I confess I’m a retired physician with a healthy interest in sports, sports celebrities, and the treatment of sports injuries. For awhile, the new platelet-rich plasma treatment for soft tissue injuries was front and center of all the news media reports. When any big time player got this treatment, we all heard about it. But it seems to have fallen off. What’s the status of this treatment technique? Was it all media hype and bogus or is there something to it?

It turns out that the simple idea of using the body’s own platelets with its powerful growth factors to speed up healing is more complex than originally thought. What started out as a way to remove a person’s own plasma and platelets and inject them into injured tendons, ligaments, or muscles quickly opened up Pandora’s box.

One concern raised by a group of expert scientists who reviewed 5000 published studies on this treatment is the lack of quality control over platelet-rich plasma. There is no way to standardize the product because the body simply doesn’t produce the same amount of platelets every hour of every day in every person. What you eat, how well you sleep, medications you take, and even the exercise you get can all affect platelet levels in the blood.

There’s more than one way to extract (remove) the platelet-rich plasma (PRP) and that can also affect the quality of the product. Other components of the blood (such as white blood cells) may get in the sample used and alter the body’s healing response (not always favorably).

A closer look at the different studies highlighted some of the difficulties in comparing one study to another. That may explain why results can be opposite from study to study. One common theme seems to be that platelet-rich plasma may be most effective for chronic musculoskeletal injuries. It’s not a given that the results obtained in one condition will be the same for another type of soft tissue injury.

Another problem is the wide range of tissue types being treated (e.g., cartilage, bone, tendons, ligaments, muscles). Results seem to differ within the tissue types so that how platelet-rich plasma affects a ligament in the knee may not be the same as the effects on a similar ligament in the ankle.

And a major stumbling block in the research that’s being done on platelet-rich plasma (PRP) is the way results are recorded. Some studies look at patient response in terms of pain levels and activities of living. Others are measuring strength after treatment or speed of wound healing during recovery.

The treatment isn’t bogus at all. It’s just that there are some concerns that need to be addressed before platelet-rich plasma is used for any and all soft tissue injuries. For example, we need to determine who’s a good candidate for this treatment? What kind of conditions can be treated effectively with platelet-rich plasma? How long should we wait after having platelet-rich plasma before resuming normal activities?

Engineering healing with platelet-rich plasma is an exciting area of research and study. If successful, it could result in fast, effective healing of all types of soft tissue injuries. We’re not quite ready for any real treatment guidelines yet but we are a step closer to organizing and directing future studies.