Platelet Rich Plasma Therapy (PRPT)

What is PRPT? New treatment gaining popularity in the Sports Medicine field of rehabilitation used for orthopedic injuries Patient’s own blood is drawn and then re- injected into the area needing treatment Platelet rich plasma is believed to significantly enhance the healing process of an injury

What is platelet rich plasma? Concentrate extract of platelets of patient’s own blood Step by step process 1. Patient’s blood is drawn 2. Blood is centrifuged once 3. 2 separate levels appear 4. Blood is centrifuged again 5. 3 levels in the blood appear, on of them being platelet rich plasma Higher concentration of platelets in the blood after centrifuge Plasma is taken from centrifuge and re-injected into area of injury

How does it work? Platelets contain growth & healing factors Platelets help stimulate and accelerate the immune system which initiates tissue regeneration of ligaments and tendons Promotes angiogenesis Stimulates growth of new healthy cartilage

Who is it for? Tendinopathy Torn ligaments Research has been done on treatment of the elbow or knee Torn ligaments Research has shown improved results for the UCL at the elbow Beneficial treatment for osteoarthritis of the knee Hip arthritis Tendinitis At the hip/ rotator cuff/ achilles tendon Greater trochanter bursitis

What are the results? Effective at relieving pain Hastens the healing process Proof of tissue repair has been seen through ultrasound and MRI In both ligaments and tendons Decreases need for surgery

Common Side Effects Localized swelling Pain Risk of hematoma Infection Scarring

Contraindications Cancer Pregnancy Active infection Patient on anti-coagulants

Complications More research needs to be done A controlled clinical study needs to be completed Insurance companies are not yet covering PRPT No standard protocol for how much PRPT or how often treatment should be Treatment will vary from patient to patient

How does it effect PT? PT should follow PRPT injection Patient should not do physical activity for 1 week after injection Start patient on progressive strength program Typically lasting 8 weeks Specific exercise programs will vary depending on the patient’s affected area

References Park Y, Han S, Song S, Kim T, Ha C. Platelet-rich plasma therapy for knee joint problems: review of the literature, current practice and legal perspectives in Korea. Knee Surgery & Related Research [serial online]. June 2012;24(2):70-78. Available from: MEDLINE, Ipswich, MA. Accessed October 10, 2012. Podd D. Platelet-rich plasma therapy: origins and applications investigated. JAAPA: Official Journal Of The American Academy Of Physician Assistants [serial online]. June 2012;25(6):44-49. Available from: MEDLINE, Ipswich, MA. Accessed October 10, 2012. Araki J, Jona M, Yoshimura K, et al. Optimized preparation method of platelet-concentrated plasma and noncoagulating platelet- derived factor concentrates: maximization of platelet concentration and removal of fibrinogen. Tissue Engineering. Part C, Methods [serial online]. March 2012;18(3):176-185. Available from: MEDLINE, Ipswich, MA. Accessed October 11, 2012. http://www.treatingpain.com/diagnosis-and-treatments/platelet-rich-plasma.htm http://www.kevinmd.com/blog/2012/09/prp-work-knee-injuries.html http://www.jointrehab.com/hip_pain_prp_therapy_los_angeles.htm http://www.dierenartshoegaerts.be/nl/therapie/injecties/documents/prpguide.pdf http://ptsportswellness.wordpress.com/2012/01/14/platelet-rich-plasma-prp-injection-therapy-a-musculoskeletal-panacea/