12 Mar Platelet Rich Plasma (PRP) – Hype or Hope
We are all looking for a quick fix for our injuries. Most of my patients want to get better yesterday. Rest is not an option. Always seems like the club championship is tomorrow!
WHAT ARE BIOLOGIC SOLUTIONS LIKE PRP?
Biological solutions for tendon tears, arthritis, and sprains and strains are on the rise but unfortunately, the science is lacking as proof of efficacy. Insurance doesn’t pay for it. There’s no standard yet of preparation or application of these products. But with smart, honest use, I believe they work in many cases and have been a nice addition to my practice.
WHERE CAN PRP BE USED?
Tennis elbow aka lateral epicondylitis is a perfect example where PRP and biologics have helped us make people better. This problem is caused by an overload of the tendon that extends our wrist. Micro tears are caused, and for unknown reasons sometimes it doesn’t heal. It is very painful. It is very hard to cure. It is impossible to cure within a time frame acceptable to most people. It can happen at work and in other sports other than tennis.
WHAT DOES PRP DO?
What PRP does exactly is still up for debate. It induces tendon cells to make a more normal tendon. It attracts stem cells (cells in our body that can become anything) to the area to help heal the injury and promote new tendon degeneration. In a classic article 93% of patients had a reduction in pain after one PRP injection. This review article summarizes nicely what we know about PRP and the amazing growth factors that can help.
WHERE ELSE CAN PRP BE USED?
The other area I really like using PRP is arthritis. Traditionally we have used hyaluronic acid injections for pain relief for mild to moderate arthritis. Usually when it works (70 % on average) it lasts about 6 months. Studies have shown that PRP alone or in combination with HA injections can last up to or longer than a year.
Biologics are disease-modulating. Meaning they can control the pain. In some cases, like in tendon injury, they can be curative.
ACHIEVING PAIN RELIEF IS THE GOAL!
My philosophy has been to use these wisely. In the right patient and the right setting along with other medications, therapy, and sometimes modification of sports and work, we can achieve all patients’ goals. Relieve their pain.