Platelet Rich Plasma (PRP) Injections
Platelet Rich Plasma (PRP) injections are a type of therapy that involves using the patients own blood constituents to create an injectable product that helps with various soft tissue and joint problems. It can give long lasting reduction in pain associated with tendon, ligament and joint degeneration. As the process involves using no other products apart from the patients own platelets and growth factors to help healing in the tissue, it is popular for those who want to avoid artificial interventions or surgery. It is also a popular option if you have tried a range of other therapies but are still struggling. It is important to stress that it is still paramount that it accompanies a structured rehabilitation strengthening plan to achieve the best results.
Research in this field is growing and shows promising results of pain relief of approximately 1 year for arthritic knee pain. It has also become popular for the treatment of tendon and ligament injuries in elite sports where it is seen as a way to accelerate the bodies natural healing processes.
What to expect at a PRP injection appointment
The first step is to draw blood from the patient. This is exactly like having a blood test. A centrifuge is then used to spin the blood down, in order to separate it into its different constituent and layers.
One specific layer of the separated blood is plasma which will contain 2-5 times the usual number of platelets for a similar sample of normal blood. This layer is then extracted into a syringe ready to be injected back into the damaged area to stimulate healing. Over the last 10 years research has consistently demonstrated that this enriched plasma has a regenerative effect on the tissues of the body by triggering natural healing processes.
The PRP injection will always be delivered under ultrasound guidance to ensure we target exactly the right area.
Most research shows that a series of 3 PRP injections each 1-2 weeks apart gives the best outcome for Knee Osteoarthritis. However we also offer PRP and Hyaluronic Acid combination injection which gives the added benefit of Hyaluronic Acid in the same syringe as the PRP injection, hopefully delivering an even more successful treatment.
Treatment options will vary depending on your injury. Options include a single PRP injection, a series of 3 PRP injections or a combination PRP-Hyaluronic Acid injection.
How will I know if a PRP injection is right for me?
Your initial assessment will involve diagnosing your condition. This will include a physical assessment and ultrasound scan. Once we have discussed your injury with you, we will then discuss your various treatment options. We will need to know about your medical history including current medications you are taking to see if the treatment is right for you. We may liaise with your GP if there are any concerns regarding your general medical condition to ensure your safety.
What should I expect during a PRP injection appointment?
The appointment will last around 30 minutes. You should keep yourself well hydrated on the day of the appointment as this will make drawing the blood out of your arm easier. Once we have prepared the injection, we will use an ultrasound scanner to guide the injection to the damaged area. We will usually not use local anaesthetic for a PRP injection to ensure we do not alter the natural healing benefits of the PRP. As a result it can be a little sore after the injection for a day or two. It can also be common to experience a “post injection flare” which is a general pain at the injury site due to the local inflammation and may last for a week or so. This is nothing to be concerned about. We would encourage you to not take anti-inflammatory medication for the pain but instead use paracetamol or ice if required.
There may be a bit of discomfort at the time of the injection procedure, but Ultrasound guidance means that injections can be delivered much more accurately and comfortably. There may be pain at the site for 1-2 days. If you experience a post injection flare, this can last around 2 weeks.
Instructions for after the injection
You will be emailed instructions on things to look out for and avoid after your injection. We usually recommend that you avoid loading the area for a few days. You should give the body a chance to start the regenerative process by avoiding heavy loading of the area for 5 days. If the injection is in or around a tendon, we may ask you to avoid heavy loading for 2-3 weeks to avoid aggravating the post injection flare.
On the day of the procedure you can usually go about your day as normal. However if the injection is around a tendon you may wish to consider arrangements for getting home after your injection because the tendon can be painful to walk long distances, cycle or drive with.
Will I need another injection?
If you get relief from PRP injections, then the treatment may be safely repeated when required. In the treatment of osteoarthritis in the knee, the benefits of PRP have been shown to last around 1 year.
What are the risks and side effects from PRP injections?
As its your own blood plasma we are injecting back into the body, most people have PRP injections without any side effects.
As with any injection into the body, there is always a risk of infection. This is extremely rare across all injections administered in all healthcare settings. Around 1:50,000 patients may get an infection according to the literature following an injection procedure.
We perform a “no touch” aseptic technique to ensure your safety during the procedure to minimise any infection risk. If the joint or injection site becomes very painful and hot, you should seek medical attention immediately, especially if you are also feeling generally unwell.
When you have an injection there is a potential for injury or trauma to nerves, blood vessels or soft tissue structures. The clinician uses ultrasound guidance and is trained to take all appropriate steps to minimise risks and avoid injecting or traumatising any soft tissue structures when performing the injection. However with particular injections at certain locations there will always remain a very small risk that this could occur. This will be discussed further at your appointment.
What if I am taking other medication when I have a PRP injection?
It is safe for you to take other medications alongside the PRP injection. We would encourage you to not take anti-inflammatory medication (eg Ibuprofen, Naproxen) 1 week prior and 4 weeks after the procedure to avoid altering the regenerative process.
However, you must tell the clinician performing the injection, if you are taking an anti- coagulant (blood thinning) medication as they may need to discuss this with your GP before proceeding with any treatment.
Pregnancy and breastfeeding
Unfortunately, due to a lack of research in this area we are not able to offer PRP injections to patients who are pregnant or breastfeeding.