PRP: helpful or hype?

PRP injections have been questioned by recent studies, but some doctors and patients still believe this treatment is the potential cure for challenging diagnoses. Let’s talk clearly about PRP.

di Liana Zorzi

Platelet rich plasma (PRP) – also referred to as platelet-rich in growth factors, platelet-rich fibrin matrix, platelet-rich fibrin, fibrin sealant, platelet concentrate – is a new treatment used for some common orthopedic conditions. In broad terms, PRP may be defined as a volume of the plasma fraction of autologous blood (our blood) having a platelet concentration above baseline, and is therefore a concentrated source of autologous platelets.
Platelets contain a number of growth factors (GF) that play an important role in the healing of injured tissue: they signal the body to initiate a healing response.
PRP is prepared from a volume of our blood using extracorporeal blood processing techniques such as blood cell savers/ separators, table-top devices (centrifuges) and filtration methods. This volume may contain variable concentrations of cells depending on the specific preparation technique that is used.

Platelet-rich plasma (PRP) is now being widely used to treat musculoskeletal injuries in sports. The use of PRP in many fields of medical practice has recently expanded rapidly, in particular in athletes with sporting injuries, especially in elite athletes where there is a relative urgency to facilitate a rapid return to competition. Chronic painful tendon disorders are common invalidating conditions in athletes, who can also suffer from acute and chronic, partial and complete, tendon tears. Tendinopathy is characterized by swelling, pain and inability to perform at full capacity. PRP is one treatment that is a considered option for the management of chronic tendon injuries in athletes, with a positive effect of PRP on tendon healing having been established in several animal studies.

Injections are a common treatment for tendon problems. Different types of injections including cortisone and PRP injections are commonly used to treat tendon conditions. Cortisone is a powerful anti-inflammatory medication often used to treat acute inflammation (tendonitis) or chronic tendon problems (tendinosis). Cortisone is not a pain-relieving medication, it only treats the inflammation. When pain is decreased from cortisone it is because the inflammation has diminished. By injecting the cortisone into a particular area of inflammation, very high concentrations of the medication can be given while keeping potential side-effects to a minimum.
PRP injections are the latest treatments available for overuse injuries. Used to treat tennis elbow, patellar tendonitis, Achilles pain, and other orthopedic conditions, PRS is a recent development that uses our own cells to stimulate healing in areas of chronic tendon damage. By injecting PRP into areas of an injury, the hope is to stimulate and optimize your body’s ability to heal the chronic conditions (as well as our platelets usually do).
In most instances, the rate of success using anti-inflammatory agents, defined as an improvement of symptoms and return to sport, is in the region of 65%, and the time to return to sport ranges from several weeks to several months.
In conclusion, reporting what the last scientific work published on British Medical Journal on November 24, 2010 on PRP clinical international studies shows, “while current evidence suggests the use of PRP is safe and helpful, and therefore the non-maleficence (do not harm the patient) principal is probably upheld; however, there are few studies that document adverse or serious adverse events, and there are no studies at all looking at long-term effects. As there is no wide scientific evidence that PRP injections are of clinical benefit, beneficence (doing good to the patient) is at this time not proven at all.”

With respect to PRP, which is widely perceived as a natural healing method, its increasing popularity appears to have jumped a little time ahead of clinical evidence. This is the opinion of 22 researchers from 13 different countries in the world in a very important document called ‘Consensus paper on the use of platelet-rich plasma in sports medicine’.


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