PLATELET-RICH PLASMA (PRP) INJECTION
What are Platelet- Rich Plasma [PRP] Injections?
Platelet-rich plasma (PRP) harnesses your body's own healing abilities to stimulate repair and regeneration of damaged tissue. PRP is derived from your own blood, and with a quality PRP system, the platelets are concentrated to at least 6 times the levels found in blood. After being injected into injured tissue, platelets release growth factors that direct and stimulate healing.
The function of these growth factors has been well studied - development of new blood vessels that nourish healing tissue, recruitment of macrophages to remove damaged tissue, attraction of fibroblasts to the area to synthesize new collagen fibers - everything needed for healing is provided by platelets. This is, in fact, how our bodies heal all injuries, which is why PRP is so effective. PRP has been used for about 40 years and now has wide applications in many areas of medicine.
Some structures in our bodies, including tendons and ligaments, are made out of what is called "dense fibrous connective tissue." They always have a poor blood supply and do not actually require much blood flow, since their metabolic rate is low. When they become injured, however, the poor blood supply means that platelets are not brought to the injury to stimulate healing. Tears and degeneration of tendons and ligaments can therefore be permanent, without proper intervention. With PRP injection, we are doing what the body cannot do by itself - bring growth factors to the injury.
PRP is also useful in osteoarthritis (OA) and has been found to be superior to injections of hyaluronate (e.g., Synvisc). In addition to growth factors, platelets contain compounds that decrease the type of inflammation that is typical of OA. Since hyaluronate is only FDA-approved for knee OA and not for any other osteoarthritic joint in the body, PRP is a good treatment option. The ability of PRP to decrease inflammatory damage is also useful in chronic nerve entrapments. When viewed surgically, these nerves are swollen, irregular and red, and PRP treats this inflammatory damage.
We use the Emcyte PurePRP II system from Accelerated Biologics,
which we believe to be the best available. Many other systems do not
adequately increase the platelet concentration. Emcyte Pure PRP II
provides an adequate concentration of platelets and a low quantity of
red blood cells. Red blood cells (RBCs) are undesirable in a PRP
injection, as they increase inflammation and post-procedure pain.
All of our injections are ultrasound guided, so that every drop of your
PRP that we prepare reaches the injury. Ultrasound guidance, coupled
with a detailed knowledge of anatomy, also allows us to avoid injuring
nerves and blood vessels when performing an injection.
PRP INJECTION INTO ROTATOR CUFF
APPLICATIONS FOR PRP
TENDON PARTIAL TEARS: rotator cuff, elbow (tennis elbow, golfer's elbow), and lateral hip (sometimes diagnosed as trochanteric bursitis)
CHRONIC LIGAMENT SPRAINS: ankle and elbow (ulnar collateral ligament)
TENDON DEGENERATION: as often occurs with chronic rotator cuff impingement and tendon overuse injuries
OSTEOARTHRITIS: Mild to moderate, all joints
CHRONIC NERVE ENTRAPMENT: carpal tunnel, cubital tunnel, common fibular nerve, greater occipital nerve, etc.
When there is a gap within injured tissue, such as a partial tendon or ligament tear, better results are obtained by injecting a filler into the gap. The best material for this is your own adipose tissue (fat). Fat grafts provide a scaffold upon which new tissue grows, and over a period of months, the fat is replaced by healthy collagen. Dr. Adams has been using fat grafts since 2014 and has seen a dramatic improvement in his results with this technique.
Please email for more information.