PRP is an innovative treatment that can stimulate a strong and long-lasting healing and pain-relieving response when injected into an injured part of the body. It has most commonly been used in treatment of knee osteoarthritis. Clinical studies have reported pain relief and improved function for over a year in patients who are on the waiting list for total knee replacement. Sports injuries as well as degenerative joint or tendon conditions can be successfully treated with PRP. It has been used by top athletes including Tiger Woods and Rafael Nadal to speed up their recovery following injury. PRP is often effective in treating patients who have failed to improve with conservative treatments (including rest, medication, physiotherapy, exercise, shockwave therapy) and are considering surgery.
A sample of blood is taken from a vein in your arm. iPS use the Arthrex double-syringe system to facilitate safe and rapid preparation of PRP. The blood sample is then placed in a machine called a centrifuge and spun at high speed to separate the various constituents of blood. The layer containing the plasma and platelets is isolated and withdrawn. The PRP is then injected into the injured / damaged tissue / joint. It is important that the PRP is accurately injected into the injured joint or tissue because it has a localised effect. Therefore, the injections are usually performed with ultrasound-guidance.
Platelets consist of special proteins called growth factors and cytokines, which help with our body's healing process and provide pain relief. PRP has a high concentration of plasma and platelets. PRP consists of approximately 5 times the concentration of growth factors and cytokines found in normal blood. Thus, PRP stimulates the regeneration of tissues including tendons, ligaments and cartilage, with an associated reduction in pain.
Extensive research has shown that PRP is highly effective in the treatment of Mild to Moderate (Grade I-III) Knee Osteoarthritis. The research consistently shows that a course of PRP injections provides significantly greater long term (often 1 year or more) pain relief and improved function than other common injections, including cortisone and Hyaluronic Acid. As a result, it is now widely accepted that PRP should be considered as a primary injection therapy for knee pain, that is not controlled by more conservative measures.
The research is very promising for the use of PRP in the treatment of other arthritic joints including ankle, hip and thumb. However, due to the small number of patients in these studies, further investigation is required before we can recommend PRP with the same level of confidence as we can for knee osteoarthritis.
A wide range of studies have investigated the effect of PRP injections in the treatment of chronic tendon problems, such as patellar tendinopathy (jumper/runner's knee), lateral hip tendinopathy/trochanteric bursitis, rotator cuff tendinopathy, tennis elbow, golfer's elbow and plantarfasciitis. The results of these studies are variable, but there are enough positive findings for PRP to be considered as a treatment option if more conservative measures are unsuccessful. As repeated cortisone injections are thought to have a negative long-term effect and the strength of tendons, PRP should be considered as an alternative treatment, especially if a partial tear of the tendon is suspected.
The number of PRP injections used in the research varies. Most of the research demonstrating the most positive outcome from PRP injections involves multiple injections. Therefore, we recommend a course of 2 - 3 injections depending on the condition.
Most patient will have no side effects following a PRP injection. The only common side effect is some soreness around the injection site. This may last a few days. Other potential side effects are extremely rare (but will be discussed with patients before proceeding with injections).
Unfortunately, no. Both Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) including ibuprofen, naproxen and aspirin and blood thinners (anti-coagulants) including Warfarin, Rivaroxaban can reduce the benefit of PRP due to their effect on platelet activation. Therefore, it is suggested that only patients who are able to stop using these medications for 2 weeks prior and 2 weeks after a course of PRP should proceed with the injections. You should not stop anticoagulant medication without discussing it with your GP first.
No. If you find the course of injections successful, you can repeat them as often as you require. Some patients opt to have PRP injections once a year to maintain the reduction and improved function.
Extensive High-quality research proving long term effectiveness of PRP injections (14 RCT level I Studies)
Better medium and long-term outcome following a course of PRP injections compared to cortisone or hyaluronic acid injections, reported in the majority of studies and systematic reviews Elksnins-Finogejevs et al, 2020
Following an extensive review of the available literature, we believe that PRP injections are an exciting treatment option for patients with moderate knee arthritis. A course of PRP injections is more expensive than cortisone injections. However, the duration of pain relief is likely to be much greater (potentially 2-3 times as long) and there are no reported negative effects from repeat injections.
We believe that they should be considered as a possible treatment option in other joint and tendon injuries/conditions that are not responding to more conservative measures. If you are considering having a PRP Injection, please call or email our specialist physiotherapist Gareth Tremain, and he will be happy to give you his opinion on whether it is the most appropriate treatment for you. If it is not, he will suggest the most evidence-based alternative. Please note, that PRP Injections are only available at our Cardiff Gate Clinic.
Time: 45 Minutes