Platelet Rich Plasma Therapy (PRP)
What is Blood Spinning?
Blood spinning, also known as Platelet-rich Plasma therapy, is a “treatment to help musculoskeletal issues,” according to Dr. Brian Halpem, Sports Medicine Physician at Hospital for Special Surgery in New York. Dr. Halpem says that it is best used for chronic tendon issues, partial tears in the tendons, and, recently, has been looked at as a treatment for osteoarthritis. The treatment, invented in the 1970s by oral surgeons looking to speed up the healing process, involves extracting blood from a patients arm and putting the blood into a centrifuge. The centrifuge spins the blood for about six minutes, separating the red and white blood cells and the platelet-rich plasma. Dr. Halpem explains, “In this substance are platelets, full of growth factors, which the body uses to heal tissues naturally; this substance is just concentrated two to three times what your body creates.”
“When you inject the substance into the problem area-say an arthritic knee- the growth factors are released. And stem cells are ‘recruited” to help in the healing process as well.” Doctors are also beginning to re-image the treated area (for example, the arthritic knee) to see if the injections did anything to replace cartilage. Though there is no way to quantify the difference in speed of recovery, Dr Halpem sees an 80% response in improve function and less pain in patients after receiving the treatment.
Halpem says, though, that the treatment is still in its research stages to find the optimum injection frequency; additionally, not all uses for the treatment are known, “The procedure is not perfect for everybody and everything- it has a lot of promise but must be approached methodically.” He explained, “PRP is not yet widely available and health insurance coverage is variable…there are not yet a lot of doctors who utilize the treatment, but it is becoming more prominent.”
Dr. Halpem said the benefits strongly outweigh any assumed negative consequences: “PRP treatment has a ton of promise. The goal is to be of benefit to the patient- we don’t want to hurt anyone. This treatment is important because we are using a patient’s own blood; the injuries are healing themselves naturally. Though tests are still being done, if it works as it seems to, Platelet-Rich Plasma treatment could really be a very important procedure for the future.
Is PRP Treatment Effective?
Several basic science studies in animal models suggest that PRP treatment can improve healing in soft tissue and bone. For example, increased numbers of cells and improved tendon strength have been noted in Achilles tendon injuries, and improved muscle regeneration has been shown in gastrocnemius (calf) muscle injuries.
These favorable findings in animal models have led to the widespread use of PRP treatment for a variety of conditions, including acute and chronic tendon problems, as well as injuries to ligaments and muscles. Some early-stage clinical studies in humans have been promising but are limited by their study design and few patients.
The most promising early results have been seen when PRP treatment is used for chronic tendon conditions, such as lateral epicondylitis (tennis elbow) and Achilles tendinosis, which impacts the Achilles tendon. Nonetheless, a recent study in the Journal of the American Medical Association reported that there was no advantage to using PRP injection compared to saline (placebo) injection for the treatment of Achilles tendinosis.
In a small study involving knee osteoarthritis, PRP treatment was shown to be more effective than hyaluronic acid treatment. PRP has also resulted in positive or similar results when used in the treatment of rotator cuff tears and medial collateral ligament (MCL) injuries in the knee.
Overall, there is limited support of PRP treatment in published clinical studies. However, because PRP is created form a patient’s own blood, it is considered a relatively low-risk treatment with the potential to improve or spread healing.
More studies are needed to prove the effectiveness of PRP treatment and to research the best ways to standardize the treatments preparation.
Key Points to Remember
- Platelet Rich Plasma (PRP) comes from a patient’s own blood.
- PRP is a concentrated source of growth factors and cellular signaling factors that play a significant role in the biology of healing.
- Basic science studies show that PRP treatment may improve healing in many tissues.
- Few clinical studies in human show the effectiveness of PRP treatment.
- Anti-inflammatory medicines should be stopped before and after PRP treatment is given.