Platelet-rich plasma (PRP) (also known as blood injection therapy) is a medical treatment being used for a wide range of musculoskeletal problems. Platelet-rich plasma refers to a sample of serum (blood) plasma that has as much as four times more than the normal amount of platelets. This treatment enhances the body’s natural ability to heal itself. It is used to improve healing and shorten recovery time from acute and chronic soft tissue injuries.
The procedure can be performed non-surgically when treating joint osteoarthritis or cartilage degeneration. Most non-surgical procedures can be done on an outpatient basis, usually in the office setting. Treatment with platelet-rich plasma is broken down into two steps: preparing the platelet-rich plasma for injection and then injection into the affected area.
First, blood is drawn from your arm and used to create the injected fluid. The blood is placed (in a test tube) in a machine called a centrifuge. The centrifuge spins the blood fast enough to separate it into layers based on weight. Heavier parts (e.g., red blood cells) stay on the bottom. Platelets and white blood cells spin out just above the red blood cell layer. Lighter particles (plasma without platelets or blood cells) make up the top layer in the test tube.
Once you have had your blood drawn, the sample is prepared right away. You can have the injection as quickly as 30 minutes later. The surgeon may use imaging such as fluoroscopy (real-time, 3-D X-rays) or dynamic musculoskeletal ultrasound to place the needle that delivers the PRP directly into the joint.
You will probably not be asleep or anesthetized unless the plasma is applied during a surgical procedure. When used on an outpatient basis for a nonsurgical treatment, a numbing agent like novacaine (e.g., lidocaine, marcaine) is used so that you don’t feel anything.
The post-operative program varies from surgeon to surgeon but often includes the use of local ice held on the knee for 20 minutes every two to three hours for a 24-hour period. Your doctor may suggest using Tylenol for pain relief but ibuprofen or other anti-inflammatories are not advised. That’s because the treatment is designed to set up an inflammatory response, so you don’t want to stop that process with medications.
You may be advised to tone down your level of activity and avoid vigorous use of the knee for at least 48 hours. Most surgeons allow their patients to put weight on the injected knee as tolerated (usually determined by pain levels).
You may see a physical therapist after this procedure to help you regain motion, strength, motor control, and function. There isn’t a known rehab protocol (standard program to follow) yet. Physical therapists are working with surgeons on a patient-by-patient basis to determine what might be best for each individual.