Platelet Rich Plasma

Platelet Rich Plasma (a.k.a. PRP) is a type of minimally invasive biologic therapy that is used commonly for the treatment of common musculoskeletal problems. These include acute and chronic tendon injuries, osteoarthritis, and acute ligament and muscle injuries. PRP is used at the site of an injury to accelerate the healing of the injured or poorly healed tissues, or decrease inflammation in the case of arthritis. PRP has been found to be successful at replacing unhealthy tissue and restoring function while allowing return to normal physical activities. Pain gradually subsides as the injured tissue restores itself. 1-3 injections may be required for full effect, and maximum benefit may be realized after weeks or months, but when successful, the effect can be lasting, without any further required treatment.

What Is PRP?

PRP is a product derived from your own blood by taking a sample of venous blood, placing it in a special tube, and spinning the blood in a centrifuge for a few minutes. This separates whole blood into its components including red blood cells, platelets, and plasma (the non-cellular fluid from blood). The middle layer contains highly concentrated platelets, the cells that normally promote blood clotting. These cells also contain a number of specialized chemicals called growth factors.  Multiple growth factors have been identified that facilitate healing, including fibroblast growth factor (FGF) and vascular endothelial growth factor (VEGF).  Other factors, such as Interleukin-4 (L-4) and IL-10 provide anti-inflammatory effects in the application of arthritis.  The basic idea behind PRP is to deliver high concentrations of growth factors to an area of injury, with hope of stimulating a healing response and reducing inflammation in the tissue.

Are any foreign or donor blood products or tissues used for PRP procedure?

No, no donor or foreign blood products or tissues are used.  PRP is derived 100% from a patient’s own blood, and contain the patient’s own growth factors.  Therefore, there are no concerns of cross-contamination or blood mismatch interactions, as may be the case with donor-recipient blood transfusions.

Are PRP injections covered by my health insurance?

In most circumstances, the answer is no.  This technology is relatively new and thus far not covered by insurance, and therefore payment is made directly to the provider.  Costs for PRP injections range from $299-399 per injection, varying on the body area.  This payment must be made in advance of the procedure.  In limited circumstances, some insurance companies are beginning to cover PRP under their plans.  Please contact your insurance provider for further detail. 

How many injections are required?

Some conditions, such as treatment of an acute muscle injury, may be treated with a single PRP injection, whereas PRP for knee arthritis is treated with a series of three consecutive weekly PRP injections.  Some conditions improve permanently after one round of PRP treatment, whereas some conditions, particularly arthritis, require periodic PRP injections over the long term to maintain results.  In recent studies, compared to hyaluronic acid (viscosupplementation, a.k.a. lubricant shots, gel shots, or rooster comb injections), PRP had better persistence of symptom relief at 6 and 12 months after treatment. 

I would like to proceed with PRP injections.  What next?

Pre-Procedure Planning: What to expect during the PRP procedure

You may use Acetaminophen (Tylenol) before or after the procedure. Please stop using anti-inflammatory medications (Motrin, Aleve, Ibuprofen, Advil) for 1 week before the procedure.

The following steps will occur when you arrive:

  • Check in at the front desk and sign your consent form
  • Our staff will draw 10ml of blood from an arm vein and place it into the centrifuge to concentrate the PRP
  • With sterile, aseptic technique, the PRP will be injected into the knee or other joint
  • You will be permitted to return home immediately after the procedure
  • The entire procedure typically takes anywhere from 30 to 45 minutes, similar to a typical office visit

What to Do (and Not to Do) After the Procedure

You may ice the area for 20 minutes every 2-3 hours for the first 24-48 hours after the procedure. About 1 in 10 patients experience a “flare” reaction beginning the day after the procedure, manifested by higher-than-usual pain. If this occurs, begin taking the prescribed pain medication. Do NOT take anti-inflammatory medications for two weeks as this counteracts what the PRP is trying to accomplish. While some redness and swelling are common after the procedure, if any progressive swelling, redness, drainage, or fever occurs, please notify our office and/or visit the Emergency Room.  Infection after this procedure is an extremely rare complication that may warrant antibiotic treatment.

Activity Level and Follow-Up

For the day of the procedure and the day after, limit the activity related to the injection site to activities of daily living. After the procedure returning to higher level activities (such as running, cycling, golf, weight training, etc) will be directed by your physician. Most patients resume regular activity within 48-72 hours. It is expected that it will take up to 6-8 weeks to adequately assess your response to the therapy. Please make a follow up appointment with your physician at that time point to assess your progress.

Knee Procedures