PRP Effective In Treating Difficult Tendon Problems
BREVARD COUNTY, FLORIDA – Orthopedic surgeons are charged with treating muscular-skeletal disorders both surgically and non-surgically. Inflammatory conditions involving the tendons can be somewhat more challenging to manage than other problems. Examples of these recalcitrant conditions are Achilles Tendinitis, Trochanteric Bursitis, and Iliotibial Band Syndrome.
Treatment of these conditions is limited by the lack of effective surgical options. Physical therapy, activity modification, and anti-inflammatory medications have been mainstays of treatment. Some patients find their symptoms are not fully addressed with these techniques.
PRP Created From Patient’s Blood
Injections of platelet rich plasma (PRP) are being used in sports medicine and other areas of orthopedics to treat these difficult tendon problems.
One of the functions of platelets, a component of blood, is to provide a healing response via recruitment of reparative cells and secretion of proteins that aid in healing. PRP is created out of a patient’s own blood, defined as autologous blood, with a concentration of platelets above baseline values. PRP has been used in medicine since the early 1990’s.
Preparation of PRP is simple
A patient’s own blood is drawn and processed in a centrifuge to separate the platelet-rich plasma from the other components. This maximizes the concentration of healing components in the specimen. The concentrated platelets are then injected into the affected site of injury or inflammation. The growth factors that platelets secrete spur tissue recovery. Generally, no chemicals or drugs are used in the process.
PRP stimulate tendon healing
Laboratory analysis has supported the clinical use of PRP. Studies have shown that human cells treated with PRP stimulate tendon healing. Increased production of blood vessels and repair of inflamed tissue has been shown in experiments on tendon cells. PRP has also been used to speed up the healing of muscular injuries. One study has shown that PRP is most effective in treating high repetition muscular injuries.
Recent clinical studies support the laboratory evidence related to the use of PRP. Elbow conditions, specifically tennis elbow and golfer’s elbow, have shown improvement in pain as well as athletic performance after one PRP injection.
Use of PRP in knee tendinitis, specifically jumper’s knee, showed excellent clinical results with no associated adverse events. Seventy percent of RPR treated patients showed better, more complete functional recovery than without. Additionally, there is one study supporting the use of PRP in plantar fasciitis.
Acute muscle tears and chronic muscle strains can also be treated effectively with PRP. The time to complete healing and relief of pain were shown to be accelerated with this treatment, and recently professional athletes such as Troy Polamalu, Hines Ward and Tiger Woods to name a few, have used this technique to expedite their return to competition
Orthopedic conditions resulting from mechanical interference of anatomic structures are not likely to be helped with PRP. End-stage osteoarthritis of the hip knee or shoulder, rotator cuff tears, impingement syndrome, and carpal tunnel syndrome are the result of significant anatomic changes and are not likely to be helped with simple PRP injections alone.
The use of the platelet rich plasma in orthopedic conditions is becoming more popular. Judicious use of this technique appears to provide more rapid return to function and relief of painful inflammatory symptoms.
ABOUT THE AUTHOR
Jeff O’Brien, MD, is a Board Certified Orthopedic surgeon who has practiced in Brevard County, Florida since 1996. He is a graduate of Hahnemann University School of Medicine in Philadelphia, Pennsylvania and completed a Hand and Upper Extremity fellowship at the University of Pennsylvania. He treats patients from all over the county at the Orthopedic Center in Merritt Island.