Are PRP Injections a Magic Wand for Fixing Athletes?
It is intriguing to think that such a minor procedure, which has minimal known risk and requires no hospitalization, could speed up or improve the natural healing process returning athletes to the activities they love. People are increasingly familiar with the term platelet-rich plasma (PRP), but what do we really know about it and how it works? Platelet-Rich Plasma (PRP) Human blood is made up of several components, including cells and plasma. The watery part of blood is called plasma and contains important proteins. Some of these proteins stick together to form a platform/scaffold during blood clotting. This gel or scaffold can then bridge the gap in damaged tissue to provide binding for other cells to stick to and ultimately support healing. Cells in blood include red cells that carry oxygen, white cells that fight infection, and platelets that help with blood clotting. Platelets clump together and work along with the other “scaffold” proteins in plasma to form blood clots after injury. During clot formation platelets release growth factors which stimulate many beneficial processes for healing.
Platelet-rich plasma is made by taking a sample of whole blood and spinning it in a centrifuge. The first spin separates the red blood cells from the plasma containing the platelets, white cells, and clotting factors. A second spin then separates out the white blood cells leaving behind plasma where the platelets are concentrated. This platelet-rich plasma, with all of its helpful growth factors, can then be injected to improve healing. When we look at the evidence associated with using PRP the results are mixed. For instance it does seem to help reduce the pain from tennis elbow when compared to steroid injection, but has not proven to significantly help treat Achilles tendinitis. Similarly some studies have shown improvement with the symptoms of knee arthritis, but other studies have not shown a significant benefit. The types and concentration of growth factors vary between people and between different blood draws in the same person. We don’t really know which factors are the most important and we don’t know if a single injection is enough, or if we need to do a series. Currently, there are few reported complications, but there may be more if usage becomes widespread. Finally, it’s still considered experimental and not covered by most insurance plans, so people must pay out-of-pocket for the treatment. The magic of using a person’s own blood, which contains a wonderful abundance of growth factors, to help heal or speed up recovery, is an exciting prospect. Researchers have a lot of work to do to understand where and when PRP is most useful, and how to deliver it cost-effectively in order to realize all the theoretical benefits to enhance tissue healing.