Prolotherapy Therapy with Platelet Rich Plasma
By: Hal S. Blatman, MD
Tendons and ligaments connect muscles to bones, making it possible to do all kinds of physical activities. Overuse or damage to tendons over a long period of time causes the collagen fibers that make up the tendons to form small tears, a condition called Tendinosis. Ligaments are composed of collagen fibers and hold bones together, stabilize joints and control range of motion. Tendons and ligaments have poor blood supply, and they do not easily heal from the damage caused by sprains, strains, and repetitive motion.
What is Platelet-Rich Plasma?
Platelet Rich Plasma, or PRP is blood plasma with concentrated platelets (the body's repairmen for damaged tissue). The concentrated platelets found in PRP contain huge reservoirs of bioactive proteins, including growth factors that are vital to initiate and accelerate tissue repair and regeneration. These bioactive proteins initiate connective tissue healing, bone regeneration, and repair, promote development of new blood vessels, and stimulate the wound healing process.
How does PRP Therapy Work?
To prepare PRP, a small amount of blood is taken from the patient. The blood is then placed in a centrifuge. The centrifuge spins and automatically produces the PRP, which is then injected directly into the center of the injury. Ultrasound guidance is used to monitor the position of the instrument and visualize the injury. The entire process to prepare your blood takes less than 15 mnutes and increases the concentration of platelets and growth factors at the site of injury up to 500%.
I've heard of Cortisone Shots; is this the same?
Studies have shown that cortisone injections may actually weaken tissue. Cortisone shots may provide a quick fix for temporary relief and lessening of inflammation, but the doctor can only do them a few times in any area because of this tissue weakening effect. They do not generally provide long term healing. PRP therapy is healing and strengthening for these tendons and ligaments. Treatment with PRP has strengthened and thickened tendons up to 40%.
What are the Potential Benefits of Treatment?
Patients can see a significant improvement in symptoms. This may eliminate the need for more aggressive treatments such as long term medication or surgery, as well as a remarkable return of function and a much shorter recovery time.
How many treatments & How often is this therapy?
While responses to treatment vary, most people will require 3-6 sets of injections. Each set of treatments is spaced approximately 4 weeks apart. There isno limit to the number of treatments you can have, the risks and side effects do not change with the number of injections.
Is PRP right for me?
If you have a tendon or ligament injury and traditional methods have not provided relief, then PRP therapy may be the solution. The procedure is less aggressive and less expensive than surgery. It will heal tissue with minimal or no scarring and alleviates further degeneration of the tissues. There will be an initial evaluation with the doctor to see if PRP therapy is right for you.
PRP injections can be helpful for treatment of:
- Wrist & Hand
- Hip/Pelvis/SI joints
- Lower leg
- Ankle & Foot
- Arthritic joints
- Osgood-Schlatter's disease
Are there any special instructions?
You are restricted from the use of non-steroidal anti-inflammatory medications (NSAIDs) one week prior to the procedure and throughout the course of treatments.
Initially the procedure may cause some localized soreness and discomfort. Most patients only require some extra-strength Tylenol to help with the pain. Ice and heat may be applied to the area as needed.
The first week after the procedure, patients will continue their home or physical therapy program, but aggressive physical activity is discouraged.
How soon can I go back to regular physical activities?
This therapy is stimulating the growth and repair of tendons, ligaments, and joint cartilage, which requires time and rehabilitation. Regeneration largely depends on the individual and their age, although good results typically require between one and three treatments at least 2-3 weeks apart. Through regular visits, Dr. Blatman will determine when you are able to resume regular physical activities.
Does insurance pay for PRP?
With the exception of Medicare, most insurance companies will cover partial reimbursement after pre-authorization if you have out of network coverage.
What are tendons & Ligaments?
Tendons connect muscles to the bone, making it possible for you to do many every day physical activities. Overuse or damage to the tendon over a long period of time causes the collagen fibers in the tendons to form small tears, a condition called tendinosis. Damage to tendons most often occurs in the knee, ankle, shoulder, wrist, biceps, calf, and Achilles tendons.
Ligaments are composed of collagen fibers that hold one bone to another, stabilizing the joint and controlling the range of motion. When a ligament is damaged, it is no longer able to provide support, weakening the joint.
Tendons and ligaments have poor blood supply. Combined with the stress of day-to-day activities, they do not easily heal from damage. As a result the tendons and ligaments become inefficient causing chronic pain and weakness. Medical intervention is now possible in a new way.