Is the Hype Justified? Platelet-Rich Plasma (PRP) and Sports Injuries
If you follow sports injuries or are in the business of caring for athletes, you surely have heard of platelet-rich plasma also known as PRP. Many people have heard of it as a treatment for professional athletes or themselves, but they don’t quite really know how it is proposed to work. I wanted to take the opportunity to dive a little deeper into this subject as PRP injection becomes more commonplace in the treatment of orthopedic injuries.
What is platelet-rich plasma (PRP)?
PRP is a blood-derived product that contains elevated levels of platelets. The product is created by drawing a patient’s blood and separating the cells into different layers. After the separation process, the top layer is called plasma and contains a high level of platelets. Therefore, the term platelet-rich plasma just means the plasma portion of blood that has a very high level of platelets in it. Platelets are believed to contain and stimulate growth factors and cells to stimulate a healing response. In addition to platelets, there are also white blood cells within PRP that help with stimulating an inflammatory response to help with tissue repair.
What is activated platelet-rich plasma (PRP)?
There are several ways to prepare a PRP specimen, which can sometimes cause confusion in regards to how the product is utilized. A popular step in preparing the PRP is to activate the platelets in order to release the growth factors from within. Activation can occur by adding a product such as thrombin or calcium to the plasma in order to stimulate the platelets into action. Keep in mind, there is still debate whether activation is necessary to achieve the intended outcome.
How is platelet-rich plasma (PRP) used in sport injuries?
Generally speaking, when an athlete has an injury, either acute or chronic, the body is tasked with healing the affected tissue. However, many times the body is unable to repair the tissue appropriately which leads to persistent pain or disability. In theory, if platelet-rich plasma (PRP) is injected around the site of injury, the healing process can be “jump-started” by the growth factors found within PRP. platelet-rich plasma (PRP) is commonly used to treat a condition called tendinopathy which is chronic degeneration of a tendon after prolonged injury. According to the literature, PRP has been used to treat tendon, ligament, muscle and cartilage injuries with varying success. Theoretically the science is sound, however, there are many conflicting opinions and research papers on the true benefit of this treatment. One competing argument is that the simple act of placing the needle for the injection will cause local inflammatory response and bleeding, which results in similar stimulatory effects to healing as are believed to occur with platelet-rich plasma (PRP).
Why we will Hear a lot more About PRP in Sports
The biggest reason why I believe PRP will continue to grow in popularity is that the safety profile and adverse reactions are low. The biggest deterrent is that insurance usually does not cover the treatment and it comes with a hefty price tag. However, when cost is not a significant factor, such as in professional sports, a common sentiment is that the treatment is worth a try. Keep in mind, the jury is still out on the overall utility and benefit of a platelet-rich plasma (PRP) injection for treatment of musculoskeletal injuries. The lack of consensus comes from the variety of preparations of PRP as well as its usage in a variety of situations with mixed results. If you have the money, it might be worth it, otherwise, there are other options out there that might get the job done for those chronic nagging injuries.
Reference: Wu PI, Diaz R, Borg-Stein J.Phys Med Rehabil Clin N Am. 2016 Nov;27(4):825-853.