Many times we will get an email or a phone call from someone who is exploring the use of PRP to heal an injury. They will write or ask “Does Platelet Rich Plasma Therapy (PRP) work?,” then they will ask – “Where is the research?” The research is right here and there is a lot of it. First we will look at PRP for osteoarthritis and then tendinopathy and damaged ligaments.
Platelet Rich Plasma Therapy or PRP, is a non-surgical alternative for repairing damaged joints. In the hands of an experienced clinician, it is not a treatment to delay joint replacement, it is a treatment that can help a patient avoid a surgery. It works by stimulating the natural immune repair mechanisms and supplying the building blocks necessary to build tissue. This is a far cry from surgery where tissue is not built or repaired but removed.
The treatment involves collecting blood from the patient, spinning it in a centrifuge, removing the platelets from the blood, and then inserting the patient’s platelets into the injured area to stimulate healing and regeneration. The treatment relies on the components in blood to work. Blood is made up of four main components; plasma, red blood cells, white blood cells, and platelets. Each part plays a role in keeping your body functioning properly. While white blood cells help the body fight infection and disease, Platelets act as wound and injury healers. They are first on the scene at an injury, clotting to stop any bleeding and immediately helping to regenerate new tissue in the wounded area.
In fact research has shown that PRP works exactly in this capacity to help heal surgical wounds:
- PRP enhances rotator cuff repair following arthroscopic shoulder surgery.1
- PRP enhances recovery after hip surgery.2
- PRP helps you heel from Tommy John Surgery.3,4
Doctors also found that PRP helped patients with other medical conditions that would make healing more difficult such as diabetes and heart disease.5
Bone Healing and Regeneration
Doctors support the use of PRP in large bone defects to assist healing and bone regeneration.6 PRP gel accelerated healing and growth of bone in large bone tumor created defects.7
Research looked to assess the safety and symptomatic changes in 40 patients receiving platelet-rich plasma (PRP) to osteoarthritis of the hip and found Twenty-three (57.5%) patients reported a clinically relevant reduction of pain (45%), Sixteen (40%) of these patients were classified as excellent responders who showed an early pain reduction at 6-7 weeks, which was sustained at 6 months, and a parallel reduction of disability.8
January 2016: “Results indicated that intra-articular PRP injections offer a significant clinical improvement in patients with hip osteoarthritis without relevant side effects.”9
Degenerative disc disease
Research has shown PRP to be effective in treating degenerative disc disease by addressing the problems of spinal ligament instability and by stimulating the regeneration of the discs indirectly (discs were not directly injected but showed increase in disc height) 10 Research presented by international scientists in Milan in August 2015 showed that PRP is able to recover the mechanical properties of denatured discs, thereby providing a promising effective therapeutic modality.11
Knee Osteoarthritis and Menicsus
In a very recent study, doctors found Platelet Rich Plasma therapy showed better improvement in patient’s knees than hyaluronic acid injection and placebo in reducing symptoms and improving function and quality of life.12 In another study PRP was seen to be more effective than hyaluronic acid in younger, active patients with low-grade osteoarthritis.13
“Intra-knee-articular injection of PRP to treat knee articular cartilage degeneration is safe, which can alleviate symptoms of pain and swelling and improve the quality of life of patients” 14
In one study researchers looked at 261 patients with knee degeneration were treated with PRGF (plasma rich in growth factors) (PRP). At 6 months following intra-articular infiltration of PRGF in patients with OA of the knee, improvements in function and quality of life were documented. 15
Other research sought to “evaluate the clinical effects of intra-articular platelet-rich plasma (PRP) injections in a small group of patients with primary and secondary osteoarthritis. Most of the current treatments for osteoarthritis are palliative and attack the symptoms rather than influencing the biochemical environment of the joint. Autologous platelet-rich plasma has emerged as a treatment option for tendinopathies and chronic wounds…The study demonstrated significant and almost linear improvements in Knee Injury and Osteoarthritis Outcome Scores, including pain and symptom relief.”16
Researchers noted Platelet Rich Plasma (PRP) has the ability to not only achieve pain relief and show a halt of progression of meniscal damage but to regenerate tissue as demonstrated in several experimental studies.17 In a supportive research in the surgical journal Arthroscopy, doctors concluded that PRP injections are a viable treatment for knee osteoarthritis and should be considered in patients with knee osteoarthritis.18
Studies like these add to the accumulating evidence that PRP can halt and reverse meniscus degeneration.19,20
Knee cap and tendons
Chondromalacia patella is a condition that has been show to respond very favorably to our regenerative techniques. Platelet Rich Plasma Therapy.21 Researchers in the Netherlands evaluated the outcome of patients with patellar tendinopathy treated with platelet-rich plasma injections (PRP) and whether certain characteristics, such as activity level or previous treatment affected the results. What they found was: “After PRP treatment, patients with patellar tendinopathy showed a statistically significant improvement. In addition, these improvements can also be considered clinically meaningful.”22
Most recently doctors in Switzerland compared PRP injections to cortisone in the shoulder. The doctors found good results for the PRP and were able to conclude that PRP injections are a good alternative to cortisone injections, especially in patients with contraindication to cortisone.23 Equally, in June 2015 new research suggested that bone marrow stem cell therapy showed encouraging results in pain and motion relief for patients with rotator cuff and shoulder osteoarthritis. 24
Doctors looked at the increasing popularity of platelet-rich plasma therapies for soft tissue injuries such as ligament, muscle and tendon tears and tendinopathies.
