical therapy and are back to regular or heavy activity within 1-2 weeks or longer.
What should I do before the procedure?
Patients scheduled for PRP therapy are restricted from the use of non-steroid anti-inflammatory medications (NSAIDs), one week prior to the procedure and throughout the course of treatments. Initially the procedure may cause some localized soreness and discomfort at the injection site. Most patients only require some extra-strength Tylenol to help with the pain. Ice and heat may be applied to the area as needed.
Who is using PRP?
Professional athletes, collegiate athletes, high school athletes, recreational athletes, and non-athletes. Ages from high school to senior citizens.
Is it right for me?
If you have a tendon or ligament injury and traditional methods have not provided lasting relief, then PRP therapy may be the solution. The procedure is less aggressive and less expensive than surgery. It will heal tissue with minimal or no scarring and alleviates further degeneration of the tissues. At the conclusion of your initial evaluation with Dr. Brooks, he will discuss your treatment options, including if PRP therapy is right for you.