By Laura Freeman
In recent years, healthcare providers have begun using platelet-rich plasma (PRP) more frequently to help patients get faster relief from chronic conditions and recover faster from injuries and surgery without the side effects of some of the standard treatments used in the past.
“In orthopedic conditions that we’ve usually treated with steroids, platelet-rich plasma gives patients a new option,” Michael Ewing, MD of Orthosports Associates said. “It offers high potential to ease pain and speed healing without the possible downside of steroids. This is particularly important in conditions that tend to need repeated treatment through the years.
“One area where my patients are finding PRP particularly helpful is in early arthritis when inflammation in the knees starts causing pain. With one injection of PRP concentrated from the patient’s own blood, we see the inflammation calming down and the pain eases. This can help patients get back to active living faster while delaying or even avoiding the need for more aggressive treatments. It can also help buy time in other cases when surgery needs to be delayed or avoided.
“While we’ve had a lot of hope for other innovative approaches such as injectable gels, which can be helpful in some cases, the response in others hasn’t always been what we hoped to see. However, I’ve been impressed with our results from platelet-rich plasma. All patients are different, of course. Everyone has a different body and DNA and immune system, but where there’s a good chance PRP can help, I like to offer my patients that option.”
In addition to arthritic knees, PRP can be helpful in treating tennis elbow and other tendon, ligament, muscle and joint conditions. It can also help to speed healing after surgery.
“Torn rotator cuffs can be difficult to heal, even with the most experienced surgeons making the repairs, but injecting PRPs really seems to improve the odds for achieving a good outcome,” Ewing said. “Overall, my patients have been happy with the results. Some also tell me they feel better knowing PRP comes from their own blood rather than using something not normally found in their body.”
Growth factor and other biological elements found with concentrated platelets have shown to be especially effective in calming down inflammation and encouraging tissue repair. The process of gathering, concentrating and injecting PRPs can be done in the same office visit. After examining the patient, evaluating treatment recommendations will include an overall review of the patient’s health and history, and a look at labs and current medications.
“We take about 30 to 60 CCs of blood and spin it down, then draw off three to five CCs of the platelet-rich plasma. It’s ready to inject where it’s needed in about 15 minutes. Then patients are on their way. We usually tell them to avoid anti-inflammatories for a few days and let them know the area may feel a bit worse for a few days before it begins to feel better. That’s the immune system working. But then, as healing progresses, most patients tell us they start seeing a noticeable difference,” Ewing said.
The degree of improvement and duration of results tend to vary from patient to patient, according to each person’s specific condition, individual health influences and factors from everyday life. However, most of Ewing’s patients who receive PRP treatment report that they are pleased with the results and open to using the technique again.
“One consideration slowing the use of plasma rich platelets is that insurance companies have tended to be slow offering coverage and accepting PRPs as the standard of care. I anticipate that will be changing soon, as they see the results we’re seeing without the common side effects from steroids, anti-inflammatories and some of the other medications,” Ewing said.
Platelet-rich plasma is considered to be a biologic, which are medications derived from living things, including human and animal cells, as well as bacteria and yeast. They are usually larger molecules used to treat chronic conditions, autoimmune illnesses and cancer by targeting specific immune pathways. In addition to blood components, the class includes monoclonal antibodies, recombinant proteins and cellular/gene therapies.
“We’re moving into the era of biologics,” Ewing said. “As insurance companies track the data and follow the results those of us who work with them every day are seeing, we think biologics will be the direction medicine is going.”