PRP Injection Therapy
In one study published in the American Journal of Sports Medicine, at two years after the PRP injection, more than 90% of patients demonstrated a reduction in pain. Most were better within the first six months. When applied to hard to heal wounds (diabetic ulcers, venous stasis ulcers etc.) in several clinical studies, the wound has healed in 8-12 weeks. Most recently, PRP is being used in Regenerative Injection Therapy where PRP is purcutaneously injected into joints and soft tissue to treat plantar fasciitis, tendonitis, muscle tears, partial ligament sprains/tears, lateral epicondylitis, Achilles tendonitis etc. It is no surprise that clinicians consider the use of PRP Injection Therapy to be an alternative minimally invasive approach in providing a scaffold for promoting the healing cascade to their patients.
PRP Injection Therapy-Hines Ward
Despite two weeks of intensive physical therapy, Hines Ward got on the field for last Sunday’s Super Bowl probably because of a platelet rich plasma (PRP) injection. Ward suffered a sprained medial collateral ligament of his right knee during the AFC Championship Game. These injuries can often take weeks to heal, but Hines wasn’t about to let it affect his ability to play. For this reason, the Steelers’ medical staff pulled out all of the stops, including the use of a new treatment for tendon and ligament injuries.
According to Brian Halpern, MD, a sports-medicine specialist at The Hospital for Special Surgery, “Tendon and ligament healing relies on adequate blood supply and cellular migration. Platelet-derived growth factors are critically involved in this process.”
Platelet rich plasma (PRP) injections help the body regenerate and heal by harnessing these growth factors. To obtain the PRP, a small amount of a patient’s own blood is drawn. The blood is then spun down in a centrifuge for a few minutes, which isolates the PRP Injection with growth factors. The PRP isolate is then injected back into the injured area. The goal is to enhance the healing environment by concentrating the essential components of repair from the patient’s own blood, thus limiting side effects and facilitating healing.
Hines Ward isn’t the only professional athlete to reap the benefits of PRP Injection Therapy. Takashi Saito, the closer for the L.A. Dodgers, was able to pitch in the playoffs thanks to a PRP injection into his right elbow’s ulnar collateral ligament, which saved him from Tommy John surgery.
What’s most exciting is that these injections aren’t just reserved for professional athletes. Tendinitis affects just about everyone sometime in their life. Whether it’s the rotator cuff, patellar tendon, or tennis elbow, tendinitis is usually the result of overuse of the affected tendon. Usually the condition is temporary and can be easily relieved with rest, ice, and the use of inflammatory medicines (such as Ibuprofen). Sometimes physical therapy and/or cortisone injections are necessary. That being said, there are times when the pain persists. According to Halpern, “It can seem crippling to the sufferer, and when the pain and dysfunction reach that point, a high-tech answer in the form of PRP is available for suitable patients.”
PRP Injection Therapy will become a routine part of the treatment algorithm for tendinitis. “In patients who fail to respond to anti-inflammatory medications and physical therapy, an injection of PRP may save patients a trip to the operating room,” adds Dr. Halpern. “The future looks very promising as we attempt to concentrate these biologically active growth factors at the bedside to help patients in pain. Allowing the body to heal itself is not just logical. …It is very effective.”
What Is PRP Injection Therapy
Platelet Rich Plasma (PRP) has the ability to deliver a cocktail of bioactive growth proteins. Growth proteins shown to enhance the body’s natural healing process found in PRP include:
Platelet Derived Growth Factors (PDGF) initiate connective tissue healing including bone regeneration and repair. PDGF also increases mitogenesis (healing cells), angiogenesis (new blood vessel growth), and macrophage activation (debridement of the wound site and second phase source of growth factors).
Transforming Growth Factor Beta (TGF-ß ) increases the chemotaxis and mitogenesis of osteoblast (bone) precursors and they also stimulate osteoblast deposition of the collagen matrix of wound healing and bone regeneration.
Epidermal Growth Factors (EGF) induce epithelial development and promote angiogenesis (new blood vessel growth).
Vascular Endothelial Growth Factors (VEGF) have potent angiogenic, mitogenic, and vascular permeability-enhancing activities specific for endothelial cells.
Fibronectin and Vitronectin are proteins called cell adhesion molecules. As part of cellular proliferation and migration, cells move to new positions to lay down their products, such as tissue, bone or cartilage (called osteoconduction when describing bone healing). Fibronectin and vitronectin seem to be able to provide a foothold or grip for cells as they move.
Fibrin is a cross linked protein derived from the fibrinogen in plasma. Like fibronectin and vitronectin, it contributes to cell movement in the wound. When fibrin crosslinking occurs as part of the clotting process in a wound, it traps platelets, white cells and red cells and provides a scaffold or surface for cell movement. This results in a random distribution of platelets and the growth factors they contain throughout the wound.