PLATELET-RICH PLASMA INJECTIONS
Autologous platelet-rich plasma (PRP) injections were first used in 1987 in open heart surgery. Today, PRP injections have been safely used in many fields, including sports medicine, orthopaedics, cosmetics, fasciomaxillary and urology.
Blood contains plasma, red blood cells, white blood cells and platelets. Platelets are small discoid cells with a life span of about 7-10 days. Inside platelets contain granules, which contain clotting and growth factors. During the healing process, the platelets are activated and aggregate together. They then release the granules, which contain growth factors, which stimulate the inflammatory cascade and healing process.
Blood typically contains 6% platelets, whereas PRP has a significantly increased supra-physiological platelet concentration. Although this level can vary depending on the method of extraction and equipment, studies have shown that clinical benefit can be obtained if the PRP used has an increased platelet concentration of 4x greater than normal blood.
What is PRP?
Platelet Rich Plasma (PRP) injections offer a non-medication, non-surgical option for treating chronic injuries involving joints, ligaments, and tendons. This treatment leverages the body's own platelets to stimulate tissue regeneration, providing a promising alternative to more invasive treatments for managing pain, injury, and age-related conditions.
PRP is extracted from a patient’s blood sample, and processed using a TGA approved medical device and a centrifuge, within the same appointment. The system we use has been chosen because of the ability to provide a high concentration of the patient’s own platelets in a small volume of their plasma.
What is Alocuro?
Alocuro devices can provide a high platelet concentration of up to 9x baseline, with ability to reduce leukocytes to a very low leukocyte concentration of 0.15x baseline and extremely low neutrophil collection of 0.3% if required. Whilst not yet fully decided, it is thought that this type of PRP ‘recipe’ is ideal for joint injections to treat symptomatic osteoarthritis and for chronic tendon conditions.
For many PRP procedures, a platelet concentration of 3-6 x is used. To protect patient safety, there is TGA legislation regulating PRP procedures within Australia. Alocuro PRP devices are listed on the ARTG register and they are approved by the TGA specifically for the purpose of manufacturing platelet-rich plasma (PRP). Alocuro system and protocols meet the current TGA regulations and the PRP produced is ‘regulated as blood components, but exempt from most regulation requirements when the Alocuro PRP procedures have medical practitioner professional supervision. This is because Alocuro's system is a point-of-care therapy, involves minimal manipulation of patient's blood and the collected PRP is used as a homologous application.
Alocuro devices offer the latest technology for PRP kits available within Australia. All items required to manufacture a high platelet concentration and ‘pure’ PRP are provided.
What injuries may be treated with PRP?
PRP injections can be used in the treatment of many musculoskeletal injuries including that of tendons, muscles and joints. Typically, two or more injections are required, separated by 4-6 weeks apart. This may vary dependant on your injury. This image shows ultrasound views demonstrating the healing of a supraspinatus injury using PRP injection.
Plantar fasciitis tear
Plantar fasciitis tear post
PRP treatment
What medications do not work well with PRP?
If you take Coumadin, Heparin, Lovenox, Warfarin, Pradaxa, Debigatran, Orgaran, Innohep, Fragmin, Argatroban, Plavix, Effient, Prasugrel, ReoPro, Ticlid, Trental, Persantine, or any other blood thinner medication, please notify Dr Ibrahim. This medication must be discontinued prior to an injection and requires permission from the provider prescribing it.
In addition please inform Dr Ibrahim if you take aspirin or any aspirin related products, and all non-steroidal medications (e.g. Motrin, Advil, Naprosyn, Naproxen, Aleve, Indocin, Lodine, Orudis, Relafen, Daypro, Tolectin, Mobic, Torodol, Voltaren, Trilisate, Dolobid, Arthrotec, Ibuprofen, Diclofenac and Clinoril).
PRP Aftercare
Afterwards you will be advised to rest for a few minutes before being allowed to go home. You may experience a worsening of pain in the injured area for three or four days after the treatment, during this time you should rest as much as possible. You can take painkillers but avoid non-steroidal anti-inflammatory drugs such as Ibuprofen for at least 10-14 days.
The risks of an allergic reaction are very small as the blood is taken from your own body however there is some risk of infection, nerve injury or tissue damage.
You may not notice an immediate improvement as PRP injections promote healing rather than providing immediate relief from symptoms. However, over the next few weeks or months after the injection the area should begin to heal faster than it would have done without the PRP injection.
What injuries can be treated with PRP?
Knee osteoarthritis
Knee medial collateral ligament tears
Trochanteric bursitis
Hip osteoarthritis
Which tendons can be treated with PRP?
Tennis Elbow (Common extensor tendinosis)
Golfer's Elbow (Medial epicondylitis)
Jumper's Knee (Patella tendinosis)
Achilles tendinosis
Plantar fasciitis
Hamstring tendons
Adductor tendons
Gluteal tendons
Which muscle injuries can be treated with PRP?
Hamstring
Calf
Quadriceps
FAQ's for PRP
How long does the PRP procedure take?
When will I start to see results?
Patients report they start to notice a change after a week. A good result is a 30% improvement by the second injection or a 10% improvement each week.
Can I drive home from the procedure?
Yes - We do however advise you rest for 10 minutes post injection prior to leaving.
How long will the PRP last?
PRP into tendon tears will fix the problem.
PRP into joints may need a 'top-up' once a year.
When can I return to exercise
post PRP injection?
Depending on the area involved a return to some activity may be attempted after a few days. Your doctor will be more specific on the do's and don'ts post PRP injection.
More information
Visit www.prpinjection.com.au. This patient education website was developed by Dr Ameer Ibrahim and his colleagues. It includes a step-by-step guide to the procedure and links to medical research articles on platelet rich plasma injections.
Recent Articles
Platelet rich plasma versus steroid on lateral epicondylitis: meta-analysis of randomized clinical trials
Objectives: Lateral epicondylitis (LE) is a common tendinopathy for which an effective treatment is still unknown. The purpose of this meta-analysis was to compare the effectiveness of platelet rich plasma (PRP) vs steroid in reducing pain and improving function of the elbow in the treatment of LE.
Conclusions: This network meta-analysis provided additional information that PRP injection can improve pain and lower the risk of complications, whereas AB injection can improve pain, disabilities scores and pressure pain threshold but has a higher risk of complications.