In Achilles tendinopathy and plantar fasciitis, PRP is an effective and safe alternative for the management of patients with a poor response to conventional non-surgical treatment. 25,26. PRP was effective in patients affected by mid-portion Chronic Recalcitrant Achilles Tendinopathies treated with a single platelet-rich plasma (PRP) treatment.27
Platelet Rich Plasma Therapy Injections for Shoulder Injury
Platelet Rich Plasma Therapy Injections for Knee Injuries
Platelet Rich Plasma Therapy Injections for Hip injuries
For more information about Platelet Rich Plasma Therapy, please contact us at 310-231-7000 or email us using the form above.
1. Yang J, Sun Y, Xu P, Cheng B.Can patients get better clinical outcomes by using PRP in rotator cuff repair: a meta-analysis of randomized controlled trials. J Sports Med Phys Fitness. 2015 Oct 16. [Epub ahead of print]
2. Rafols C, Monckeberg JE, Numair J, Botello J, Rosales J. Platelet-Rich Plasma Augmentation of Arthroscopic Hip Surgery for Femoroacetabular Impingement: A Prospective Study With 24-Month Follow-up. Arthroscopy. 2015 Oct;31(10):1886-92. doi: 10.1016/j.arthro.2015.03.025. Epub 2015 May 15.
3. Hoffman JK, Protzman NM, Malhotra AD. Biologic Augmentation of the Ulnar Collateral Ligament in the Elbow of a Professional Baseball Pitcher. Case Rep Orthop. 2015;2015:130157. doi: 10.1155/2015/130157. Epub 2015 Jul 9.
4. Dargel J, Boomkamp E, Wegmann K, Eysel P, Müller LP, Hackl M. Reconstruction of the lateral ulnar collateral ligament of the elbow: a comparative biomechanical study. Knee Surg Sports Traumatol Arthrosc. 2015 May 10. [Epub ahead of print]
5. Salamanna F, Veronesi F. New and Emerging Strategies in Platelet-Rich Plasma Application in Musculoskeletal Regenerative Procedures: General Overview on Still Open Questions and Outlook. BioMed Research International. Volume 2015 (2015), Article ID 846045, 24 pages
6. Oryan A, Alidadi S, Moshiri A Platelet-rich plasma for bone healing and regeneration. Expert Opin Biol Ther. 2015 Dec 4:1-20. [Epub ahead of print]
7. Mattiello A, Cacciapuoti C. Autologous Platelet Gel Improves Bone Reconstruction of Large Defects in Patients with Bone Giant Cell Tumors. In Vivo. 2015 09-10;29(5):533-540.
8. Civinini R, Nistri L, Martini C, Redl B, Ristori G, Innocenti M. Growth factors in the treatment of early osteoarthritis. Clin Cases Miner Bone Metab. 2013 Jan;10(1):26-9. doi: 10.11138/ccmbm/2013.10.1.026. PUBMED ABSTRACT
9. Dallari D, Stagni C, Rani N, Sabbioni G, Pelotti P, Torricelli P, Tschon M, Giavaresi G. Ultrasound-Guided Injection of Platelet-Rich Plasma and Hyaluronic Acid, Separately and in Combination, for Hip Osteoarthritis: A Randomized Controlled Study. Am J Sports Med. 2016 Jan 21. pii: 0363546515620383. [Epub ahead of print]
10. Gullung GB1, Woodall JW, Tucci MA, James J, Black DA, McGuire RA. Platelet-rich plasma effects on degenerative disc disease: analysis of histology and imaging in an animal model. Evid Based Spine Care J. 2011 Nov;2(4):13-8. doi: 10.1055/s-0031-1274752.
11. Khalaf K, Nikkhoo M, Ya-Wen Kuo, Yu-Chun Hsu, Parnianpour M, Campbell-Kyureghyan N, Haghpanahi M, Jaw-Lin Wang. Recovering the mechanical properties of denatured intervertebral discs through Platelet-Rich Plasma therapy. Conf Proc IEEE Eng Med Biol Soc. 2015 Aug;2015:933-6. doi: 10.1109/EMBC.2015.7318516.
