PRP Injections In Scottsdale

Overview

A platelet-rich plasma (PRP) injection is made from the patient’s own blood.    The patient’s blood is spun in a centrifuge in order to separate the blood into 3 layers: plasma, red blood cells and the buffy coat (platelets and white blood cells).    The buffy coat is injected into the patient’s area of injury in order to promote healing and healthy cell growth. [1]

Blood is composed of a yellowish fluid medium called plasma and 3 kinds of cells: red blood cells (erythrocytes), white blood cells (leukocytes), and platelets (thrombocytes).    Red blood cells carry oxygen, white blood cells fight infection and platelets are responsible for clotting and healing.

PRP injections take advantage of the function of the platelets—clotting and healing; so, when a large number of platelets are collected and put into a single injection, research shows this allows the tissue to heal faster for some conditions. [2] [3] [4]

Why it’s done?

PRP Injections are a treatment option for people with chronic joint pain, sports injuries, tendonitis [5] , ligament injuries and muscle injuries.    These injections are also is good for improved healing due to the growth factors in PRP. [6]

Patients also seek PRP injections for:

  • Osteoarthritis
  • Degenerative joint disease
  • Shoulder injuries (rotator cuff tears) [7]
  • Golfer’s elbow [8]
  • Tennis elbow [8]
  • Ligament injuries (knee, ankle, elbow, wrist)
  • Hamstring pulls
  • Knee arthritis [7]
  • Achilles tendonitis [7]
  • Cartilage injuries
  • Injuries that have a lengthy healing time [7]
  • Injuries that are un-responsive to alternative treatments
  • Chronic pain problems

Risks and Complications of Platelet-Rich Plasma Injections

Since PRP injections use the patient’s own blood, risks are lower; however, there is always risk when a needle breaks the skin.

  • Common (Typically lasts a few days to 1 week)
    • Post-injection pain or numbness
    • Soreness
    • Mild bruising
    • Feeling lightheaded or dizzy
  • Rare.
    • Infection
    • Allergic reactions
    • Bleeding
    • Myonecrosis (typically heals within a month) [8]

Patients often have the following questions:

  • “Do PRP injections hurt?”
  • “How much does a PRP injection hurt?”
  • “How long does the pain last after a PRP injection?”
  • “What makes PRP hurt so much?”

While everyone has different pain tolerances and it is dependent upon the area being injected, the injection of PRP itself is slightly painful; however, the area is numbed with lidocaine first to minimize pain.    After the lidocaine wears off, there is usually mild to moderate pain for a few days up to a week.    The reason it hurts is because it is restarting the phases of healing.    Over the following month, the region begins to go through the healing process and starts to get better.    Some research suggests there can be improvement for up to 6 months after a PRP injection.

What to do before PRP injections

A PRP injection is an outpatient procedure that does not require hospitalization or an overnight stay; between the blood draw, spinning of the blood and injection, the appointment runs about half an hour.

Corticosteroids and NSAIDs like Ibuprofen, Motrin or Aleve interfere with PRP injections; so, patients will need to stop taking them for at least one to two weeks before and at least 2 weeks after.

Additionally, any blood thinning herbs, supplements or vitamins can also interfere with PRP injections, so those will need to be stopped as well.

If you are taking oral steroids, or anti-inflammatories for certain conditions, consult with your physician about stopping them or about the results while still taking them.

Make sure to eat breakfast and hydrate well (to make the blood draw easier) before your treatment.

How PRP Injections are prepared and administered

The patient’s blood needs to be collected into a special tube specifically designed for PRP injections; usually, 20-100 ml is collected from the arm.

The tube is put into a centrifuge and spun at a high speed in order to separate the blood into layers: red blood cells, white blood cells, platelets, and plasma.

The blood is processed and the platelets are extracted.    Yield is usually 3-7 ml of platelet-rich plasma that is collected with a syringe.

Then the final needle contains 1-2 teaspoons of solution that contains the PRP and is injected into the desired site with ultrasound guidance.

