Biologics: Using Platelet Rich Plasma Therapy to Promote Healing in Tendons, Ligaments and Muscle
By Walter R. Lowe, M.D.
Although platelet rich plasma therapy has been used in Europe for nearly a decade for treating sports injuries and orthopedic diseases, it has only recently gained attention in the United States. It took Super Bowl champion Hines Ward’s rapid recovery to spotlight PRP as a promising new therapy for stubborn sports injuries affecting ligament, tendon and muscle tissue.
Growing medical interest in PRP
Since this news, interest within the medical community has accelerated rapidly, inspiring numerous studies and a clearer picture of valid applications for the therapy. Early test results are promising for treatment of degenerative arthritis, chronic tendonitis, tennis elbow and medial collateral damage in the knee.
How PRP works
It is now known that blood platelets play a far greater role in the healing process than simply forming clots. When platelets are present at the site of an injury, they release growth factors, or proteins known as cytokines, which aid in the natural healing process. PRP is in a relatively new class of medicine called bbiologics, which includes gene therapy and the use of blood to rally healing stem cells and proteins to the site of injury.
A simple procedure
PRP therapy is a relatively simple procedure that can be performed in the doctor’s office in an hour or less. A small sample of the patient’s blood is placed into a centrifuge and spun for approximately 15 minutes, separating red blood cells from platelets. The result is a highly concentrated platelet rich gel.
Guided by ultrasound, an injection of about a teaspoon of the gel is delivered to the exact site of the injury. When injected into poorly vascularized areas of the body, PRP delivers the targeted healing response of platelets and stem cells, without triggering the clotting response for which platelets are typically known.
Although clinical evidence is still being gathered, anecdotally, PRP makes a difference by catalyzing healing where chronic conditions exist. It accelerates healing in muscle, and promotes healing in tendon and ligament tissue where the supply of blood is naturally low and healing often requires surgery.
What we now know
PRP therapy may help athletes avoid surgery and return to play sooner. There are no contraindications and no known deleterious side effects, however, the injection can be uncomfortable and even painful. Use of anesthesia is not advised because it is known to deactivate growth factors and reduce the helpful effect of the therapy.
Presently, the Federal Drug Administration (FDA) has approved very few applications for PRP. We need a lot more research on the precise and correct applications and dosages, and that research is being done now. The next step is to get PRP added to formularies in order to receive government and insurance endorsement, and bring down costs.
Low cost procedure
As to the current cost, PRP is a simple, low-tech procedure that is not expensive to administer. However clinics specializing in biologics can charge up to $1,000 per shot. Memorial Hermann Sports Medicine Institute offers affordable PRP therapy for as little as $150 per injection. To schedule a PRP therapy consultation, call the Memorial Hermann Sports Medicine Institute at 713.704.4000.
Walter R. Lowe, M.D., is an orthopedic surgeon at the IRONMAN Sports Medicine Institute at Memorial Hermann.