Story by: Erica Coghill on January 10, 2019
People living with orthopedic pain are increasingly considering platelet-rich plasma (PRP) injections as an alternative to surgery. The procedure uses the body’s own healing properties to treat muscle, tendon and ligament injuries.
Platelets are a type of blood cell that lives in the bloodstream. As platelets flow into wounds, they play a large role in the body’s healing process, assisting with inflammation, tissue rebuilding and wound healing.
In short, during a PRP injection procedure, the doctor harvests platelets from the patient, then concentrates them in the patient’s own plasma before injecting them into an injury to promote healing.
“We most often use PRP injections in tendon injuries,” said Ryan Modlinski, M.D., orthopedic sports medicine specialist with Norton Sports Health. “Tendon injuries have somewhat poor blood flow, which tends to mean poor healing. The PRP injections ensure ample amounts of platelets are reaching the wounded area, enhancing the healing process.”
PRP injections begin with a quick blood draw. Then, that blood is run through a centrifuge, which is a machine that rapidly spins, separating the parts.
“We get rid of the white blood cells, the red blood cells, the plasma and, basically, isolate only the platelets,” Dr. Modlinski said.
A second set of rotations in the centrifuge brings the platelets to 10 times their original concentration, hence the term platelet-rich plasma.
The physician then has a window of about 30 to 60 minutes to inject the platelet-rich plasma. An ultrasound is used to pinpoint the targeted tissue.
The injection triggers an inflammatory healing response, so the patient can expect to feel some soreness afterward.
“They will feel a little worse the next day,” Dr. Modlinski said. “I tell them that for the next three days it will feel like you pulled a muscle or re-injured yourself, then it will start feeling better.”
When the procedure is finished, the patient should rest the treated joint so the platelets can do their job in healing the tissue. Some patients use an arm brace or crutches to help avoid joint movement.
PRP injections don’t involve a hospital stay.
“We do a lot of our PRP injections on Fridays so that patients can get back to work on Monday,” Dr. Modlinski said. That’s if you work a job that doesn’t require labor or a lot of movement. For those with physical jobs, working a few weeks of light duty is recommended.
Norton Sports Health physicians typically use PRP injections on small tears and chronic strains. Some of the most common tendon injuries Dr. Modlinski has treated with PRP injections are Achilles tendon and patella injuries, as well as tennis elbow and rotator cuff injuries.
PRP injections also can help with arthritis, specifically in the knee.
“Recent research has shown some positive outcomes for knee osteoarthritis,” Dr. Modlinski said. “The injections were found to reduce pain for upward of six months to a year.”
If you have a large tendon injury, PRP injections are not the ideal treatment. Dr. Modlinski suggests it would be better to restore function to that tissue with surgery.
“It is not a miracle drug — it is not going to grow cartilage, it is not going to heal a full-thickness rotator cuff tear — so people have to be realistic with what they expect it to do,” Dr. Modlinski said.
A consultation with your doctor is key in determining whether PRP injections are the right course of action.
The sports medicine specialists with Norton Sports Health provide innovative, leading-edge treatments for athletes and active individuals who want to get moving again.
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Most commercial insurance companies won’t cover PRP injections. The procedure is common in Europe but fairly new in mainstream U.S. health care.
“There are good studies highlighting the effectiveness of PRP injections, but it’s still a somewhat novel treatment,” Dr. Modlinski said. “I think once that novelty wears off, we will see more insurance companies supporting PRP injections for more conditions.”
Out-of-pocket, you can expect to pay about $700 for the procedure. For many people weighing the cost of PRP injections with surgery, it’s worth it.
“I have several patients who’ve chosen to avoid costly surgery and instead went the route of using their own body’s ability to heal through PRP injections,” Dr. Modlinski said.
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