Dr Amit Chakraborty, Sep 2021
What is platelet rich plasma?
Platelet rich plasma (PRP) is a specialised liquid that is extracted from the recipient’s own blood. It is rich in anti-inflammatory and healing nutrients. As the name suggests, it is called plasma, which is the liquid component of the patient’s own blood.
How is platelet rich plasma derived?
Platelet rich plasma is derived from the patient’s own blood. On the day of the procedure, 5-10 ML of your own blood is collected and sent to the pathology laboratory for special processing. Here, they place the specimen in a tube and spin it in a centrifuge machine. This high rotational centrifuge motion separates the liquid component of the blood from the cellular components such as the red cells. The liquid component is then separated and made available for injecting back into your own body.
What is platelet rich plasma good for?
Even though there is some debate as to its efficacy, it is generally believed that platelet rich plasma encourages tissue healing, especially in muscles and tendons. It is believed that a direct injection of platelet rich plasma in an area where the muscle fibres are disrupted encourages prompt healing.
The method of action is different to that of injectable corticosteroids. Injectable steroids act to reduce inflammation and does provide symptomatic relief. Platelet rich plasma actually aids in healing.
How is platelet rich plasma injected?
The injection procedure is similar to that of a corticosteroid injection under ultrasound guidance. The liquid that is separated from the patient’s blood is made available in a sterile syringe. Your radiologist does a quick scan of the affected body part and determines the area to be injected and the amount to be injected. Sterile precautions are then taken, a small amount of local anaesthetic is then applied to the skin surface. Under ultrasound guidance, the plasma is then injected directly within the muscle substance in the affected area.
What to expect from a platelet rich plasma injection?
Platelet rich plasma is designed to accelerate healing. With adequate rest and timely rehabilitation such as physiotherapy, most muscle and tendon injuries can heal completely. This is, however, not an overnight process and can take several weeks, depending on the body part and the area injured.
What are the side effects?
Initially, there may be an increase in the amount of pain in the region of interest. As opposed to the corticosteroid injection, the platelet rich plasma is designed to encourage inflammation, rather than suppress it. The inflammation is, in fact, body’s attempt at healing. As a result of this, you may experience increased pain at the injection site. Regular use of painkillers can sometimes be beneficial.
Platelet rich plasma is your own body’s chemical. As such, chances of allergic reaction are minimal.
There is a small chance that the injection may be ineffective. Sometimes more than one injection is required to achieve the desired result.
Post procedural instructions:
The patient is generally advised to rest the affected body part for some time. The exact amount of rest will be determined based on the degree of injury and the affected body part. Clear instructions will be given to the patient on the day. It is generally encouraged to commence gentle exercise of the affected body part within 1-2 weeks. This encourages blood flow and supports healing. This also prevents joint stiffness and weakness.
What preparations should patients take before the injection?
Generally, no major preparation is necessary for a platelet rich plasma injection. Ensure that you wear comfortable clothing and that the affected body part can be easily exposed. It is advisable that you refrain from heavy manual work for 24-48 hours following the procedure.
It is also a good idea to make an appointment with your local doctor in 2-3 days’ time.
Conclusion:
In the recent years, platelet rich plasma injection has emerged as a new and novel therapy for musculoskeletal injuries. This can be easily done an office environment by a skilled radiologist. Whilst there is some debate as to its efficacy, in our experience, the vast majority of the patients report
substantial improvement in their symptoms within a few weeks.