12. Kanchanatawan W et al. Short-term outcomes of platelet-rich plasma injection for treatment of osteoarthritis of the knee. Knee Surg Sports Traumatol Arthrosc. 2015 Sep 19. [Epub ahead of print]
13. Pourcho AM, Smith J, Wisniewski SJ, Sellon JL.Intraarticular platelet-rich plasma injection in the treatment of knee osteoarthritis: review and recommendations. Am J Phys Med Rehabil. 2014 Nov;93(11 Suppl 3):S108-21. doi: 10.1097/PHM.0000000000000115.
14. Li M, Zhang C, Ai Z, Yuan T, Feng Y, Jia W. Therapeutic effectiveness of intra-knee-articular injection of platelet-rich plasma on knee articular cartilage degeneration. Li M, Zhang C, Ai Z, Yuan T, Feng Y, Jia W.
15. Wang-Saegusa A, Cugat R, Ares O, et al. Infiltration of plasma rich in growth factors for osteoarthritis of the knee short-term effects on function and quality of life. Arch Orthop Trauma Surg. 2011 Mar;131(3):311-7. Epub 2010 Aug 17.
16. Injection of platelet-rich plasma in patients with primary and secondary knee osteoarthritis: a pilot study. Sampson S, Reed M, Silvers H, et al. Injection of platelet-rich plasma in patients with primary and secondary knee osteoarthritis: a pilot study.Am J Phys Med Rehabil. 2010 Dec;89(12):961-9.
17. Blanke F, Vavken P, Haenle M, von Wehren L, Pagenstert G, Majewski M. Percutaneous injections of Platelet rich plasma for treatment of intrasubstance meniscal lesions. Muscles Ligaments Tendons J. 2015 Oct 20;5(3):162-166.
18. Campbell KA, Saltzman BM, Mascarenhas R, Khair MM, Verma NN, Bach BR Jr, Cole BJ. A Systematic Review of Overlapping Meta-analyses. Arthroscopy. 2015 Nov;31(11):2213-21. doi: 10.1016/j.arthro.2015.03.041. Epub 2015 May 29.
19. Wu CC, Chen WH, Zao B, Lai PL, Lin TC, Lo HY, Shieh YH, Wu CH, Deng WP. Regenerative potentials of platelet-rich plasma enhanced by collagen in retrieving pro-inflammatory cytokine-inhibited chondrogenesis. Biomaterials. 2011 Sep;32(25):5847-54. Epub 2011 May 25.
20. van Buul GM, et al. Platelet-Rich Plasma Releasate Inhibits Inflammatory Processes in Osteoarthritic Chondrocytes. Am J Sports Med. 2011 Nov;39(11):2362-70. Epub 2011 Aug 19.
21. Kon E, Buda R, Filardo G, Di Martino A, Timoncini A, Canacchi A, Fornasari PM, Giannini S, Marcacci M. Platelet-rich plasma: intra-articular knee injections produced favorable results on degenerative cartilage lesions. Knee Surg Sports Traumatol Arthrosc 2010; 18(4):472-479.
22. Gosens T, Den Oudsten BL, Fievez E, van ‘t Spijker P, Fievez A. Pain and activity levels before and after platelet-rich plasma injection treatment of patellar tendinopathy: a prospective cohort study and the influence of previous treatments.Int Orthop. 2012 Apr 27. [Epub ahead of print]
23. von Wehren L1, Blanke F, Todorov A, Heisterbach P, Sailer J, Majewski M. The effect of subacromial injections of autologous conditioned plasma versus cortisone for the treatment of symptomatic partial rotator cuff tears. Knee Surg Sports Traumatol Arthrosc. 2015 May 28. [Epub ahead of print]
24. Valencia Mora M, Ruiz Ibán MA, Díaz Heredia J, Barco Laakso R, Cuéllar R1, García Arranz M. Stem cell therapy in the management of shoulder rotator cuff disorders. World J Stem Cells. 2015 May 26;7(4):691-9. doi: 10.4252/wjsc.v7.i4.691.
25. Guelfi M, Pantalone A, Vanni D, Abate M, et al. Long-term beneficial effects of platelet-rich plasma for non-insertional Achilles tendinopathy. Foot Ankle Surg. 2015 Sep;21(3):178-81. doi: 10.1016/j.fas.2014.11.005. Epub 2014 Dec 11. PUBMED ABSTRACT
26. López-Gavito E, Gómez-Carlín LA, Parra-Téllez P, Vázquez-Escamilla J. Platelet-rich plasma for managing calcaneus tendon tendinopathy and plantar fasciitis. Acta Ortop Mex. 2011 Nov-Dec;25(6):380-5. PUBMED PRP ABSTRACT
27. Gaweda K, Tarczynska M, Krzyzanowski W. Treatment of Achilles tendinopathy with platelet-rich plasma. Int J Sports Med. 2010 Aug;31(8):577-83. Epub 2010 Jun 9. PUBMED ABSTRCAT