Platelet Rich Plasma (PRP) was originally developed in the 1970’s and was first used during an open heart surgery in the late 1980’s. Its use was expanded into maxillofacial surgery to aid in wound healing in patients who underwent reconstructive jaw surgery for cancer in the early 1990’s. PRP was used in the treatment of non-healing wounds and reconstructive skins flaps during this same time period. In the late 1990’s, orthopaedic surgeons began using PRP in surgical cases of fracture non-unions.
In 1999, Dr. Allan Mishra, an orthopaedic surgeon in California, used PRP as a part of the treatment for a torn Achilles tendon in San Francisco 49ers quarterback, Steve Bono. This is one of the first reports of PRP being used in Sports Medicine. Several years later, Dr. Mishra began using PRP to treat chronic elbow tenonditis.
The American Journal of Sports Medicine published a paper in 2006 that suggested that PRP use appeared to accelerate wound and tissue healing. Shortly thereafter, numerous well known professional athletes and sports figures were successfully treated with PRP which has helped it gain popularity as a viable treatment.
Numerous orthopaedic conditions have been successfully treated with PRP based on published studies and anecdotal reports ranging from chronic tendonitis and cartilage injuries to ligamentous and tendon disorders. PRP has also been used to treat neck and back pain.
The procedure is performed by drawing blood from a patient and placing it in a centrifuge to separate the platelets from the rest of the blood components. The concentrated platelets are then directly injected into the injured area of tissue. The “rich” platelets contain multiple growth factors that can stimulate new tissue growth. Some of these factors include transforming growth factor, connective tissue growth factor, epidermal growth factor, and vascular growth factor. These growth factors recruit new cells to the area to stimulate healing.
Repeat injections often need to be performed a defined time intervals based on response of the patient and the condition being treated.
At the present time, there are not many large, well controlled studies that have focused on PRP use. There are some smaller studies that have been published with level I and II evidence (Evidence-based medicine) showing the PRP is beneficial for certain conditions. Further studies are needed to define specific treatment protocols including ideal concentration of platelets and preparation methodology. Risks of PRP therapy appear to be relatively small.