What is a Plasma Injection? (PRP)?
Platelet-rich plasma (PRP) treatment is using patients’ blood platelets to stimulate healing in injured or degenerative tissue.
PRP has been in use for more than 10 years primarily by sports medicine physicians. It is gaining popularity because of its relative low cost, simplicity and efficacy.
The Science Behind Platelet Cells
Blood platelet cells contain granules rich in bioactive growth factors (GFs), proteins and cytokines. These together with other extracellular plasma proteins and cytokines, initiate and regulate tissue repair. This is a complex process involving multiple cells and cell signaling some of the important GFs include platelet-derived (GFs), vascular endothelial (GFs), transforming (GFs), fibroblast (GFs), epidermal (GFs), hepatocyte (GFs) and insulin-like (GFs).
When the skin sustains a bleeding cut, platelets release clotting factors to stop the bleeding while at the same time releasing GFs to repair the injured tissues. GFs stimulate healing whether it be making new capillaries, attracting mesenchymal stem cells to the injured area, repairing nerves or forming collagen to repair muscle, tendon, skin and chondral tissue.
Safety of PRP Injections
Because PRP therapy uses autologous blood products” the immune system does not consider the injected platelet cells and plasma to be foreign and there is no allergic reaction. As the platelet cells are very small, flare-up from the injection is usually mild but is more common when injecting denser tissues such as tendons rather than the more spacious joints.
What is the actual process to undertake PRP injections?
During your consultation the doctor will draw some of your blood. The amount of blood drawn will depend on the injured/degenerative area/s. Once the patient’s blood is drawn, it will be placed in a centrifuge to separate out the red blood cells, plasma layer and platelets. The layer containing the plasma and platelets are extracted then injected into the damaged portion of the tendon or cartilage. The injection process may be guided by an ultrasound machine.
The whole process should take approximately 30 to 45 minutes from the time of blood draw to the time of the actual injection.
Patients are put on a program of relative rest followed by physical therapy if recommended by the doctor. After about 6 to 12 weeks, patients are re-evaluated for improvement. Some patients with more difficult injuries may require more than one injection to achieve successful outcomes. The majority of PRP patients find that within 3 months they can return to most or all of the activities they were doing before the pain started.
Cost of the PRP- Injections
Cost of the PRP injections
Your initial PRP injection will incur a fixed cost of $250
If additional injections are required, this will incur a cost of an additional $150 per injection if the injections are performed within the same appointment.
There is no rebate through Medicare or private health insurance.
Using PRP as a Pre-Indicative Test for Stem Cells
It is our hypothesis that this function of platelets can be used as a test to see if people will be responders or non-responders to stem cell therapy. We have tested this on a large number of patients using various combinations and the test has some usefulness.
Using Plasma/Platelets has not improved the results when given at the same time as stem cells but there may be some utility when given two weeks before stem cells and in the healing time after stem cell therapy.
Plasma Injections vs. SVF (Stem Cells)
Using the cytokines contained in platelets is like have a burst of stem cell activity. The results can last for one week in some patients whilst in others the results can be much longer lasting up to a year or more. There will be a very small group of patients who only need plasma injections to treat their osteoarthritis but a large group of patients will perform very well if we are treating soft tissue injuries with Plasma Injections.
Many other patients whom have severe injuries, cartilage defects, osteoarthritis or an auto-immune condition will need SVF (stem cells) to get lasting and complete effect.
Ting Yuan et al, Augmenting tendon and ligament repair with platelet-rich plasma (PRP), Muscles Ligaments Tendons J. 2013 Jul-Sep; 3(3): 139–149