PLATELET RICH PLASMA (PRP) INJECTION

PLATELET RICH PLASMA (PRP) INJECTION

Morgan Cartoon is offering Platelet Rich Plasma (PRP) injections using a dedicated PRP kit and centrifuge system.

Platelet count

Platelet Rich Plasma is defined as plasma with greater than 5 times increased platelet concentration when compared to whole blood1.

Many PRP systems do not meet this criteria, being classified as lower (2.5 – 3 times) rather than higher (5 – 9 times) baseline concentration systems2.

Our system achieved an 11.5 times increase in platelet concentration (recent testing on ourselves) (see below).

Leukocyte count

Studies3 also indicate that non platelet cellular components in platelet concentrates are important for proper platelet function, including thrombin generation, clot retraction and growth factor release.

Leukocyte rich PRP is defined as PRP with 4 times increased leukocyte count compared to baseline.

The PRP leukocyte count on our system was increased 5.4 times.

Indications for PRP

The technique of PRP preparation and accepted indications for injection are evolving. Many studies have demonstrated beneficial effects of PRP on the healing of tendons and ligaments and growth factors in PRP have been shown to significantly enhance the healing of tendinopathy.

Studies suggest that PRP injections are most useful for the treatment of chronic tendinopathy, particularly lateral epicondylitis (tennis elbow) and Achilles tendinopathy, but PRP injections have also been used to treat ligament and muscle tears and mild to moderate knee osteoarthritis.

Prior to the Procedure

  • All anti-inflammatory medications (including over the counter Naproxen, aspirin and Ibuprofen) should be avoided 7 days prior to the procedure
  • Cardiac patients should continue taking aspirin
  • No steroid injection at the treatment site administered in the last month

How the procedure is performed

The affected region is scanned, prior to the procedure, to confirm that it is amenable to PRP injection. Between 15ml and 30ml of blood (depending on the site of injection) is drawn and centrifuged at high speed.

   

Using our disposable PRP kit the fraction containing an increased platelet/leucocyte concentration and associated growth and healing factors is collected.

Using US guidance and under local anaesthesia 2-3ml of this collected concentrated PRP is injected into the affected/injured region using sterile technique.

Post-injection Protocol

  • NSAIDs (other than aspirin for cardiac patients) should be discontinued for a further 10 days after the injection
  • Rest of the affected area is advised for the first 2 days (or until the injection pain subsides)
  • Pain and stiffness of variable intensity and duration is common in the first few days, peaking at day 3 and subsequently decreasing. Simple analgesics and a cold compress are generally helpful
  • During the first week, discomfort may reduce ability to work or use of the affected region so activities should be limited to those of daily living
  • Occasionally pain may be more severe or last for several weeks, particularly for those with high grade pathology
 AJR 2011; 196:628-636
2 International Cellular Medical Society. Guidelines for the use of Platelet Rich Plasma (adopted 2011).
3 BMJ Open Sport Exerc Med 2016;2