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Platelet Rich Plasma uses your own blood to orchestrate the regeneration of a wide range of tissues including ligaments, cartilage, and tendons. The infusion of PRP at the injury site initiates the body’s healing mechanism by promoting and activating natural therapeutic biochemicals and growth factors that eventually rebuild and remodel the injured soft tissue. The objective of PRP treatment is to regenerate tissue and eliminate the underlying condition permanently.
Platelet Rich Plasma is a biomaterial that is derived from your own blood. You may wonder how an infusion that is derived from your own blood can be more effective at healing than regular blood?
The best way to understand this is to examine the contents of a typical blood sample. Generally, a sample of whole blood contains about 93% red blood cells, 6% platelets and 1% white blood cells (WBC). To create PRP, the sample that was drawn is placed in a centrifuge where the platelets and white blood cells are separated from the red blood cells. The mixture is inverted in terms of the proportions. The concentration of the red blood cells, which do little to promote healing, is reduced to around 5%. Beneficial platelets and white blood cells (WBC) are increased to about 94% in the sample. Your physician will then inject the platelet-rich plasma in and around the damaged joint or tissue to initiate the regeneration process. (The PRP sample may also contain a small amount of harmless anticoagulant similar to vitamin C.)
When platelet rich plasma is injected near the site of the injury, platelets flood the area and stabilize it by promoting hemostasis. The PRP helps produce fibrin and initiates the creation of new connective tissue and also promotes the building of veins. The platelets contain growth factors such as PDGF, BMP, TGF-β1 bFGF, VEGF, FGF-2 and EGF; and the powerful Interleukin cytokines of IL-1, IL-4 and IL-6. The white blood cells contain enzyme-rich neutrophils and infection-fighting macrophages and phagocytes. They all work together to build extracellular matrices that help regenerate cartilage, tendons, ligaments and bone.
Platelet Rich Plasma is also very effective for treating a wide range of osteoarthritic conditions. For example, all of the growth factors below have been found to be beneficial when treating OA and all have been identified in PRP:
- Tissue Growth Factor-β (TGF-β)
- Insulin-like Growth Factor1 (IGF-1)
- Bone Morphogenic Proteins (BMP)
- Platelet Derived Growth Factor (PDGF)
- Vascular Endothelial Growth Factor (VEGF)
- Epidermal Growth Factor (EGF)
- Fibroblast Growth Factor (FGF)
- Hepatocyte Growth Factor (HGF)
Some researchers have suggested that pain may be reduced by the presence of platelets that contain serotonin, histamine, and dopamine that provide an analgesic effect. For some patients, significant pain relief and functional restoration can occur after one or two treatments. No two patients are alike and some heal faster than others. Recovery rates, therefore, depend on several factors such as age, diet, nutrition, overall health and the intensity of the original injury.
PRP is a safe, relatively painless choice for treating subacute and chronic injuries such as tendinopathies, ligament sprains, muscle strains, injured joints, rotator cuffs, intervertebral discs, most cases of neck and back pain, post-concussion syndrome, and non-union fractures. PRP is used, sometimes with stem cells, to regenerate cartilage, tendons, meniscus and bone.
PRP is currently used for a broad spectrum of conditions in fields that include orthopedics, sports medicine, dentistry, otolaryngology, neurosurgery, ophthalmology, urology, wound healing, plus cosmetic, cardiothoracic and maxillofacial surgery.
PRP has also been used to reduce post-operative inflammation, blood loss, and infections. It can be used for medication reduction and osteogenesis promotion. Interestingly, PRP has even been used to treat male pattern baldness.
PRP is a natural treatment that is derived from the patient’s blood. The risks of rejection, infections or allergic reactions are low. PRP is also an opioid-free treatment that uses the body’s own pain reduction mechanisms to reduce pain related to traumatic injury. Opioid addiction has reached epidemic levels in the United States.
Every patient is different, plus there are factors such as age, the severity of the injury, immune response, and the rate of healing to consider. For some patients, positive results may be felt within a week. Other patients may require several months of healing. It is essential to keep in mind that the treatment is activating your body to heal itself by regenerating soft tissue. Prior to any treatment, Dr. Greenberg and his team will review the treatment plan designed to help you heal.
Doctor Scott Greenberg is a pioneering leader in prolotherapy, PRP, and stem cell procedures. He serves as the chair of the Institutional Review Board of the American Association of Stem Cell Physicians and is a founding board member. He was a member of the first team to repair a meniscus tear using stem cell therapy and has treated many professional and Olympic athletes among the thousands of people helped since starting his practice in 1999. Dr. Greenberg is a Medical Staff Member of The Bryn Mawr Hospital and an affiliate of The Main Line Health Dee Adams Center for Integrative and Regenerative Medicine at Bryn Mawr. Additionally he serves as a Clinical Professor at the Marcus Institute of Integrative Medicine at Thomas Jefferson University Hospital.
Guidelines for the Use of Platelet Rich Plasma
ICMS, Harmon, Hanson, Bowen, Greenberg, Magaziner, Vandenbosch, Harshfield, Shiple & Audley;
http://www.cellmedicinesociety.org/attachments/206_ICMS%20-%20Guidelines%20for%20the%20use%20of%20Platelet%20Rich%20Plasma%20-%20Draft.pdf
Clinical Update: Why PRP Should Be Your First Choice for Injection Therapy in Treating Osteoarthritis of the Knee; Cook, Smith; Curr Rev Musculoskelet Med. 2018 Dec