Arthritis Treatment: Is Platelet-Rich Plasma PRP Therapy Effective?

To help heal damaged tissue, both athletes and non-athletes alike - particularly those in the Baby Boomer generation- have been attracted to the use of platelet-rich plasma (PRP) therapy. PRP is made by obtaining a specimen of a patient's blood (usually 60 cc's) and centrifuging it to isolate the platelets, (cells responsible for clotting), in a small volume of plasma.

This concentration of platelets is then injected, using ultrasound guidance, into the site of the patient's injury. The theory surrounding PRP is that growth and healing factors, stored in small packets located inside platelets, accelerate tissue recovery.

Tendonitis, or more accurately, tendinopathy, is a universal soft tissue injury problem and is a common affliction of both athletes as well as Baby Boomers.

These tendon injuries tend to become chronic, and are due to microscopic tearing of the tendon with formation of scar tissue. These tendinopathies heal poorly because they are usually located in "watershed" areas, regions where there is as relatively poor blood supply. An example would be the Achilles tendon.

Since poor blood supply restricts the ability of nutrients as well as healing or growth factors to get to the area, the application of PRP fixes that problem.

So theory aside, what has the data shown?

A number of studies conducted on the effectiveness of PRP have come up with mixed results. Some studies have shown benefit while others have not.

So why the discrepancy and does PRP really work?

Some investigators have argued that the placebo effect accounts for the success of PRP since it is a dramatic procedure involving a needle.

Another explanation is that the process of needling a tendon cause irritation and bleeding and this is known to help healing by attracting growth factors in the blood.

Another factor that might suggest a discrepancy in the results of studies is the difference in the rehabilitation program. For optimal results following a PRP procedure, a patient requires rest, modification of activity level and a specifically designed rehabilitation program with stretching and strengthening. The rest is important for the first few days since a significant amount of pain is experienced by many patients following PRP.

A patient is considered a candidate for PRP if they have either failed at least two to three months of other therapies or have a significant tendon or ligament issue that needs immediate attention.

Usually patients respond to one treatment but may require at least one more. Patients rarely require three.