Platelet-rich Plasma (PRP)
Platelet-rich plasma (PRP) is an emerging treatment in a new health sector known as "Orthobiologics." The philosophy behind Orthobiologics is to merge cutting edge technology with the body's natural ability to heal itself. PRP is a specialized process by which the growth factors from a patient's own blood are injected into the site of inflammation to stimulate the healing process to decrease pain.
Blood is made of red blood cells, white blood cells, plasma and platelets. Platelets were initially known to be responsible for blood clotting. In the last 20 years we have learned that when activated in the body, platelets release healing proteins called growth factors. Cumulatively, these growth factors accelerate tissue and wound healing. By increasing these platelets, we are able to deliver a powerful mixture of growth factors that can dramatically enhance tissue recovery.
PRP injections have been used extensively on professional athletes for a wide variety of injuries, and the early results are very exciting. Although more data is still needed, PRP may provide an alternative to surgery or to other types of injections.
First, a small amount of blood is drawn from a patient's vein. The blood is then placed in a centrifuge that spins the blood for approximately 15 minutes to remove the plasma, white and red blood cells, as these are not primarily responsible for healing. What remains is an increased concentration of platelets, rich in healing properties called growth factors. While this process is underway, the patient receives either local anesthetic (injected) or conscious sedation (via IV), as determined beforehand by the physician and patient. Using musculoskeletal ultrasound or other imaging techniques, the hip joint is identified and the injection is performed with ultrasound guidance to ensure that the injection goes into the joint.
After the injection, the patient rests for five to ten minutes and is discharged home with post procedure instructions. It is not uncommon to experience increased pain for approximately seven days following the injection, as this represents part of the healing process. Follow up is usually in four weeks. For osteoarthritis, a three injection series is required at four week intervals. Patients are encouraged to participate in physical therapy following the injection to enhance and speed recovery.
Who is a candidate?
PRP injections may be an appropriate choice for patients who have hip arthritis or have had a recent hip injury. The ideal candidates are adult patients (over the age of 18) who have long standing arthritis who have failed previous treatment or have the inability to tolerate oral anti-inflammatory medications due to medical problems or allergies. These candidates should have sufficient symptoms to be considering surgery or repeated injections. Because this treatment starts the growth of new, healthy tissue, a person who has digestion problems, chronic fatigue, irritable bladder, chronic nutritional, hormonal or allergic issues will need to have these problems corrected before the body will be able to respond to this type of treatment.