Platelet-Rich Plasma Injections (PRP)

Over the past decade, PRP or Platelet-Rich Plasma injections, have gained much popularity as a non-surgical alternative to the treatment of various injuries. This mainly stems from high-level athletes attributing PRP injections to getting them back to playing-shape quickly and without surgery. Most sports injuries have historically been treated with medications, physical therapy, and sometimes surgery. PRP provides an alternative modality to invasive surgical procedures. PRP also has the added benefit that it is made up of the recipient’s own blood, which greatly reduces negative reactions related to its application.

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PRP is mainly used to treat soft tissue related injuries, including chronic and acute tendonitis and acute ligament and muscle injuries. More recently, PRP has been advocated for use intraoperatively during elective and traumatic surgical repairs. This increases the osseous and soft tissue healing potential, thus reducing the healing time. PRP injections for the foot and ankle are traditionally performed in a sterile operating room setting under light sedation. Blood is drawn from the patient utilizing the specific strict aseptic technique. This blood is then placed into a centrifuge to separate the platelets from the rest of the blood content. The activated platelets are injected into the abnormal tissue and work by releasing growth factors that recruit and increase the proliferation of reparative cells.

Recovery following a PRP injection may include several days to several weeks of non-weight bearing and immobilization in a boot, followed by a transition to normal walking, along with progressive stretching and strengthening exercises in a formal physical therapy program.

The side effects of a PRP injection are very limited as the patient’s own blood is utilized for the injection. Because PRP is given in hopes of optimizing the initial acute inflammatory healing response, anti-inflammatory medications are usually stopped at the time of treatment. As PRP does contain endogenous growth factors, the WDA and USADA forbid PRP injections into muscle because of possible performance enhancement. However, no data suggest that injection of PRP leads to performance enhancement.

Studies suggest that PRP can improve the healing potential of bone and soft tissue, and should be considered an option in soft tissue and osseous injury, chronic tendonitis, and post-surgical treatment.