Platelet Rich Plasma Therapy: A cutting edge alternative to surgery for musculoskeletal problems

HARNESSING YOUR BODY’S NATURAL HEALING POWER
The body has an amazing capacity to heal itself. When the body becomes injured, a natural healing process occurs to repair the damaged tissue. The body signals platelets and other components in our blood supply to migrate to the site of injury. Under normal conditions, these platelets release a variety of factors that initiate and subsequently promote healing. New advances in medicine have been developed to harness and concentrate these platelets to be precisely introduced to the injury site in an injectable form. The implantation of these platelets from a small amount of the patient’s own blood has the potential to “supercharge” the body’s capacity for healing.

WHERE IS PLATELET-RICH PLASMA BEING EVALUATED?
Many active patients are familiar with repetitive or overuse injuries that can cause micro tears of the muscle and/or tendon fibers, resulting in weakness and pain at the injury site. This is commonly referred to as tendonitis, which is an acute inflammatory condition, or tendinosis which is a chronic degenerative condition. Both conditions can be categorized as tendinopathy and can affect the normal healing process of the damaged tissue which can lead to pain and dysfunction. Recent studies have evaluated the use of Platelet-Rich Plasma (PRP) to address these conditions. A double blind, randomized controlled trial evaluated the use of PRP for chronic lateral epicondylitis (tennis elbow) which resulted in reduced pain and increased function, exceeding the effect of the group treated with a corticosteroid injection.1 Another study evaluated the use of a single PRP injection in patients with painful medial or lateral epicondylitis for at least 6 months that were unresponsive to other nonsurgical (conservative) treatments, including a corticosteroid injection.
The results suggest that a single PRP injection can improve pain and function in patients who failed other types of nonsurgical treatment, thus avoiding surgery.2 Other studies have evaluated the use of PRP for chronic Achilles tendinopathy, chronic Plantar Fasciitis and Patellar tendinosis also known as Jumper’s knee.3, 4, 5 It’s important to speak with your treating physician to learn more about the studies that have been published evaluating the use of PRP for tendinapothies.

PROCESS FOR RECOVERING PLATELET-RICH PLASMA
A very small amount of blood is drawn from the patient into a sterile tube in the exact same manner as a standard blood sample. The tube containing a patient’s blood is placed into a centrifuge and spun to separate the platelets from the other blood components. After a few minutes, the concentrated platelets are removed from the same tube and re-introduced into the patient at the site of the injury. Using a sterile needle, your physician will inject the PRP in and around the injury site. This is all accomplished without using any animal products or other foreign material.

NON-SURGICAL TREATMENT APPROACHES TO UNRESPONSIVE INJURIES
Patients who are interested in exploring non-surgical treatment options before resorting to surgery may want to consider PRP. Traditional non-surgical interventions include: Corticosteroid (“cortisone”) injections, oral anti-inflammatory medications, exercise and bracing. In many cases these modalities may not cure the condition, whereupon PRP may potentially be of great benefit.1 Before you can be considered a candidate for PRP, a complete examination must be performed by your treating physician. This will include a physical examination and diagnostic evaluation. Prior to treatment, you may be asked to refrain from taking non-steroidal antiinflammatory drugs (NSAIDS) for a week. Following the PRP treatment, some localized soreness may occur, which is typical of any injection. This can be addressed with ice, heat, or elevation as well as with
acetaminophen. Physical therapy may be prescribed.

IS PLATELET RICH PLASMA THERAPY SAFE?
For over twenty years, PRP has been used in many different fields of medicine including: cardiac surgery, oral surgery, dentistry and periodontal implants, orthopaedics, wound care, sports medicine, neurosurgery, general surgery and cosmetics.1 Research and clinical data show PRP derived from the patient’s own blood is safe, with minimal risk of adverse reactions or complications.2,3 Because the platelets are produced from your own blood, there is no risk of rejection or disease transmission. As with any injection into the body, there is a small risk of infection, however it is very rare.

WHEN WILL I START TO FEEL RESULTS?
In two different studies evaluating the use of PRP for the treatment of epicondylitis (tennis elbow) both showed a gradual improvement at one month, three months and six months. These studies along with other studies treating different conditions suggest a reduction in pain and improvement in function. However, the results may vary depending on the patient and the severity of the condition. If you do not feel any improvement at your follow-up visit, additional injections may be necessary. It is important to exercise with restraint and to have routine follow-up examinations with your doctor before resuming normal physical activities. Discuss all your options with your treating physician to determine whether PRP is right for you.

WHO IS PROVIDING PRP THERAPY IN THIS COMMUNITY

PRP therapy is provided by David Goltra MD at Carolina Imaging Specialists in Mt. Pleasant South Carolina.  Dr Goltra is a Radiologist with extensive interventional radiologic training and experience.  In this community only Dr Goltra is utilizing ultrasound guidance for PRP injections.  Ultrasound is a completely safe and very powerful imaging modality which allows Dr Goltra to visualize the area of injury or degeneration and actually visualize the PRP as it is injected into the affected area

1. Peerbooms JC, Sluimer J, et al. Am J of Sports Med. 2010; 38:225.
2. Hecthman K, Uribe J, et al. Orthopedics. 2011; 34:2
3. De Vos RJ, Weir A, et al. JAMA. 2010; 303(2):144-149.
4. Barrett S, Erredge S, Podiatry Today. 2004; 17:36-42.
5. Kon E, Filardo G, et al. Injury. 2009; 598-603.