Our clinic offers platelet rich plasma injections (PRP) performed by specialist practitioners.
Platelet rich plasma is a blood product, drawn from your body, which has a high concentration of platelets that release various growth factors.[1–3]
These growth factors are thought to have a beneficial effect in tissue healing, and more recently the white blood cells have been thought to provide both anti-inflammatory and ant-infective effects.[4-6] Sports Physicians use PRP as an adjunctive tool to rehab.
Currently there are only a few studies of adequate quality that show that PRP is effective for early knee osteoarthritis[8-10], however there is more evidence than for arthroscopic surgery of the knee.[11–13] Studies comparing it to other injections for arthritis of the knee have showed it is superior.[13–16] At this stage there are no predictors of who will respond to each of these injections, and the sensible approach seems to be to use them judiciously to facilitate realistic functional goals. Compared to Cortisone injections, PRP injections don’t seem to delay recovery or increase recurrence of tendon disorders including plantar fasciitis, tennis elbow, rotator cuff problems and jumpers knee.[17–27]
PRP Injections can be used for joints, ligaments, tendons and muscles.
PRP has potential benefits for the right problem in the right patient. It is only one part of the whole management regime for any problem. Despite all the research, overall the current evidence-base for PRP is at high risk of bias.[11,31,32] However, it is very safe and a temporary post-injection flare of symptoms is the most likely adverse effect.[4,33]
Other specific problems that PRP appears to be effective for include:
The out of pocket cost is quite significant because Medicare specifically exclude any rebate when PRP is performed. It ranges from $300-$900 each, and overall costs depend on the type of PRP used and the number of injections recommended. Sports physicians usually provide the service within the context of understanding the overall problem. When combined with optimisation of diet and exercise, patients are much more likely to experience benefit.
The main risks are considered the same as any other injection. There is an estimated 1 in 20,000 chance of infection or significant bleeding. These risks are minimised through the use of a sterile technique and an ultrasound to guide the safest course for the needle. About 5% of patients experience a flare of the pain can last 24-48 hours but this is very manageable with analgesia and rest.
The whole process takes between 20-30 minutes. First, about 10-15mL of your blood is drawn from your arm. Then that blood is centrifuged for 10 minutes. The PRP is then extracted, and injected under ultrasound guidance after the area is cleaned. Local anaesthetic is sometimes used but never in the same injection as the PRP as this destroys the platelets. Anti-inflammatory medications (Celebrex, Mobic, Voltaren etc) should be stopped 2 days prior to injection, and for 2 days afterwards, because these impair platelet function.
You should plan to rest the injected area for 2-3 days following the injection. Depending on the site of the injection, this may involve getting driven to your appointment, wearing a protective sling, boot or other device (especially the foot/ankle or shoulder).