Orthobiologics

Platelet-Rich Plasma Therapy at SMaRT Health & Wellness

What is Platelet-Rich Plasma (PRP)?

Our blood is composed of a liquid component known as plasma, and three main solid components which include red blood cells (RBCs), white blood cells (WBCs), and platelets. Platelets are crucial in forming blood clots and they contain special proteins, known as growth factors, which assist our body’s healing process.

Platelet-rich plasma or PRP is plasma that has a high concentration of platelets. A typical blood specimen contains only 6% platelets, while PRP contains 94% platelets and 5 to 10 times the concentration of growth factors found in regular blood, providing superior healing properties.

PRP can be divided into two categories based on the concentration of leukocytes (white blood cells):

Leukocyte-Rich PRP (LR-PRP):

Contains a higher concentration of leukocytes in addition to the platelets.

• Benefits: The leukocytes have antimicrobial properties which may help reduce the risk of infection and play a role in the removal of debris from an injury site.
• Downsides: The higher concentration of leukocytes, especially neutrophils, may lead to increased levels of catabolic and pro-inflammatory cytokines which could potentially impede the tissue healing process. This could also cause more pain and swelling after the injection.
• Indications: LR-PRP may be beneficial in cases where there’s a need for infection control or in the early stages of wound healing due to its antimicrobial properties and its role in debris cleanup. It is also the preferred solution for conditions such as rotator cuff tendonitis, tennis elbow, golfer’s elbow and achilles tendonitis.

Leukocyte-Poor PRP (LP-PRP):

Contains a lower concentration of leukocytes but still a high concentration of platelets.

• Benefits: LP-PRP typically presents a more anabolic and less inflammatory profile compared to LR-PRP, potentially creating a more favorable environment for tissue regeneration and healing, with less pain and inflammation post-injection.
• Downsides: LP-PRP lacks the antimicrobial properties that come with a higher concentration of leukocytes.
• Indications: LP-PRP might be preferred in conditions like osteoarthritis, cartilage injuries, meniscus tears, or chronic injuries where the goal is to promote tissue regeneration without the potent inflammatory effects of leukocytes.

When is PRP Therapy Indicated?

PRP is a relatively new treatment method for several orthopedic conditions such as muscle, ligament, and tendon injuries; arthritis; and fractures. PRP injections can help alleviate painful symptoms, promote healing, and delay joint replacement surgeries.

The PRP Injection Procedure

The PRP therapy procedure involves drawing about 50-60cc’s of blood from the large vein in your elbow. This blood is then spun in a centrifuge machine for about 10 to 15 minutes to separate the platelets from the remaining blood components. The injured part of your body is then anesthetized with a local anesthetic. The platelet-rich portion of your blood is then injected into your affected area. In some cases, ultrasound guidance may be used to ensure proper needle placement.

Post-Procedure Care following PRP Injections

Following PRP injections, it is normal to feel some discomfort at the injection site for a few days. You should avoid applying cold compresses or ice for 3 days after the procedure. You will be instructed to stop any anti-inflammatory medications. While you can resume your normal activities, you should avoid any strenuous activities such as heavy lifting or exercises.

Risks and Complications of PRP Injections

The risks associated with PRP injections are very minimal but may include increased pain at the injection site, infection, damage to adjacent nerves or tissues, formation of scar tissue, and calcification at the injection site.

Conclusion

While PRP therapy has been used for various conditions, the evidence for its efficacy is still evolving and not yet fully established. Moreover, protocols for PRP preparation and application can vary, adding another layer of complexity to its use. As a medical professional, it is always advisable to stay updated with the latest research and guidelines for the best patient outcomes. At SMaRT Health & Wellness, we’re committed to providing the most up-to-date and effective treatments for our patients.

What is Viscosupplementation?

Viscosupplementation refers to the injection of a hyaluronan preparation into the joint. Hyaluronan is a natural substance present in the joint fluid that assists in lubrication. It allows smooth movement of the cartilage covered articulating surfaces of the joint.

Indications of Viscosupplementation

Hyaluronic Acid Injections is one of the most commonly used hyaluronan preparations. It is indicated in the management of shoulder, knee, hip or ankle osteoarthritis that has not responded to non-surgical treatment options such as pain medications, physical therapy and corticosteroid injections.

Viscosupplementation Procedure

Hyaluronic Acid Injections provides symptomatic relief and delays the need for surgery. It is injected directly into the joint to replenish the diminished synovial fluid, thereby enhancing its lubricating properties. A single dose or a total of three separate doses of Hyaluronic Acid Injections, over several weeks, may be required for optimum benefit.

How does Viscosupplementation Work?

Hyaluronic Acid Injections not only supplements the hyaluronan in the joint but also stimulates the production of hyaluronan in the treated knee. This provides gradual symptomatic relief over the course of the injections. This effect may last for several months.

Post-procedural Care Following Viscosupplementation

Ice packs and an analgesic may be used, if required, to ease the discomfort. Any strenuous activity such as jogging or tennis should be completely avoided for 48 hours to a week after the injection and should be resumed only after consultation with your doctor.

Risks of Viscosupplementation

You may experience mild pain, swelling, warmth and redness at the injection site for up to 48 hours following a Hyaluronic Acid Injections injection. Headache and joint stiffness may also occur in some cases.

Immediately consult your doctor if you develop fever or the pain and swelling fail to resolve after 48 hours following the injection.

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