PRP Therapy - Performed by Ainsworth Institute

Platelet Rich Plasma is a groundbreaking treatment option for treating painful orthopedic injuries and conditions that have traditionally required surgery to correct. In cases where surgery is unavoidable, PRP can be used to enhance surgical repair.

In the procedure, platelets from the patient’s blood are concentrated, harvested, and re-injected into the injured area or arthritic joint. Once introduced, the platelets release substances known as growth factors that lead to improved natural tissue healing. Platelets initiate repair and attract the assistance of stem cells. This is known regenerative injection therapy.

The injected platelets release the growth factors and facilitate the process of regeneration and remodeling of the damaged area, thereby strengthening and expediting the healing process.

The therapeutic effect of PRP is thought to be facilitated through the release of a variety of growth factors:[i]

• PLT-derived growth factor AB (PDGF-AB)
• Transforming growth factor β1 (TGF β1)
• Fibroblast growth factor (FGF)
• Vascular endothelial growth factor (VEGF)
• Connective tissue growth factor (CTGF)
• Epithelial growth factor (EGF)
• Insulin-like growth factor 1&2 (ILGF)
• Keratinocyte growth factor (KGF)

In addition to these growth factors, PRP contains the chemokine Interleukin 8 (IL-8) which is believed to promote angiogenesis (the formation of new blood vessels) and improve blood flow.

These factors are located within the PLT’s themselves and are released upon activation, or in the case of PRP injection – into the injured body part to facilitate a focal and highly localized healing process.

PRP also contains the three proteins in blood known to act as cell adhesion molecules for osteoconduction as well as serve as a matrix for bone, connective tissue and epithelial migration:[1]

• Fibrin
• Fibronectin
• Vitronectin

[i] Civinni R, Nistri L, Martini C, et al. Growth factors in the treatment of early osteoarthritis. Clin Cases Miner Bone Metab. 2013;10:26-9.”

Procedure

Your physician will first draw some of your blood. This is much the same procedure you encounter when donating blood or getting lab work done. The blood is then transferred to a specialized container that has been pre-prepared with certain chemicals that aid in the separation process. The container is placed into a centrifuge and the sample is spun at high speed for 10 to 20 minutes. When this procedure is completed, the centrifuge will have separated your blood into two distinct reservoirs within the container.

One reservoir will contain plasma and the separated, concentrated platelets at the bottom (the platelet rich plasma).
The other reservoir will contain the rest of the blood which will be discarded.
The platelet “rich” portion is extracted into a syringe and prepared for injection into the problem area.

Restrictions – Before the procedure

Do not take Non-Steroidal Anti-Inflammatory Medications (NSIAD’s) for 1-week prior to the procedure – this includes aspirin, ibuprofen, Naproxen, etc. Do Not Take Steroids of any kind for 10-days prior to the procedure – this includes prednisone, Medrol dose packs, cortisone and cortisone injections.

Restrictions – After the procedure

Do Not Take Non-Steroidal Anti-Inflammatory Medications (NSIAD’s) and/or Steroids for 1-month after the procedure.

Getting back to normal

For the first 48 hours after the procedure we recommend you carry on as normal, but with no strenuous activity or exercise. After 10-12 days, you can start light exercise, but return to stressful activity only after six weeks.

**Returning to stressful activity before six weeks will result in incomplete healing of the treated tissue.

There are a ton of different companies on the market for collecting and processing PRP…all claiming to be the best. So how do you which one really is the best. Dr. Hunter doesn’t just claim to be a leader in regenerative medicine, he actually is. He’s been doing research on regenerative medicine for 20 years and has a number of publications to his credit – particularly on the subject of PRP. Most recently, he published an article comparing all of the different methods for collecting and processing PRP to determine which has the highest cell count and the concentration of the necessary growth factors. Click on the link below to see for yourself below.
Compare PRP Systems

As with any medical or surgical procedure, there is always a risk of complication. The most common complaints people have after a PRP injection is of pain an irritation. The procedure may initially cause some localized soreness and discomfort which can be treated with nothing stronger than Extra-Strength Tylenol. Ice and heat may also be applied to the area as needed.

Often, the body purposely creates inflammation around the injection site in order to lure additional assistance from growth factors and inflammatory markers. In these cases, discomfort can persist in the patient for up to 10 days.

Other potential risks include infection from drawing blood, or the process of the injection itself.

It’s important to remember:

While PRP has been proven effective, it is still technically experimental. Patients often respond well to more traditional avenues of therapy and treatment. The Ainsworth Institute recommends that PRP be pursued only after conservative treatments have been exhausted (physical therapy, anti-inflammatory medications, and rest).

As with anything considered experimental, results may vary and not every patient will have success.

PRP is a safe and accepted treatment. Patient-derived PRP has been used for over 30 years as an aid in recovery following certain surgical, orthopedic and dental procedures. There are thousands of research articles published on the safety of PRP.

In a 2008 study, Mishra reported on 140 patients with tennis and golf elbow who failed to respond to conservative treatments (physical therapy, medications, etc) and were treated with PRP. All the patients in this study were being considered for surgery. Patient were given a single treatment of PRP and were followed for 3 years. The PRP treated patients reported a 93% reduction in pain at 38 months post-injection.[1] Other studies have attempted to explore PRP and establish it as an effective treatment for regenerating cartilage in osteoarthritis.[2]

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[20] Thanasas C, Papadimitriou G, Charalambidis C, et al. Platelet-rich plasma versus autologous whole blood for the treatment of chronic lateral elbow epicondylitis: A randomized controlled clinical trial. Am J Sports Med. 2011;39:2130-4.
[21] Gosens T, Peerbooms JC, van Laar W, den Oudsten BL. Ongoing positive effect of platelet-rich plasma versus corticosteroid injection in lateral epicondylitis: A double-blind randomized controlled trial with 2-year follow-up. Am J Sports Med. 2011;39:1200-8.
[22] Nguyen RT, Borg-Stein J, McInnis K. Applications of platelet-rich plasma in musculoskeletal and sports medicine: an evidence-based approach. PM R 2011; 3:226-50.
[23] Filardo G, Kon E, Della Villa Set al. M. Use of platelet-rich plasma for the treatment of refractory jumper’s knee. Int Orthop 2010; 34:909-915
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