Platelet Rich Plasma Injections into the Ligaments and Tendons

What is a Platelet Rich Plasma injection?
Platelet Rich Plasma, or PRP, is blood plasma with concentrated platelets. The concentrated platelets found in PRP contain huge reservoirs of bioactive proteins, including growth factors that are vital to initiate and accelerate tissue repair and regeneration. These bioactive proteins initiate connective tissue healing, bone regeneration and repair; promote development of new blood vessels; and stimulate the wound healing process.

What is the Purpose of a PRP Injection?
When PRP is injected into the damaged area, it stimulates the tendon or ligament, causing mild inflammation that triggers the healing process. As a result, new collagen begins to develop. As this collagen matures, it begins to shrink, causing the tightening and strengthening of the tendons or ligaments of the damaged area.

PRP can also be injected into the spinal discs. This is discussed in the hand out ‘Disc Injection Therapy’. PRP can also be injected into the peripheral joints, such as the knee or shoulder. This is also discussed under regenerative medicine.

Which Patients are Candidates for a Platelet Rich Plasma Treatment?
PRP treatment works best for chronic ligament and tendon sprains/strains that have failed other conservative treatments.

PRP injections can be performed in tendons and ligaments all over the body. Sports injuries, arthritic joints, lower back, degenerative disc disease and more specific injuries including tennis elbow, carpal tunnel syndrome, ACL tears, shin splints, rotator cuff tears, plantar fasciitis and iliotibial band syndrome may all be effectively treated with PRP.

How is the Procedure Performed?
To prepare PRP, a small amount of blood is taken from the patient. The blood is then placed in a centrifuge. The centrifuge spins and automatically produces the PRP. The entire process takes less than 15 minutes and increases the concentration of platelets and growth factors up to 500%.

The procedure is done under ultrasound guidance. This ensures the needle is in the correct location. Local anesthesia is obtained before the PRP injection.

Will the Procedure be Painful?
There is a certain amount of discomfort involved with this procedure. Most of the pain occurs when the skin and underlying tissues are numbed. The smallest sized needle that will accomplish the procedure is always used. A pressure sensation is common when the medication is injected. You may be sedated for this procedure, but most people do it under local anesthesia.

What are the Risks and Side Effects?
Complications for this procedure are low. Whenever a needle enters the skin, bleeding or infection can occur.

You may have an allergic reaction to any of the medications used. If you have a known allergy to any medication, especially x-ray contrast dye or local anesthetics, notify our staff before the procedure takes place.

The most serious side effects from intravenous sedation are sudden death, brain damage from low blood pressure, or allergy from the medication. However, these are extremely rare and have never happened in my practice. A nurse will be monitoring your blood pressure, blood oxygen level, and heart rate. If necessary, oxygen will be administered through a tube inserted in your nose.

How long does it take for the procedure to work?
PRP therapy helps regenerate tendons and ligaments, but it is not a quick fix. As this therapy is stimulating the growth and repair of tendons and ligaments, it requires time and rehabilitation. Through regular visits, your doctor will determine when you are able to resume regular physical activities.

What Restrictions Will I Have on the Day of the Procedure?
We ask you not to increase your activity too quickly as you get better to avoid any setbacks.

If you have been sedated, you will not be allowed to drive, operate machinery, or make legal decisions until the next day. You should not soak until the skin is healed. You may shower the same day. You should avoid any vigorous activity for several days.