PLATELET RICH PLASMA (PRP) TREATMENT MELBOURNE

What is PRP treatment?

Platelet Rich Plasma (PRP) is a treatment used to promote healing. Usually, treatment is performed in patients suffering from tendinosis, tendon tear or joint pathology. This treatment involves the injection of the patient’s own blood (Autologous Blood Injection [ABI]) into the injured tissue area in order to speed up and induce the body’s recovery process.

PRP concentrates the important factors in the blood so a more concentrated product is injected into the injured region. This form of treatment’s aim is to assist in the body’s healing of musculoskeletal injuries naturally, without subject to additional risks or adverse effects.

What are the treatment options available?

If only tendinosis is present, then Dry Needling (DN) alone may be performed while severe tendinosis or tendinosis not responding to other therapies and tendon tears can be treated with PRP.

Dry needling is commonly used to treat muscle or tendon injuries, by using a needle to target specific injured tendons or muscles which have been previously injured but are not responding to conservative methods of treatment. Depending on the issue Dry needling and PRP can be combined.

How does PRP treatment work?

ABI/PRP and DN are thought to work on the basis that blood carries growth factors which trigger stem cell recruitment and fibroblast stimulation; cells which induce the healing cascade. These treatments are usually done in conjunction with strengthening exercises and physiotherapy.

How effective are PRP injections?

The success rate is difficult to predict, with evidence suggesting that around 70-80% of patients see an improvement, which can be quite dramatic in many cases. It is important to note that the degree of response to treatment depends on several factors including:

1. Body part injected.
2. Degree of tendinosis and size of the tear of the tendon.
3. The chronicity of the injury.
4. If treatment is for joint pathology there are several variables including, the problem itself, e.g., cartilage damage, meniscal damage, marrow oedema, chronicity and other factors.

What if there is no improvement after the treatment?

If there is no clear improvement following the treatment, the procedure may be repeated if necessary. This follow up treatment is then usually performed 4-6 weeks after the initial procedure.

How to prepare before your treatment?

All anti-inflammatory medication should be ceased about 10 days before the procedure, including aspirin and ibuprofen.

How is the procedure performed?

All these procedures are performed under ultrasound control so that the injured region can be directly visualised and accurately injected. If you have not had a prior ultrasound, an expert musculo-skeletal sonographer or radiologist will usually first scan the area of concern to confirm the pathology and plan the treatment.

Treatment procedures:

If PRP is being performed, a small cannula (similar to having a blood test) will be placed into a vein in an arm and left there for the duration of the procedure. If ABI/PRP is not to be performed, this step will be left out. For PRP about 10 ml of blood is taken. The skin is then cleaned with an antiseptic agent. Local anaesthetic is usually then injected into the skin and around the tendon to make the procedure more comfortable.

Dry needling treatment:

If dry needling alone is performed, this will be performed under ultrasound control. This consists of repeatedly passing a needle through the abnormal area of the tendon to cause small bleeds.

If ABI/PRP is to be performed, DN may be performed first to fenestrate the tendon. If PRP is to be performed, the blood will first be centrifuged which takes around 10 minutes. This causes the heavier components of blood, such as red blood cells, to be separated from the plasma or fluid component.

Is the injection painful?

The degree of discomfort varies depending on:

• Area to be injected.
• Degree of inflammation in the area.
• Previous experiences (good or bad) and fear of needles.

Overall, however, the procedure is well tolerated and usually produces only minimal discomfort. There can be a slight increase in pain and stiffness in the area injected for a day or two afterwards, occasionally lasting up to a week.

What if I still have pain or discomfort after the treatment?

We try to limit the use of ice-packs or anti-inflammatory (e.g., ibuprofen) medication after treatment for about 10 days. However, paracetamol-based products are acceptable for use.

Risks and Side effects:

The procedure is usually well tolerated and adverse reactions are rare.

• After injection discomfort is variable. Usually mild and may last a few days and rarely up to a week. Painkillers such as Paracetamol can be used if necessary.
• Bruising: Usually minor.
• Non – response: Difficult to give percentages as there are many variables, but if the treatment is suited to the underlying problem, the procedure is very effective.
• Tendon rupture: Uncommon. Possibly due to overuse post injection as a result of symptom improvement or progression of disease.
• Infection: This is rare! Features of infection include: Pain (increasing after 2-3 days at the injection site), redness, swelling, temperature and feeling of being unwell. If occurs, please consult your doctor as soon as possible.

What to expect after the procedure?

Immediately post procedure, variable. From no discomfort to mild. Occasionally there can be quite significant discomfort that can last for up to 20-30minutes.

You may well experience initial pain relief due to the local anaesthesia provided prior to the procedure. There may be some subsequent mild discomfort for a couple of days. The maximum effect of the treatment usually occurs at the 4–6-week mark. What you will be able to do after the procedure will depend on the area injected and reason for the treatment.

What exercises can I do after the treatment?

Post procedure rehabilitation/ exercise regime is variable depending on the area/structure involved, degree of injury and the individual circumstances. This will usually be organised/ supervised by your referring doctor or physiotherapist. Usually, you will be asked to avoid strenuous activity during the first two weeks, with a gradual return to full activities.

Contact our clinic

If you have any questions or concerns after treatment please contact Independent Sports Imaging or your referring physician.

Additional Information

Download a patient information brochure:
Patient Fact Sheet on Autologous Blood Injections, Platelet Rich Plasma and Dry Needling

Comprehensive review article on Platelet Rich Plasma:
Review article on the use of Platelet Rich Plasma