PLATELET-RICH PLASMA (PRP) THERAPY IN ORTHOPEDICS

It is a concentration of patient’s own blood component called platelets, used to accelerate the healing of injured tendons, ligaments, muscles and joints.

It is based on the principal of using patient’s own healing system to improve musculoskeletal problems and since no drugs are involved in this therapy- it is considered a form of biological(natural) treatment with no major adverse effects.

Preparation of PRP begins by taking the specific volume of own (autologous)blood from the patient, through a syringe containing an anticoagulant.

This sample is then spun (centrifugated) in a special machine into two component parts – the lower part containing red blood cells and an upper part consisting of plasma, in which the platelet layer will be isolated and injected into the patient’s knee under a sterile environment.

In accordance with the guidelines- blood collection, preparation and injection are carried out as a single continuous procedure with no blood products being frozen or stored.

In general 2 PRP injections spaced at 1month intervals is the preferred regimen which gives good outcomes, particularly for Aging Arthritis of the knee and other joints. For other minor problems like Tennis Elbow single-dose injection is usually sufficient in providing good pain relief.

PRP is considered Chondroprotective – which literally means it’s a form of cartilage protective treatment. It contains platelet cells which secrete growth factors that stimulate the proliferation of cartilage forming cells (chondrocytes + mesenchymal stem cells) thereby assisting in the synthesis of Type II collagen which is an important component of healthy joint cartilage. The end result is stronger tissue, reduced pain and improved function

PRP is effective in a variety of conditions listed below-

• Aging Arthritis of Knee joint (Osteoarthritis) – Mild and Moderate stages
• Aging Arthritis of Other joints (Osteoarthritis) – Ankle/Shoulder etc
• Sports Injuries – Shoulder rotator cuff tears, labral tears, tennis elbow, knee sprains, meniscal tears, ACL sprains, arthritic joints, plantar fasciitis and ankle sprains
• Spine – degenerative disc disease, sciatica
• Repetitive Stress injuries – Wrist pain due to tendonitis/tenosynovitis, Heel/elbow pain from bursitis

PRP is definitely effective in aging arthritis of knee. Apart from growth factors which stimulate synthesis of Type II collagen, it also causes suppression of inflammatory mediators such as IL-1 which results in reducing pain. It has excellent safety profile and assists in decreasing intake of painkillers in patient with long standing knee pain.

PRP injection is safe and effective in all age group patients although clinical studies have shown that it is more effective in Early and intermediate stages of Arthritis with no major associated Varus/valgus alignment deformities as compared to advanced or end stage Arthritis with associated deformities.

• Younger age groups(< 60yrs) do relatively better when compared to Elderly
• Lower BMI(25-30) patients have better results when compared to Higher BMI(>35)
• Patients with No or mild leg alignment deformities tend to do better than those with major deformities who generally need additional bone re-allignment surgery

• Multiple dose PRP injection is particularly indicated and used in treatment of Aging Arthritis of knee and other joints. For other minor problems like Tennis Elbow single dose injection is usually sufficient in providing good pain relief.