Blood is made up of plasma, red blood cells, white blood cells and platelets. PRP stands for platelet-rich plasma. PRP therapy is, simply put, the injection of a concentrated source of platelets into an area of injury.
It’s also an innovative treatment that has shown promise as an effective line of therapy for osteoarthritis and improved joint health.
The science behind PRP
Platelets contain hundreds of bioactive growth factors. The simplified theory behind PRP is that delivering a high concentration of platelets will also deliver a high concentration of these bioactive growth factors to stimulate and enhance healing.
The reality is that all tissues heal differently and require different cells and a different “milieu” to optimize the healing response. While scientists have discerned some key components of the process, healing is incredibly complex and continues to be studied.
The actual process of PRP therapy is relatively straightforward. Blood is drawn (like a regular blood test) then centrifuged to isolate the cellular components of the plasma. The red cells are discarded (they are chondrotoxic – harmful to cartilage – in joints), and the platelets are separated out and concentrated. Once this occurs, they’re ready to be injected back into the area of concern.
PRP in the sports medicine community
PRP first gained popularity in the early 2000s when it was used on athletes trying to recover from various injuries. One of the first documented cases was for San Francisco 49ers quarterback Steve Bono’s torn Achilles tendon. The first published study of PRP in humans was for lateral epicondylosis (tennis elbow) in 2006.
It was in 2009 that PRP gained mainstream attention when Pittsburgh Steeler’s wide receiver Hines Ward credited PRP for the quick recovery of his medial collateral ligament (MCL) injury prior to the team’s Super Bowl win. Subsequent to this, other elite athletes, including golfer Tiger Woods, have experimented with PRP as part of their rehabilitation from various injuries.
There are now numerous case studies and substantial anecdotal reports of success with PRP. Professional and elite athletes are often willing, and able, to employ any possible tool or treatment at their disposal to speed their recovery from injury in order to return to training and competition. Numerous professional sports teams now regularly use PRP.
What is the evidence for PRP?
As a sports medicine practitioner, I’ve had positive outcomes with various uses of PRP, but it’s important to understand the difference between successful “case reports,” such as those mentioned, and the best evidence-based practice that’s built upon unbiased, ideally double-blinded, randomized control trials. The higher quality studies don’t universally support the use of PRP in all injuries or all tissues. In particular, there’s a scarcity of such studies of PRP use in muscle or ligament, and the evidence currently isn’t as strong for generalized use in tendon.
Osteoarthritis, however, has shown benefit, with the knee having been the most studied and showing the strongest evidence for PRP use. Exercise, strength and weight loss are still the pillars of osteoarthritis treatment, but PRP is now considered among the adjunctive next steps of therapy – exciting news for anyone wanting to maximize conservative therapies for improved joint health!
Risks involved with PRP are the same inherent with any local injection or joint injection. No significant long-term negative side effects of PRP have been reported in the literature.
Is PRP for everyone?
Factors that can influence the outcome and success of PRP include the area of injury, the tissue type involved, the chronicity or acute nature of an injury, other treatment strategies already employed, performance demands, recovery goals, post-injection rehab, an individual’s overall health and medications.
Talking with a healthcare provider who is knowledgeable in PRP and up-to-date on the literature is of utmost importance to ensure the treatment plan is based on the best evidence available globally.
PRP therapy is now available at the Copeman Healthcare Centre in Calgary and will be available in Vancouver later this year.
Check out this webinar on platelet-rich plasma therapy for more information.