•  PRP  • 

 

Platelet Rich Plasma

 

A non-surgical orthopedic injection treatment

What is PRP?

PRP is an abbreviation for platelet rich plasma. PRP therapy is a specific form of Prolotherapy  that uses the patient’s own blood (plasma) to accelerate tissue regeneration and promote healing of tendons, ligaments, muscles and joints.

How does PRP work?

PRP injection therapy starts by drawing a large vial of the patients blood.  This vial is then placed in a centrifuge, a machine that spins the vial so quickly that the different parts of the blood separate out.  Once separated, the plasma that has the most platelets is injected back into the injured area.

 

The extra platelets increase the number of cells ready to heal and repair, and trigger the body’s natural healing response.

What is Plasma? What are Platelets

Plasma is the largest part of your blood.  Made up of water, salts, enzymes and proteins.  It is the fluid that carries your red blood cells, white blood cells and platelets through your body. When it is separated from the rest of your blood it is a light yellow color.

 

Platelets are a type of blood cell that helps blood clot and helps wounds heal.  Platelets are made in our bone marrow and are an integral part of the body’s healing process.

 

“Dr. Keene: gentle, informative…  had Prolotherapy on my knee, he is brilliant, answered every question, he is funny…   I feel humbled that he is here in Santa Cruz for all of us!!!”

– Robert W.

What are the benefits of PRP?

• PRP treats and alleviates chronic pain, joint laxity, and many other musculoskeletal issues without the risks or long recovery time or surgery. 
• Compared with pricey MRIs and surgery, PRP is extremely cost effective.
• Patients typically notice improvement with their symptoms within the first month or two post treatment.
• PRP heals pain and discomfort at the source ultimately strengthening the body.

Like to get into the research?  Read a large case study review here.

How long is the healing process?

Post treatment, the treated area will feel sore as if it has been re-injured again.  The soreness will subside within about a week and as soon as a couple days.

Tissue growth takes time.  and repeating PRP in the same area is not recommended for at least six months, depending on the injury.  Traditional prolotherapy can be offered during this time to boost the effects of the PRP if necessary.

Similar to Prolotherapy there are three healing stages that occur:

1. Stage One – The extracellular tissue matrix develops (4-6 weeks).  This matrix is the foundation necessary for tissue regrowth.  This is a critical stage and Dr. Keene often recommends bracing, splinting or something similar for the first 2-4 weeks post treatment to ensure strong development.
2. Stage Two – Fibroblast activity (4-6 months).  A fibroblast is a type of cell that predominantly composes connective tissue.  Fibroblast cells provide the framework critical to wound healing and cell regrowth.
3. Stage Three – Connective tissue matures (1-2 years duration).  The connective tissue matures and provides new stability and strength to the treated area.

How is are PRP and Traditional (Dextrose) Prolotherapy different?

After receiving a Prolotherapy with Dextrose treatment, there is no recovery time, however post PRP treatment there is a required recovery time of the injured area.  Patients can continue to work and participate in usual daily activities but to build the strongest foundation for healing the treated area needs to rest completely for 2-4 weeks.

What conditions are commonly improved by PRP?

• Back and neck pain
• Herniated / degenerated discs
• Shoulder pain
• Rotator cuff tears
• Knee pain (Learn more)
• Elbow pain
• Hand / wrist / finger pain
• Ankle / foot / toe pain
• Plantar Fascitis (Read the Research 2019) (Read the Research 2015)
• Joint laxity / hyper-mobility
• Tendonitis
• Sports injuries
• Ligament sprains and tears
• Myofascial pain
• Early osteoarthritis
• And more…

What will my Treatment Plan look like?

The first appointment is a PRP evaluation.  During the evaluation Dr. Keene will complete a detailed examination, create a treatment plan according to your needs and answer any question you might have.  Each PRP treatment plan is unique.  At this point you will be advised on what, if any, additional medical equipment you will need for after the treatment.  

 

PRP treatment appointments are 60 minutes long.  You arrive 20 minutes prior to your treatment to do the necessary blood draw.  About 50-60cc per kit will be drawn.  To prepare for the blood draw it is important that you are well hydrated and fed.  Please bring a small snack and juice of your choice for after the blood draw.

 

After the blood draw, the vials are spun in a centrifuge for 10 minutes leaving about 6cc’s of platelets for treatment.

 

Your platelets are then used for your injection therapy.

What will my Post-Treatment Plan look like?

IMMEDIATELY following your PRP injection therapy you will be advised to:

• limit the use of the treatment site
• use a supportive/ durable medical device like a brace or splint for about two weeks. This is a critical part of ensuring that your body has the time it needs to lay the proper foundation for the healing process and maximize treatment success.
• referred to a physical therapist who will manage care through the next steps of the healing process.

 

After 2+ weeks you can start doing gentle range of motion exercises of the treated are to slowly get things moving.  You must continue to be cautious and avoid any excessive forces on the treated area for a few more weeks.

 

After 4-6 weeks, you can start physical therapy (PT) exercises of the treated area.  For the first few weeks of PT you should focus on isometric and eccentric exercises while continuing to improve range of motion.

 

After 2 months the extracellular matrix has developed and you can increase the isotonic exercises as recommended by your PT.

 

After 3-4 months schedule a follow-up appointment to review your progress and determine next steps.