PRP: An Innovative Treatment for Musculoskeletal Pathologies

By Nat Padhiar, Consultant Podiatric Surgeon

Please get in Contact to book an appointment with Dr. Nat Padhiar

Abstract

Renowned surgeon, Mr. Nat Padhiar, contextualises PRP therapy within a range of other common treatment methods and outlines the implications for professional athletes, providing a comprehensive overview of the benefits and applications of PRP in treating musculoskeletal pathologies.

Article

PRP is an innovative treatment for Musculoskeletal Pathologies, which uses the body’s natural ability to accelerate healing of muscle, tendon and ligament injuries.

Healing can often result in scarring, which affects function. Most of the current therapies treating sports injuries do not alter the intrinsically poor characteristics of healing. Given this situation, biologically based strategies involving the stimulation of cell activities through the delivery of Growth Factors have attracted considerable interest.

Platelet Rich Plasma is derived by placing a small amount of your blood in a filtration system, which separates red blood cells from platelets. The high concentration of platelets (containing a high level of Growth Factor) is then injected into the injured tissue, which initiates the body’s natural healing response.

All the injections provided at The London Musculoskeletal Centre are performed under ultrasound guidance. After treatment, cold therapy/icing of the affected area may be beneficial.

Usually 2-3 injection are required depending on the severity of the injury and the chronicity of the symptoms.

Platelet Rich Plasma Therapy in Musculoskeletal Medicine

Platelet rich plasma injections (PRP injections) can be used in the treatment of many musculoskeletal injuries. Typically 2 or more injections 1-4 weeks apart are required. This may vary depending on the injury.

Muscle and Tendon injuries that can be treated with PRP

Muscles Injuries:

● Hamstring
● Calf
● Quadriceps

Tendon Injuries:

● Tennis elbow (common extensor tendinosis)
● Golfer’s elbow (medial epicondylitis)
● Jumper’s knee (patellar tendinosis)
● Achilles tendinosis
● Plantar fasciitis
● Hamstring tendons
● Adductor tendons
● Gluteal tendons

Other injuries that can be treated with PRP:

● Knee MCL tears
● Knee osteoarthritis (9,10, 12-14)
● Hip Osteoarthritis (11)
● Acromioclavicular Injuries

How is PRP different?

● PRP can potentially accelerate healing and reduce injury time.
● With its concentration of growth factors, PRP stimulates the healing process.
● PRP focuses on restoring normal tissue composition while avoiding further degeneration.

Platelet Rich Plasma (PRP) Injections: The Procedure

Ultrasound guidance is used to visualise the site of injury. There is no exposure to ionising radiation; it is the same technology used in pregnancy imaging.

Platelet Rich Plasma (PRP) Injections: Safety

This section addresses potential adverse effects and contraindications to platelet rich plasma (PRP) injections. The 2011 World Anti-Doping Code (WADA) has deemed all musculoskeletal PRP injections to be considered legal with no notification required. However, if you are an athlete and in a registered testing pool, always confirm with your practitioner the latest WADA regulations, as they may have changed.

Side Effects

Platelet rich plasma (PRP) is prepared from autologous or the patient’s own blood so there is no risk of developing a growth of tumour or cancer. Adverse effects are rare but as with any injection there is always the small risk of infection or injury to nerves or blood vessels. Scar tissue formation and calcification at the injection site are also possible.

Is it painful?

It is usual that you may feel some pain during and following the injection. Our specialists prefer that you use paracetamol (e.g. Panadol) for pain relief. If you experience persistent severe pain or an adverse reaction following the injection, you should contact your specialist.

When you should not have PRP:

You should not have a PRP injection if you have one or more of the following:
● Cancer or metastatic disease
● An active infection
● A low platelet count
● You should also not have a PRP injection if you are pregnant or are breastfeeding

Medications to avoid before PRP

You should not have a PRP injection if you have used non-steroidal anti-inflammatory medications (NSAID’s) in the 7-10 days leading up to your appointment. If you are considering having this injection, please switch to another painkiller such as paracetamol or for other options, check with your local doctor or chemist.

WADA and PRP (Anti-Doping Requirements for Athletes)

The World Anti-Doping Authority (WADA) has deemed all musculoskeletal PRP injections for athletes legal to use with no notification required.

Before having an injection, always ask your doctor for the latest information on the WADA.