Platelet Rich Plasma Therapy (PRPT)

1. Platelet Rich Plasma Therapy (PRPT)

2. What is PRPT? • New treatment gaining popularity in the Sports Medicine field of rehabilitation used for orthopedic injuries • Patient’s own blood is drawn and then re-injected into the area needing treatment • Platelet rich plasma is believed to significantly enhance the healing process of an injury

3. What is platelet rich plasma? • Concentrate extract of platelets of patient’s own blood • Step by step process • 1. Patient’s blood is drawn • 2. Blood is centrifuged once • 3. 2 separate levels appear • 4. Blood is centrifuged again • 5. 3 levels in the blood appear, on of them being platelet rich plasma • Higher concentration of platelets in the blood after centrifuge • Plasma is taken from centrifuge and re-injected into area of injury

4. How does it work? • Platelets contain growth & healing factors • Platelets help stimulate and accelerate the immune system which initiates tissue regeneration of ligaments and tendons • Promotes angiogenesis • Stimulates growth of new healthy cartilage

5. Who is it for? • Tendinopathy • Research has been done on treatment of the elbow or knee • Torn ligaments • Research has shown improved results for the UCL at the elbow • Beneficial treatment for osteoarthritis of the knee • Hip arthritis • Tendinitis • At the hip/ rotator cuff/ achilles tendon • Greater trochanter bursitis

6. What are the results? • Effective at relieving pain • Hastens the healing process • Proof of tissue repair has been seen through ultrasound and MRI • In both ligaments and tendons • Decreases need for surgery

7. Common Side Effects • Localized swelling • Pain • Risk of hematoma • Infection • Scarring

8. Contraindications • Cancer • Pregnancy • Active infection • Patient on anti-coagulants

9. Complications • More research needs to be done • A controlled clinical study needs to be completed • Insurance companies are not yet covering PRPT • No standard protocol for how much PRPT or how often treatment should be • Treatment will vary from patient to patient

10. How does it effect PT? • PT should follow PRPT injection • Patient should not do physical activity for 1 week after injection • Start patient on progressive strength program • Typically lasting 8 weeks • Specific exercise programs will vary depending on the patient’s affected area

11. References • Park Y, Han S, Song S, Kim T, Ha C. Platelet-rich plasma therapy for knee joint problems: review of the literature, current practice and legal perspectives in Korea. Knee Surgery & Related Research [serial online]. June 2012;24(2):70-78. Available from: MEDLINE, Ipswich, MA. Accessed October 10, 2012. • Podd D. Platelet-rich plasma therapy: origins and applications investigated. JAAPA: Official Journal Of The American Academy Of Physician Assistants [serial online]. June 2012;25(6):44-49. Available from: MEDLINE, Ipswich, MA. Accessed October 10, 2012. • Araki J, Jona M, Yoshimura K, et al. Optimized preparation method of platelet-concentrated plasma and noncoagulating platelet-derived factor concentrates: maximization of platelet concentration and removal of fibrinogen. Tissue Engineering. Part C, Methods [serial online]. March 2012;18(3):176-185. Available from: MEDLINE, Ipswich, MA. Accessed October 11, 2012. • http://www.treatingpain.com/diagnosis-and-treatments/platelet-rich-plasma.htm • http://www.kevinmd.com/blog/2012/09/prp-work-knee-injuries.html • http://www.jointrehab.com/hip_pain_prp_therapy_los_angeles.htm • http://www.dierenartshoegaerts.be/nl/therapie/injecties/documents/prpguide.pdf • http://ptsportswellness.wordpress.com/2012/01/14/platelet-rich-plasma-prp-injection-therapy-a-musculoskeletal-panacea/