Platelet Rich Plasma (PRP) Therapy

Knee

• Osteoarthritis [10] [14]
• Patellar tendinosis [32]

Shoulder

• Osteoarthritis [15]
• Ligament sprains and tears [16]
• Tendonitis and tendinosis [18]
• Acromioclavicular joint dysfunction and pain [16]

Foot & Ankle

• Osteoarthritis [10]
• Achilles tendonitis and tendinosis [19]
• Plantar fasciitis [31]
• Ligament sprains and tears [24]

Elbow, Hand & Wrist

• Osteoarthritis [25]
• Epicondylitis (tennis and golfer’s elbow) [21] [22]
• Tendonitis and tendinosis [18]

Spine / Back

• Degenerative Disc Disease [17]
• Facet joint osteoarthritis [23]
• Sacroiliac Joint Dysfunction [29]

Hip

• Osteoarthritis [26] [28]
• Acute Hamstring Injuries [34]
• Proximal Hamstring Tendinopathy [33]
• Labral tear [20]
• Trochanteric bursitis [26] [27] [30]

Pre-procedural restrictions are necessary to ensure good quality PRP with high platelet integrity. Please let your provider know what medications and supplements you are currently taking so that they may advise you appropriately.

1. Stop NSAIDs 1 week pre-procedure (2 weeks is most optimal
2. Ideally, stop any blood thinners 3-5 days pre-procedure. Consult with your prescribing provider to ensure that this can be done safely.
3. Stop any anti-inflammatory supplements 1 week prior to procedure (eg. Vitamin E, turmeric, curcumin, fish oil, ginseng, gingko, ginger, garlic extract, etc.)
4. Arrive early to your appointment and make sure that you are well-hydrated.

PRP therapy is usually done in-office and takes 30 minutes to an hour, from pre-procedural prep to bandaging injection sites. After identifying the tailored PRP solution needed to treat your pain, blood is drawn from your arm and run through a centrifuge which separates the blood into its components. Plasma, which contains the beneficial platelets, is collected and further refined, concentrating these vital platelets and healing molecules. Once this is done, the site of treatment will be prepared for injection. A local anesthetic may be injected into the treatment area, helping to minimize any discomfort. The final, personalized PRP solution is then injected into the affected area (joint space, disc or soft tissue such as tendons or ligaments). Ultrasound or fluoroscopic guidance is frequently used to ensure precise delivery of PRP. Our clinical team will walk you through each step of your procedure, providing you with the information and guidance you need to maximize recovery.

Most patients report an increase in pain and some swelling immediately following the injection, lasting up to several days. This is normal and results from the body’s natural inflammatory response flooding the region with healing factors. Please notify your physician if this increased pain does not resolve itself within three days.

Immediately after the procedure, it is recommended that you not soak your body in water for 24 hours (ie. baths, hot tubs) to mitigate risk of infection at the injection site. Showering is fine. It is also recommended that you abstain from anything that will inhibit the natural inflammatory response triggered by the PRP treatment (ie. nonsteroidal anti-inflammatory drug (NSAIDs). For pain relief, extra strength Tylenol is recommended. If stronger medication is requested, a short course of opioids (or non-NSAID pain relievers) may be prescribed. Ice is not recommended as it causes vasoconstriction and reduces inflammation. Heat is acceptable for pain relief.

Many patients resume their activities of daily living immediately after the procedure. Your provider will discuss specific limitations and rehabilitation protocols with you before leaving the office.

At about 2 weeks post-procedure, most patients will experience some relief from pre-injection pain levels. The greatest benefit is typically reported at 4-6 weeks post-injection and can occur up to 6-9 months after. To maximize recovery, we strongly suggest that you adhere to the guidelines recommended by your treating physician. This may include short-term non-weightbearing protocols, reduced activity, formal physical therapy, and at-home exercises.

Your treatment plan is created based upon the severity and duration of the injury or degeneration. Usually, one treatment with PRP is sufficient for returning to desired activities after 6-8 weeks of rehabilitation and at-home exercises. However, more severe conditions may need ‘booster’ shots after four weeks [1]. Your provider will evaluate your situation and advise if you need repeat treatment after your first follow-up appointment.

There are complementary treatments to PRP, such as Bone Marrow Concentrate (BMC), Extracorporeal Shock Wave Therapy (ESWT), and hyaluronic acid that may help maximize your results.

Healing that occurs from PRP therapy is usually long-term. However, if the etiology of the injury is not addressed (such as flat feet leading to knee or hip pain), then repeated wear and tear will continue to degrade the joints and/or tendons. For this reason, a comprehensive approach which incorporates PRP therapy with structured physical therapy, and other adjunctive therapies may be recommended.

It is important to note that the results of PRP vary and depend on the quality of one’s own platelets. Every patient’s level of health and chemistry are different, hence their platelets are somewhat different as well. Our team will develop a treatment and care plan personalized to your needs, ensuring the best possible outcome.

No, PRP comes from your own body and is used immediately. Therefore, there is no risk of rejection and very low risk of infection (the same risk as any other injection). In addition, the aspiration is done under sterile conditions to mitigate any contamination with pathogens and the injection is done using aseptic technique.

This depends on what type of procedure is done. Microfracture surgery is a common surgical procedure done to restore the cartilage surface in your knee. If your doctor performs this procedure on you, there are numerous scientific articles that show a far more robust patient outcome when augmented with PRP. [11]

Numerous clinical studies have confirmed that PRP provides significant healing and long-lasting pain reduction for a variety of injuries. [3]

• Several recent studies and reviews have demonstrated PRP to be more effective than corticosteroids or hyaluronic acid, the current, standard treatments for knee osteoarthritis. [4] [5]
• A study in the American Journal of Sports Medicine revealed that patients with elbow tendinosis receiving PRP reported a 46% reduction in pain by week four, and an 81% reduction in pain after six months. At the study’s conclusion, 93% of patients were completely satisfied with their PRP treatment and had avoided s [1]
• MRI imaging across numerous studies has also confirmed significant improvements in pain relief. Studies show that over 70% of patients receiving PRP for knee osteoarthritis have delayed further progression of the disease and prevented further knee degeneration. [6] PRP may, in some cases, eliminate the need for more aggressive treatments such as long-term medication or surgery.

The characteristics of PRP composition is critical to final outcomes. Commercially available PRP processing kits vary in white blood cell count, red blood cell count, platelet yield and integrity, and the total volume of product produced. Variances in these categories will result in altered healing and efficacy. [7] [8]

We offer the highest standards and quality in PRP therapy available today. As a group we use only the most advanced scientifically proven PRP system available, which includes:

1. A therapeutic dose of over 1 billion platelets per mL of PRP. [9]
2. A high dose of growth factors released at the site of injury. [9]
3. A high platelet yield which recovers over 80% of platelets present in your blood [2].
4. The purest form of PRP available, removing red blood cells and neutrophils prior to the procedure, thereby reducing inflammation and a host of negative effects. [2]

The cost of a PRP treatment varies based on the procedure performed. Our office staff can assist you with payment options and any other questions you may have.

Although PRP in musculoskeletal applications is well-supported by clinical studies, the broader use of PRP therapy in treating pain is still considered relatively new at this time, PRP is not typically covered by commercial insurance companies and Medicare, and is provided as a cash-pay procedure.

PRP can be highly effective in substantially reducing pain in patients with even advanced arthritis. [10] Often, patients are able to delay total knee replacement for years with PRP therapy.