What is Platelet Rich Plasma (PRP)?

Dr Julien Freitag performs Platelet Rich Plasma (PRP) at Lifecare Prahran. PRP is a growth factor rich medium that is developed from your own blood. It is not synthetic.

Research has shown PRP to be effective in the treatment of many musculoskeletal conditions. Recent developments of PhotoActivation have been successful in increasing the naturally derived anti-inflammatory mediators within PRP.

Increased anti-inflammatory mediator post PhotoActivation. (Reproduced with the approval of Adistem Pty Ltd)

What is Involved?

PRP therapy involves three injections into the injured area over two weeks.  Injections are done under strict sterile surgical conditions, with local anaesthetic and using ultrasound guidance.

On each occasion you will be required to donate blood for generation of the PRP. Each procedure will take approximately 45 minutes.

It is recommended that you have someone to drive you home after an injection due to some potential residual effects of the local anaesthetic or discomfort from the procedure.  Patients undergoing Platelet Rich Plasma therapy are required to also be actively involved in a supervised tendon rehabilitation program.

Risks

  • Bleeding/Bruising
  • Infection
  • To reduce chance of infection all injections are done under strict sterile conditions using ultrasound guidance for accuracy
  • PRP has natural anti-bacterial properties that reduce chance of infection
  • Pain/Discomfort
  • Injections into a tendon are not always comfortable. Where possible a regional nerve block is performed to improve comfort
  • Some people may experience a vasovagal episode during or post injection where they feel lightheaded and sweaty
  • This is self-limiting

Contraindications

Whilst very safe, use of platelet rich plasma is contraindicated in the following conditions

  • Pregnancy
  • Cancer
  • Bleeding disorders

Evidence

Level 1 scientific research has shown PRP to be effective in the treatment of various musculoskeletal conditions/injuries.  Studies have indicated that PRP achieves better results than cortisone or placebo injections. Results from PRP injection in combination with an eccentric exercise program are also better than doing an exercise program alone.

Research Articles

Creaney et al (2011) Growth Factor-Based Therapies Provide Additional Benefit Beyond Physical Therapy in Resistant Elbow Tendinopathy: A Prospective, Single-Blind, Randomised Trial of Autologous Blood Injections Versus Platelet-Rich Plasma Injections. Br J Sports Med, Online Publication

Rabago et al (2009) A Systematic Review of Four Injection Therapies for Lateral Epicondylosis: Prolotherapy, Whole Blood and Platelet-Rich Plasma. Br J Sports Med;43:471-481

Anitua et al (2006) New Insights into and Novel Applications for Platelet-Rich Fibrin Therapies, Trends in Biotechnology. Vol 24, 5:227-234

Edwards et al (2003) Autologous Blood Injections for Refractory Lateral Epicondylitis, J Hand Surg, Vol 28, 2:272-278

Cost

The cost of Photo Activated Platelet Rich Plasma is approximately $400. 

Patients require a GP or medical specialist referral for PRP. Patients will also receive a greater rebate (and thus reduced out of pocket) if referred by their regular doctor or another physician.

Pensioners have a reduced out of pocket expense (approx $250) 

Post Injection Instructions

1. Pain Flare

To improve the comfort of the procedure local anaesthetic is infiltrated at site of the injection.  Where possible a regional nerve block is performed.  Some patients may experience a small flare of their pain after the local anaesthetic wears off.  This can last between 12 - 72 hours.

It is advised that on return to home that you take 2 paracetamol (Panadol) tablets. You will be supplied with a script from your treating doctor for stronger analgesia/pain relief if required.

2. Return to Activity/Work

Patients in low impact work roles are expected to need up to 3 days off work due to potential discomfort.  Higher impact jobs that require heavy lifting may need longer.  It is advised that patients should not return to their regular work/activities until their pain has returned to their pre-injection level of comfort.

3. Exercise post-Injection

It is advised that patients should re-commence their exercise/strengthening rehabilitation program (physiotherapy guided) when their pain returns to pre-injection baseline levels.

4. Physiotherapy/Massage

It may be useful to have range of motion therapy and also soft tissue massage in the immediate week after your injection.