PRP Therapy and its Efficacy

Prp stands for platelet rich plasma and essentially it is a whole compilation of growth factors taken from a patients’ blood. These growth factors are then injected into damaged ligaments, tendons and joints to induce healing and reduce arthritic pain.

Prp does not contain stem cells but does have the milieu of growth factors that induce a healing response.

The primary goal of PRP Therapy is to heal damaged ligaments, tendons and joints that cause pain and dysfunction. Also the naturally occurring biochemicals in PRP can reduce inflammation in arthritic joints.

Precisely injecting growth factors into a damaged area triggers the same type of response that the body uses when it is initially injured. However people develop chronic pain and do not easily recover from injury especially as we age because circulation to these areas is minimal, therefore the body has a hard time healing it on its own.

The components have a variety of functions such as reducing inflammation, triggering circulation, removal of damaged tissue and triggering its restoration. This is ideal as we use the same mechanism that the body tries to repair itself.

It’s a biomaterial as it contains biologically active proteins and what makes it so effective for healing is these proteins and biochemicals trigger the exact healing reaction that the body uses.

Because the growth factors come directly from the body.

There are a concert of at least 10 different factors that we are aware of and they are all key. Just like an orchestra, the body works in concert to produce its result and one growth factor is not more important than the other. They are all important.

Prp originally started in the 1980s and it was made into a gel to help keep heart bypass arteries from leaking where they were connected. It served as a sealing glue.

Traditional treatments such as cortisone just reduce inflammation but do not induce a healing reaction. Furthermore repeat treatment of cortisone can damage and weaken a joint whereas this does not happen with Prp.

We try to minimize the white blood cells as they are inflammatory and make the recovery from the procedure more painful. Platelets can both help to aggregate proteins and growth factors around a damaged area and they also directly release chemicals like PDGF.

They help with direct repair of tendon and bone and also improve circulation in the area to help other growth factors permiate into the damaged region.

The growth factors inately trigger the creation of new connective tissue and blood vessels throughout the process.

PRP therapy directly promotes extracellular matrix formation and tissue remodeling.

Red blood cells are irritating, contain iron, and also are not intimately connected to the healing process. By reducing them, we allow the plasma to work more efficiently.

It interacts perfectly as the first steps are to remove the damaged cellular debris using cells known as macrophages. These are like the body’s own Pac-men. Then the repair cells can come into the area and stimulate regeneration.

First, removal of frayed tissue and cellular debris, second rebuilding of that tissue and reducing of inflammation. Lastly maturation of the tissue occurs. However this process takes time as final maturation comes months later.

Injured areas are weak and loose and leads to instability and arthritis. If performed correctly, PRP can restabilize a joint and prevent instability and arthritis.

This is really fascinating and we use it in cases where bones do not heal on their own known as non-union or delayed union. The PRP acts like a tissue matrix to help fill in the defect and the BMPs in PRP (bone morphogenic proteins) directly trigger the production of new bone.

Since it has been used for decades it should not be considered experimental. There are thousands of research papers supporting its use. However since there are no major pharmaceutical companies that can make money off of Prp so this slows its adoption in medical society.

Research has shown many things from being more effective than cortisone for arthritis to back pain to repairing rotator cuff injuries. 

Yes it is completely allowed under FDA regulations.

Healing tissues completely like a tendinitis is a permanent process. When patients are healed with a condition such as this, they will not require further treatment unless they reinjure the area.

The real challenge is economics… as without a pharmaceutical company to make sure it’s covered by insurance it is difficult to get the procedure covered by insurance. However this just goes to prove how effective it is since if a procedure was not covered and did not work and was out-of-pocket it would quickly go by the wayside.

Patients seeking more information on PRP clinical trials can review PubMed and clinicaltrials.gov for the latest in ongoing and completed PRP clinical trials.

The studies are generally in the 50-85% range based on the study. However these studies are usually just single joint injections and do not use the comprehensive Greenberg method of treatment where the entire area is evaluated and treated.

Outcomes are far superior to placebo and to standard medical therapy.

There are infinite ways in which Prp can be prepared and this does provide a variability in research. From this we need to look at general trends when we examine the research but again keep in mind that it’s just not platelets, it’s the whole concert of growth factors that induces healing.