What is the effect of PRP therapy in orthopaedics?

Are you familiar with a treatment called "PRP therapy"?

PRP therapy is a treatment method where PRP (platelet-rich plasma) from your own blood is injected into the damaged part of your body to help your own repair power. It is used for treatment in all fields such as dentistry and plastic surgery, and PRP therapy is also used in orthopaedics to treat sports injuries and arthritis.

What is PRP (Platelet Rich Plasma) therapy?

PRP Platelet Rich Plasma

PRP (Platelet Rich Plasma) is plasma that contains a large amount of platelets. PRP is produced by extracting platelets from the patient's own blood.

PRP therapy - a treatment that promotes the "tissue repair power" of platelets.

PRP therapy is used to collect the patient's own platelets and inject them into the damaged part of the body to treat difficult to heal or injuries and diseases that take time to heal.

What do platelets do exactly?

Platelets have mainly "the function of solidifying blood" and "the function of producing growth factors that promote tissue repair".

As you may have experienced, after a while after bleeding from a cut, the blood stops and the wound closes naturally. When a sprain occurs, the affected area swells immediately after the injury (internal bleeding), and eventually it turns blue and the swelling gradually disappears.

Platelets play an important role in these healing processes. The action of platelets enables our body to maintain its self-defence and heal itself.

However, when there is an imbalance between the ability to repair tissue and the ability to destroy tissue, the ability to heal itself is weakened.

Therefore, PRP therapy is a treatment that can bring out the repair power that one originally has by injecting PRP, which contains a large amount of platelets, into the damaged part.

Indications for PRP therapy

PRP therapy is also used in the treatment of various injuries and diseases as well as in aesthetic medicine. In particular, it is a treatment method widely used in dental treatment ( implant treatment , bone formation treatment, etc.) and beauty medicine (skin regeneration treatment, etc.). In addition, PRP also has the function of closing the wound quickly, so it is generally used to treat wounds after surgery.

There are no particular restrictions for indications in orthopaedics. PRP therapy is often used for general conditions such as osteoarthritis and arthritis of the knee, as well as for sports-related tendinitis, ligament injuries and muscle strains.

Purpose of PRP therapy

PRP therapy is a treatment that repairs damaged tissue, but the ultimate goal of the treatment depends on the condition.

PRP therapy for sports trauma stress, fractures, etc.

The purpose of PRP therapy for sports injuries such as strains and fractures (injuries that occur suddenly with a single external force) is early recovery.

For example, if a professional athlete is injured for three months, they may be able to play several more games if they can return after a week or two. If you have an important game coming up, your ability to play that game can make a big difference in your life.

Sports injuries like strains are injuries that will eventually heal. However, depending on the severity of the injury, treatment can take 2 to 3 months. By performing PRP therapy for such injuries, it is possible to shorten the treatment time as much as possible and aim for an early recovery from the injuries.

PRP therapy for sports injuries - Achilles tendonitis, etc.

Sports injuries such as Achilles tendonitis (chronic damage caused by repetitive strain on a specific area) usually become difficult to treat (a condition that is difficult to cure even with treatment) by enduring the pain and continuing to play sport. Injury. For such sports injuries, PRP therapy is used to achieve complete healing.

Intractable sports injuries make the tissue that should be healed hard and difficult to heal. Therefore, by injecting PRP into the damaged part, the original repair power is restored and the purpose is to heal from the injury.

PRP therapy for osteoarthritis of the knee and arthritis

PRP therapy for knee osteoarthritis has two main therapeutic goals. One is to reduce inflammation due to arthritis deformities and relieve pain. The second is to suppress the progression of deformity due to cartilage wear.

For the first arthritis, we expect the action of cytokines (substances that suppress inflammation, etc.) produced by platelets. Persistent inflammation of the joints can also cause chronic pain. By injecting PRP into the joint, we aim to reduce inflammation and eliminate pain.

Platelet growth factors play an important role in second cartilage degeneration. It is expected that the effect of growth factors on cartilage cells causes the synthesis of cartilage tissue and the proliferation of chondrocytes.

Procedure of PRP therapy

PRP-Therapie

① Blood collection

In PRP therapy, blood is first collected from the patient using PRP tubes to produce PRP. The amount of blood collected varies depending on the treatment.

  

② Centrifugation

Next, the collected blood is centrifuged with a PRP centrifuge to extract PRP.

  

③ Injection

The PRP obtained is injected into the affected area. For tendonitis, for example, about 2cc of PRP into the affected area, for arthritis about 4cc of PRP into the affected area.

For arthritis, 4cc of PRP is often used, which is twice the usual amount, because the joint has a pouch-like structure and the PRP may not stay in the affected area and spread. To reduce the spread of PRP in osteoarthritis, the patient is also asked to rest for about 20 minutes while applying pressure to the joint sac in the unaffected area so that the PRP collects in the affected area.

Since the inside of the joint is pouch-shaped and PRP can spread beyond the affected area, 4 ml of PRP is used for arthritis, which is twice the amount. In the case of arthritis, to suppress the spread of PRP, you should rest for about 20 minutes while pressing on the joint bag of the part other than the affected area so that PRP accumulates in the affected area.

 

Number of PRP treatments

There is no particular limit to the frequency of PRP therapy. Orthopaedic surgeons usually treat muscle strains once or twice to achieve early healing. For difficult-to-treat sports injuries such as tendinitis, there are individual differences in the effect and number of treatments. However, the treatment is often carried out 2-3 times.

In addition, PRP therapy for knee osteoarthritis and arthritis is usually treated 2-3 times for the purpose of pain relief. If the pain recurs after about half a year, PRP therapy can be repeated 2-3 times.

Advantages and disadvantages of PRP therapy

One disadvantage of PRP therapy is that patients have to pay for the treatment themselves, depending on their insurance.

 

Does PRP therapy have any side effects?

 

The side effects of PRP therapy are minor, but because PRP is injected directly into tissues such as muscle and tendon with a needle, you may feel pain during and after the treatment. However, if you have PRP therapy on the inside of the joint, you are unlikely to feel pain. 

The risks of the treatment are very low because you are being treated with your own blood. Small bruises, redness and swelling are rarely possible.

The future of PRP therapy

As mentioned above, the therapeutic effect of PRP therapy varies from person to person. The main problem of PRP therapy in the future is to improve the therapeutic effect by applying PRP more finely for each patient and disease.

In the future, treatment with new PRP is expected, in which not only PRP is properly applied according to the white blood cell content, but also the anti-inflammatory effect is further enhanced by dehydrating the PRP. In fact, such PRPs are beginning to be widely used in the treatment of arthritis.

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