After getting PRP Injections

After PRP Injections, you will be monitored for few minutes or up to 30 minutes to insure you can safely be released.

Make sure to keep the area clean, dry and leave the bandage on for 12-24 hours.    You can shower but be sure to change the bandage if the area gets wet.

Swelling and bruising is common for 3-7 days after.    Avoid using ice on the area.    The swelling in the area is good and helps with healing.

Medications that were stopped prior to PRP injections may be resumed 2 weeks after.

Tylenol or tramadol can be used for pain as needed but do not exceed 3,000 mg a day.

Smoking and alcoholic beverages should be avoided for a week, caffeine should be limited.

PRP injections do not provide instant relief like a cortisone injection, they take time to work and there may be increased pain at the injection site; this is expected due to the healing process being restarted.

PRP Injection success rates

The success rate for PRP Injections is around 70-80%.    Research [9] shows that it does decreased pain in the long run; which is why many professional athletes seek out PRP injections such as in 2011, when Kobe Bryant had PRP injections for his ankle and knee. [10]

References

1. Wasterlain, A. S., Braun, H. J., Harris, A. H., Kim, H. J., & Dragoo, J. L. (2012). The Systemic Effects of Platelet-Rich Plasma Injection. The American Journal of Sports Medicine, 41(1), 186–193. https://doi.org/10.1177/0363546512466383
2. Xu, Q; Chen, J; Cheng, L (July 2019). "Comparison of platelet rich plasma and corticosteroids in the management of lateral epicondylitis: A meta-analysis of randomized controlled trials". International Journal of Surgery (London, England). 67: 37–46. doi:10.1016/j.ijsu.2019.05.003. PMID 31128316.
3. Belk, JW; Kraeutler, MJ; Houck, DA; Goodrich, JA; Dragoo, JL; McCarty, EC (17 April 2020). "Platelet-Rich Plasma Versus Hyaluronic Acid for Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials". The American Journal of Sports Medicine: 363546520909397. doi:10.1177/0363546520909397. PMID 32302218.
4. Hurley, E. T., Hannon, C. P., Pauzenberger, L., Fat, D. L., Moran, C. J., & Mullett, H. (2019). Nonoperative Treatment of Rotator Cuff Disease With Platelet-Rich Plasma: A Systematic Review of Randomized Controlled Trials. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 35(5), 1584–1591. https://doi.org/10.1016/j.arthro.2018.10.115
5. Rubio-Azpeitia, E., Sánchez, P., Delgado, D., & Andia, I. (2017). Adult Cells Combined With Platelet-Rich Plasma for Tendon Healing. Orthopaedic Journal of Sports Medicine, 5(2), 232596711769084. https://doi.org/10.1177/2325967117690846
6. Wang, H. L., & Avila, G. (2007). Platelet Rich Plasma: Myth or Reality? European Journal of Dentistry, 01(04), 192–194. https://doi.org/10.1055/s-0039-1698338
7. Hussain, N., Johal, H., & Bhandari, M. (2017). An evidence-based evaluation on the use of platelet rich plasma in orthopedics – a review of the literature. SICOT-J, 3, 57. https://doi.org/10.1051/sicotj/2017036
8. Varshney, A., Maheshwari, R., Juyal, A., Agrawal, A., & Hayer, P. (2017). Autologous platelet-rich plasma versus corticosteroid in the management of elbow epicondylitis: A randomized study. International Journal of Applied and Basic Medical Research, 7(2), 125. https://doi.org/10.4103/2229-516x.205808
9. Huang, Y., Liu, X., Xu, X., & Liu, J. (2019). Intra-articular injections of platelet-rich plasma, hyaluronic acid or corticosteroids for knee osteoarthritis. Der Orthopäde, 48(3), 239–247. https://doi.org/10.1007/s00132-018-03659-5
10. McMenamin, D. (2013, October 3). Kobe Bryant of Los Angeles Lakers leaves country for medical procedure. ESPN.Com. https://www.espn.com/los-angeles/nba/story/_/id/9765198/kobe-bryant-los-angeles-lakers-leaves-country-medical-procedure

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