Platelet-rich plasma

PRP is a component of your blood (plasma) with concentrations of platelets above normal
values. PRP typically contains 3-8 times the concentration of normal platelet levels. After injury, platelets are on the front line of the healing response and play a critical role by releasing growth factors. These growth factors influence tissue repair in a variety of different cell types including tendon, muscle and cartilage cells. PRP was first used in dental and oral surgery to
improve soft tissue healing in the 1990s. Its usage in the treatment of musculoskeletal injuries
and sports medicine has increased over the past decade.

PRP preparation

PRP is prepared by centrifuging your whole blood sample. The centrifugation separates the platelet rich plasma from platelet poor plasma and red blood cells because of differences in specific gravity.

PRP administration
The PRP is injected into the tissue or joint that is determined to be the pain generator. All
injections are performed under musculoskeletal ultrasound or fluoroscopic (X-rays) guidance.
This ensures accurate placement of the PRP.

Risks of PRP?
Since PRP originates from a concentrate of your own blood, safety concerns are minimal. As
with any injection, sterile technique is performed to avoid infection.
Conditions commonly treated with PRP therapy
Chronic tendinopathies

Lateral epicondylitis

Medial epicondylitis

Rotator cuff tendinosis

Partial thickness rotator cuff tears

Greater Trochanteric bursitis

Patellar tendonitis

Retrocalcaneal bursitis

Plantar fasciitis
Chronic pain from osteoarthritis

Knee arthritis

Shoulder arthritis

Acromio-clavicular arthritis

Hip arthritis

Spine -Intradiscal -Sacroiliac joint -Facet joints

Good candidate for a PRP injection

These guidelines also apply to other regions of the body and are not specific to tendinopathy.

  1. Pain duration of at least 3-6 months or longer
  2. Symptoms and physical examination results consistent with tendinopathy
  3. Persistent pain despite standard nonoperative treatment (physical therapy, NSAIDs, activity modification)
  4. Pathological changes seen on diagnostic imaging: MRI and/or ultrasound
  5. Patient wishes to pursue alternative to surgical treatment 6. No contraindications to the procedure exist
    Relative contraindications include patients with a history of:
    -thrombocytopenia (low platelet counts)
    -anticoagulant therapy (coumadin, plavix, etc..)
    -active infection
    -tumor, metastatic disease
    -pregnancy

Before and after the injection

We advise patients to stop NSAIDs and aspirin for at least 10 days before the procedure and and preferably 3-6 weeks after a procedure. NSAIDs inhibit the prostaglandins and may reduce the beneficial effects stimulated by the release of growth factors from the injected platelets.