PRP INJECTIONS FOR KNEE ARTHRITIS
What is PRP?
Since 1987, PRP therapy has been used to promote cell regeneration in various types of surgeries. More recently, evidence has been accumulated to show PRP may also be an effective treatment for tendinitis, and since 2000, studies have been under way to assess PRP’s efficiency at treating osteoarthritis, and most research articles have only been published around 2010 or later. Because PRP injections for knee arthritis is such a new theory, research is still under way, however there is encouraging evidence to show PRP is an effective way to treat osteoarthritis.
Is It Hype or Does It Really Work?
There are plenty of studies showing the positive results of PRP for treating knee arthritis and knee pain, but PRP also has its fair share of critics and physicians who claim there has not been enough research done yet to really push this treatment. However, many patients who have had the treatment themselves and have experienced great results are more than happy to express their gratitude, such as 61-year-old Charlotte Marsden, who reported to feel completely pain-free after almost 20 years of suffering.
Pro golfer Tiger Woods received PRP injections to accelerate the healing process following his knee surgery. Troy Polamalu and Hines Ward of the Pittsburgh Steelers also had treatments before their Super Bowl victory in 2009.
Many doctors who treat professional athletes are on the forefront of new medical technologies and treatment options for sports related injuries. Dr. James Andrews, the eminent orthopedic surgeon who has treated and performed surgery on many of today’s elite athletes, indicated in a recent interview on the Dan Patrick show some interesting insights into the future of sports medicine. Dr. Andrews indicted that the arthroscope has been the biggest invention in orthopedic surgery in the last 40 years and they were always wondering what was going to be the next big revelation. For him and many other sports medicine doctors the next big thing is going to be, what he calls the biologics, stem cell therapy, tissue engineering and gene therapy. You can see and hear Dan Patrick’s complete interview with Dr. Andrews here. Start at minute 7:28 if you just want to listen to this particular section.
How You Should Prepare
Platelets are the most important component of receiving prp therapy. You want to make sure that you have a healthy platelets in your blood before receiving the treatment. Anti-inflammatory medicines like aspirin, motrin, advil, etc. can affect your platelets. So before your treatment you will want to avoid these medications a week prior to your treatment.
PRP injections are usually undertaken as an outpatient procedure, and because an experienced physician must first draw the patient’s blood before preparing for injection, a typical procedure can last anywhere between 45 and 90 minutes. The number of procedures required really depends on each individual case, and that is something your doctor should decide in a consultation with you. The typical number of treatments is usually 3 – 5, depending on the severity of your symptoms.
Sometimes when your doctor plans a series of injections, these can be planned with a single blood draw, so the remaining PRP treatments can be frozen for future use. However, some argue this lessens the effectiveness of the PRP, and recommend a fresh blood draw with every treatment.
PRP treatments for knee arthritis require an experienced physician and the use of imaging technology (such as an ultrasound) to ensure precision. This is because PRP injections are similar to Viscosupplementation treatments, and need to be injected directly into your joint capsule. There are also certain precautions that must be taken before these injections are carried out, as recommended by the American Academy of Orthopedic Surgeons. These include:
- Avoiding corticosteroid medications for around two to three weeks before treatment
- Avoiding non-steroidal anti-inflammatory drugs (NSAIDs) including arthritis medication (like Cerebrex), ibuprofen and aspirin up to a week before treatment
- Avoiding anti-coagulation medication for five days before treatment
- Drinking plenty of fluids one day ahead of procedure
Procedure explained step-by-step
As an in-office treatment, the procedure is relatively simple and involves the initial blood draw, followed by PRP preparation, and the actual injection. This is the order that your treatment will occur:
- Your doctor or physician will first extract 15 to 50ml of blood from your arm. This will go directly into a vial.
- A centrifuge machine then processes the blood.
- The centrifuged platelet-rich plasma is then prepared by a technician or doctor.
- The skin around the affected joint will be cleansed with disinfectant to ensure the area is clean.
- For ultrasound procedures, a gel will be applied so the ultrasound probe can be pressed against the skin. This allows the doctor to clearly see the joint on-screen.
- Relaxing will make the treatment a lot easier and less painful for you, so your doctor will try to ensure you are feeling relaxed. Some patients may prefer to take anti-anxiety medication before the procedure.
- Your doctor will inject a small amount of PRP (around 3 to 6ml) directly into your knee’s joint capsule.
- Your doctor will finish up by cleansing the area before applying a bandage.
What Are The Risks
Because prp treatments use your own platelets from your own blood, there are very little risks. But just like any other treatment, there are some rare risks.
Risks can include:
- infections to the injected area
- pain where the injection was inserted
- nerve damage
- tissue damage
When you compare the risks associated with surgery or cortisone injections, they are extremely minimal.
Following the procedure you will be advised to rest and avoid putting unnecessary strain on the affected knee joint. You may be advised not to take anti-inflammatory pain medication, and your doctor may prescribe you with something suitable. A brace or crutch may be required. A cold compress can be applied for 20 minute intervals. You will probably be asked to refrain from doing most activities for 48hrs following the procedure.
As with any form of medical treatment, you should consult with your physician before embarking on any treatment plan. The information contained in this article is for informational purposes only and should not be deemed accurate for the purposes of diagnosing your particular medical condition.
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