Platelet Rich Plasma Therapy
Platelet Rich Plasma (PRP) therapy is a relatively new treatment designed to aid in the healing and regeneration of soft tissues such as tendons and ligaments.
Tendons and ligaments are made up of fibers of collagen. When these fibers are stretched or torn we may refer to the injury as a “pull”, “tear”, “sprain” (ligament) or “strain” (tendon). These structures are vascular which means there are blood vessels in them. Thus, when they are injured they bleed. If there is enough bleeding we may notice bruising around the area of injury. Blood flow to the area increases to aid in healing.
The blood carries platelets and growth factors that allow for healing of the tissue by creating new collagen fibers. These new fibers need to be constructed in an organized, layered fashion to heal correctly and allow the ligament or tendon to regain its proper strength and flexibility.
Sometimes, however, the healing process does not work correctly and instead of forming healthy collagen fibers there is significant scar tissue that develops in its place. One of the risk factors for this is not getting enough blood flow to the area to provide those platelets and healing factors. The development of scar tissue even further prohibits proper blood flow as new capillaries and other small blood vessels can't penetrate through the scar tissue to provide blood flow to the injured area.
When scarred or disorganized tissue inhibits this process the blood flow to the area becomes blocked. This means that the tissue will never really have the opportunity to heal correctly. That is why sometimes ligament and tendon injuries heal and other times they do not.
PRP therapy is the solution to this problem. In PRP treatment the patient's own blood is taken with a simple blood draw. Using a special centrifuge machine the blood is spun down to separate out and concentrates the platelets and growth factors that are essential for tissue healing. This small amount of fluid with concentrated platelets and growth factors is called platelet rich plasma (PRP). Nothing else is added to the patient's own blood products so there is no risk of allergy, reaction or rejection.
The physician is then able to use a needle to inject the PRP directly into the injured area and even between tightly packed collagen fibers. Once these platelets and growth factors are in the area of injury they then become activated. They also recruit other healing proteins and factors to the area and healing and regeneration of the tissue can now begin.
Article written by Andrew Blecher, an orthopedic surgeon in Southern California. Reprinted with permission.