Platelet-Rich Plasma Injection
This concentrated injection can be thought of as “kick-starting” the healing response by bringing all the tools to the site of injury.
Blood contains blood cells suspended in a watery medium known as blood plasma. Red blood cells are the most abundant cells in the blood and bring oxygen to our organs. Platelets are also found in blood and their main function is to stop bleeds. Platelets also have another special function, as they help with tissue repair and regeneration. Platelets do this by releasing growth factors at the site of injury.
To promote healing of a joint or tissue, the concept of a platelet-rich plasma (PRP) injection was introduced. A blood sample is taken from the patient and spun (centrifuged) so that blood cells are separated from blood plasma. The end result is that a highly concentrated layer of platelet-rich plasma (called the “buffy layer”) is isolated and used for injection.
The medical research for this procedure is continually evolving. It does not work for everybody. Please speak with your physician to determine if this is the right treatment for you.
What are the benefits?
Pain relief, joint protection, and tissue repair/regeneration. As mentioned above, the research is still evolving in this field, but many see it as a way of postponing eventual surgery. The injectate is taken directly from the person’s own blood, so the risk of allergy is virtually non-existent.
How long will my pain be reduced?
As pain is thought to be reduced through the healing response, this can take up to 6-8 weeks. The overall length of relief is variable, lasting on average 9 months.
How often can I have this done?
Repeat injections after treatment typically occur after 9-12 months but can be spaced out even longer. It can be performed indefinitely.
Who can’t have this done?
Any patient who may appear to have:
- Infection within the body, near the site of administration, or the actual joint itself
What should I do in advance of my injection?
If possible, and safe:
- Avoid corticosteroid medications 2-3 weeks prior to the procedure
- Avoid non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen (Advil), 2 weeks before and after injection
- Drink plenty of fluids on the day of the procedure, so that it’s easier to draw a blood sample
What are the side effects?
- Pain after injection: A post-injection flare occurs in approximately 10% of patients. Like other injections, it usually settles within 2 days. Application of ice and Tylenol can help, if desired. Please avoid any anti-inflammatories, such as Advil (Ibuprofen) afterwards, as this can reduce how well the procedure works.
- Pain during the procedure: The skin is the most sensitive part when it comes to any injection. We minimize this by using local anesthetic and/or a vapocoolant spray on the skin. With the injectate itself, this layer is usually quite acidic, and we add sodium bicarbonate to reduce the acidity so that there is a feeling of less burning. Pain associated with the injection is usually brief and well-tolerated.
- Infection: When a needle is passed through the skin into the body, there is a very small chance of introducing a joint infection. The chance of this occurring is extremely low, less than 0.002%, or equivalent to being struck by a car as a pedestrian and experiencing a catastrophic event. To minimize this risk, we not only follow the WHO minimum best practice standards for injections, but use sterile gloves, sterile ultrasound probe covers, and sterile ultrasound gel.
- Bleeding: This is a greater risk if you have a known bleeding disorder or are taking blood thinners. By using ultrasound guidance, there is less “poking” around to get to the target tissue of interest, and thus less theoretical risk of bleeding. Pressure is maintained over the skin afterwards to reduce bleeding.
Systemic Side Effects
No specific reactions have been described.
Can I drive afterwards?
We recommend bringing a driver with you if you’re scheduled for an ankle or foot injection. Otherwise, most people can drive afterwards. Nonetheless, we ask all patients to remain in the clinic waiting room for a minimum of 15 minutes afterwards to observe for any adverse reactions to the medication.
Can I play sports afterwards?
This depends on the type of sport and intensity, but we generally recommend taking it easy for 2 days as post-injection flares may occur. Overall, please be mindful with anything you do and listen to your body.