Platelet Rich Plasma
Platelet Rich Plasma (PRP) is a new option that is emerging as a non-operative modality in treating
musculoskeletal, sports, and orthopedics injuries/pathologies. It is a process were autologous (from your
own body) platelets are harvested and then concentrated to produce a tissue graft which is then injected
back into the body to begin a healing or repair process in the area of injury/pathology. This is part of a
branch of medicine that is emerging across all spectrums of treatments – regenerative medicine. In other
fields, this technology is being used to create artificial bladders and solid organs which can be used in
patients with concerns for tissue rejection. In PRP, the platelet is used as the initiator of repair. Many of us
learned in high school that the platelet is the cell responsible for clotting blood, an important and vital
function of life. As with all of Mother Nature's designs, the platelet’s function is eloquent. It finds its way to
the right place at the right time – the site of an injury. Once there, it spills open, helping to halt bleeding but
also laying the groundwork to repair the tissue. In fact, by being the first cells on the scene of an injury, they
have a key role in initiating and coordinating the healing response. In a person’s body, receptors on the
surface of platelets tell them to go to the site of injury where they initiate clotting and interact with signaling
factors released by injured tissue. Platelets can release a multitude of signaling proteins, growth factors,
chemotactic factors which stimulate tissue repair and vascular remodeling. This returns the tissue to a
normal structure to do its job and results in reduced or no pain.
Through scientific research, much is known of the armamentarium of growth factors contained within a
platelet. Through electron microscopy and biochemical studies, it is known that platelets have many
different granules, or storage containers, for different signaling proteins, structure proteins, coagulation
factors, and proteases. The surface of the platelet has a variety of membrane embedded proteins which
provide for a dynamic action in response to tissue damage. By receiving signals from the local environment,
platelets have the ability to release their healing factors in a controlled and appropriate fashion. Remember
“skinning” your knee as a child? Look at your knee today and you will find no evidence of any wounds. Or
when you twisted an ankle? You spent days hobbled and bruised, but that is also a distant memory. Your
body has the innate power and ability to heal itself; however, in life, we can impede healing by repetitive
strain from work or sports, blocking healing with medications and not giving enough time to heal before
stressing the injured tissue again. These situations lead to chronic soft tissue changes and accelerated
degenerative changes, which in turn inhibit function and cause pain. PRP therapy shows great promise in
restoration of normal soft tissue architecture and regeneration of tissue such as tendons and ligaments.
Typically, a person will require two to three sets of injections, usually spaced six to eight weeks apart. This
graft is embedded into the damaged/diseased tissue and will accelerate recovery. This treatment can be
beneficial in tendon, ligament, and joint problems. This may preclude the need for more aggressive
treatments and/or surgery in some cases. PRP may be effectively used in the treatment of sports injuries,
arthritic joints, lower back pain, degenerative disc disease, tennis elbow, golfer's elbow, carpal tunnel
syndrome, ACL injuries, shin splints, rotator cuff injuries, plantar fasciitis, iliotibial band (ITB) syndrome,
and Achilles tendinopathy. Platelets are a normal component of blood and are traditionally remembered for
their role in stopping bleeding (clotting). However, the platelet not only provides a scaffold for clotting, but
actually begins the innate healing response. Platelets contain multiple granules which are released at the site
of injury. These granules hold countless growth factors which signal other cells to begin the removal of
damaged/diseased tissue and stimulate other cells to begin laying down new normal, healthy connective
tissue. These bioactive proteins are vital to initiate and accelerate tissue repair and regeneration, and
activate connective tissue healing, bone regeneration and repair, promote development of new blood
vessels, and stimulate the wound healing process.
Osteoartitis, tendinosis, chronic ligament laxity.