What is PRP?
PRP stands for platelet rich plasma injection. Human blood has a number of hematological components including red blood cells, white blood cells, serum and platelets. Platelets are very important for clot formation. They stick to each other and form a blood clot. Medical research has found that platelets also contain a number of chemicals and proteins that are involved in wound healing. When platelets are activated they release these components collectively called "growth factors." When blood cells are separated from blood, the resulting fluid is called plasma. Processing of plasma can concentrate the platelets and their corresponding growth factors. This concentrated solution is then mixed with a buffer and anticoagulant and injected into the injured tissue to promote healing. In essence, the doctor concentrates the patient's own healing factors and then injects them back into the injured area. This approach is very different from using anti-inflammatory medications and steroid injections which decrease inflammation and the healing response.

Is PRP new?
The technology has been used for years in surgical applications and wound care. The use of PRP for musculoskeletal injuries is fairly new and evolving into a promising treatment for both acute and chronic injuries. There are a number of medical studies supporting the use of PRP for tendon and ligament injuries.

Do I have to worry about the use of blood products?
The patient's own blood is used for the procedure so there is no transfusion risks. As with all injections including vaccines, there is always a small risk of infection where the needle enters the skin. The PRP is derived from the patient so there is no risk of a blood borne infection from a donor.

How long does it take?
Generally, a PRP injection requires an initial visit to see if the patient's injury would benefit from the injection, then a follow up visit for the injection itself. The actual injection process takes about 30 minutes. The majority of the time involves drawing and processing the patient's blood for the injection. The patient is then seen at 1 week and 4 week follow up intervals to access for healing and complications.

What does the patient have to do prior to the procedure?
Once the diagnosis is made and the PRP injection is scheduled, the patient should avoid all anti-inflammatory medications for 4-7 days prior to procedure. This includes prescription anti-inflammatory medications as well as over the counter naproxin, aspirin, and ibuprofen. Cardiac patients should continue taking aspirin.

What can I expect during and after the procedure?
30-60cc of blood will be drawn from an accessable vein. The blood is then mixed with an anti-coagulant and placed into a machine with a special separator tube that spins the blood and separates the components into blood cells, serum, and the platelet rich plasma.
During the separation process, the patient's injured area is numbed with a local anesthetic.
After the platelets are concentrated, they are extracted into a separate syringe and mixed with sodium bicarbonate. The mixture is then injected into the injured area. This requires a great deal of skill and usually ultrasound guidance.

After the procedure, the patient will experience some mild soreness in the treated area that peaks at 3 days post procedure. Analgesic medication is prescribed and the patient is instructed to avoid all anti-inflammatory medications. Most patients describe mild soreness that resolves with Tylenol. Ice and heat are avoided.