What Is PRP And How It Is Related To Orthopedics?

What Is PRP(Platelet-rich Plasma)?

Throughout the years, much has been written about a preparation called platelet-rich plasma (PRP) and its potential usefulness in relation to orthopaedic treatments. Many prominent athletes and national and international level players have gone through PRP for numerous problems. Some of these issues, such as chronic tendon injuries and sprained knees can be treated only by PRP. The typical treatment for these types of conditions has been medication, physical therapy and in some cases even surgery. There are many athletes who have given the credit to PRP for being able to return back to their game much more quickly. 

PRP Therapy, And Questions Related To It

Although PRP has received a lot of fame over the years, there are still some questions regarding it that come to mind, such as:

• What platelet-rich plasma exactly is?
• How does platelet-rich plasma work?
• What are the conditions that are covered in a platelet-rich plasma treatment?
• Is PRP treatment really effective?

Therefore, now let us tell you about PRP therapy in detail. And, how it is related to orthopaedics with all the above-mentioned questions answered as well.  

What Is Platelet-Rich Plasma Therapy?

Though blood seems only to be a liquid (known as plasma), it has several constituents. There are small solid components (white cells, red cells and platelets) in it. The use of platelets is well known for their significance in clotting blood. Apart from this, there are also hundreds of proteins called growth factors present in platelets which play their importance in the healing of injuries. PRP is plasma with an increased number of platelets than what is usually found in the blood. The concentration of platelets, hence and subsequently the concentration of growth factors, in this case, is 5 to 10 times greater (or richer) than usual. Prior to a PRP therapy, blood must first be collected from a patient. Then through a process called centrifugation, the platelets’ concentration is increased by separating them from other blood cells. The increased concentration of these platelets is then combined with the rest of the blood.

How Does Platelet-Rich Plasma Treatment Work?

Although it is still not very clear how PRP therapy exactly works, many laboratory studies have proven that the heightened concentration of growth factors in PRP can possibly quicken up the healing process. The injured area is treated with the PRP preparation to speed healing. This can be done in two possible ways, such as:

Inject PRP Injection Cautiously 

PRP can be very cautiously injected into the damaged area e.g. PRP injections for knees or PRP injections for shoulders. Other examples include Achilles tendonitis, a condition mostly noticed in tennis players and runners where the heel cord can become inflamed and swollen making it very painful. A mixture of local anaesthetic and PRP can be directly injected into this inflamed tissue. Later, the patient may feel increased pain in the area of the injection for the initial two weeks after which it will subside and it may take several more weeks before the patient actually sees the gain from the plasma treatment. 

Using Plasma Treatment For Healing 

PRP therapy has also been used to improve the healing in a patient after they go through surgery due to some injuries. An example can be where an athlete with a completely torn heel cord may need to have his tendon repaired through surgery. We can improve the healing of a torn tendon through the treatment of the injured area with platelet-rich plasma while in surgery. For this, PRP is prepared in a special way so it can be stitched actually into the torn tissues.

Conditions That Are Covered In A Platelet Rich Plasma Therapy Treatment?

There are some well-outlined conditions of the orthopaedic department that fall under the PRP treatment. And, people often have to use it as a therapy or treatment procedure to get well soon. Below, we have outlined some medical conditions and situations that are treated by PRP injections or platelet-rich plasma treatment. 

Chronic Tendon Injuries

As per most of the studies posted in relation to PRP therapy, the most effective treatment has been for chronic tendon injuries. This especially includes tennis elbow, an injury very common in tennis players that occurs on the tendons on the outside of the elbow. PRP treatment can also be used in other chronic tendon injuries which include Achilles tendonitis which is inflammation of the patellar tendon at the knee (jumper’s knee) and the results have been positive. Still, it cannot be said 100% that plasma treatment will be more beneficial than the traditional treatments for these injuries.

Acute Ligament and Muscle Injuries

Much of the fame PRP therapy has received till date has also been about the treatment of acute injuries in sports. These include muscle and ligament injuries. Professional athletes have used PRP therapy to deal with some common sports injuries like pulled hamstring muscles in the knee and thigh sprains. However, there has been no conclusive scientific evidence that PRP therapy has actually improved the recovery process in these types of injuries.

Surgery And PRP Therapy 

In recent times, PRP has been used to help heal tissues in many different types of surgeries. At first, it was widely tested to show improvement in shoulder surgery to repair torn rotator cuff tendons. However, the results for PRP being used in these types of surgical procedures have shown no or very little benefit. PRP has also been applied in surgeries to repair torn knee ligaments, especially the anterior cruciate ligament (ACL). In this instance as well, there has been very little recorded improvement from the use of PRP.

Knee Arthritis

The arthritic knee is an area where initial research is being carried out to gauge the usefulness of PRP. At this stage, it would be a little early to evaluate whether the PRP treatment would be more effective than the existing methods.

Fractures

In a very limited way, PRP treatment has been used to act as a catalyst in the process of healing broken bones. This has not shown any significant results so far. But there are certain experiments and treatments in place to see if the process can be refined. 

Is PRP Treatment Really Effective?

Several research studies have been conducted to gauge the effectiveness of PRP treatment. Since PRP results have been very varied and there are some mixed PRP reviews, the results of these studies till date have been inconclusive. Below are some factors that have been known to influence the effectiveness of a plasma treatment:

• The body area that is being treated
• The patient’s overall health
• Whether the injury is chronic (an injury that has been developing over a period) or acute (like from a fall)

Orthopaedic PRP Therapy And How It Can Be Beneficial? 

A platelet-rich plasma treatment could definitely be beneficial for you. The medical community is still looking for a lot of scientific evidence to determine the accurate amount of results from a PRP treatment, however, one thing is clear. The risks associated with this treatment are very minimal. Platelet-Rich Plasma treatment is known not to cause problems like nerve injuries, tissue damage or infections any more than the traditional treatments available. Also, when considering treatment with PRP, patients also need to make sure to check their eligibility with their health insurance provider as PRP injection Knee cost can go quite high. The cost revolves around USD $500.00 to USD $2,000.00. And, this exchange rate of price can vary depending on the medical facility provided in your country. 

Is There Any Adverse Effect Of PRP Therapy & How Good Are PRP Results?

The adverse effects of PRP therapy are poorly studied and have not been experimented any further. Furthermore, there has been no such evidence that the treatment is harmful or can be dangerous in any way or form. In 2019, Health Canada indicated that the maximum number of autologous cell therapies have little proof exhibiting they work and can establish dangers. The dangers specified as such are:

• Cross-contamination between people
• Lack of sterilized equipment
• Immune reactions based on poorly determined blood transfusions

These are just a few identified issues. But these can be avoided as per orthopaedic experts and need proper care and medical staff’s diligence. 

What Do You Need To Know About PRP Treatment In Pakistan?

In Pakistan, a very few registered orthopaedic surgeons and doctors can suggest PRP therapy to their patients. These medical PRP reviews and suggestions vary from patient to patient. This is because the therapy has not been studied any farther and has been not many experiments around it. However, as we stated above, your orthopaedic surgeon a doctor is the best expert to suggest and recommend this therapy. Therefore, always seek expert medical advise and stick to what can be beneficial for your health. You may take counter recommendations, but that will only confuse your judgment to opt or not to opt for the therapy. If you’re in Lahore, you may consult and seek advice from Prof Dr M A Wajid FRCS, FRCS(Tr & Orth) the U.K. His timings can be requested from the help desk in National Hospital, Defence.