Has anyone had experience (good or bad) with platelet rich plasma therapy (PRP)?
I underwent PRP for my patella tendinosis and a small tear. I had two injections a week apart. I started rehabbing it as soon as the acute swelling went down. Waited 6 weeks to run to really let it get strong and remodel. Then I eased into running again. Took me a good month to get to 50 minutes of running. I didn’t stray from my plan no matter how good I felt. (I’m a PT and rehabbed myself).
I have had great success with my injections. The patella tendon has a high success rate (lateral epicondylitis has the highest rate of success).
Where do you need the injection?
At the left deltoid insertion. I crashed on my bike in May and either badly bruised or broke ribs. Ten weeks until there was no pain when I took a deep breath. Have had problems with the shoulder/deltoid area since with sharp pain right at the insertion point. PT I’m seeing thinks that because of the trauma from crash everything got out of line and is causing inflammation. I haven’t been able to swim because the pull is very painful, hurts running, hurts in aero position.
My husband had it in his shoulder (car accident caused tearing in his shoulder from the seatbelt). In his case it was post-surgery, and the surgery didn’t really help. I don’t think he noticed any improvement.
If it is a more recent injury and no other procedures have been done I think it might be more helpful.
Has anyone had experience (good or bad) with platelet rich plasma therapy (PRP)?
Looking through the literature…there are several reviews that make multiple claims along the lines of: There are promising results, but no clinical trials yet.
That was in 2009 and 2011. I haven’t found anything more recent (in an admittedly quick and dirty search) that actually presents a formal, controlled study.
If the PT’s on here have something like that…please post it!
If not, save your money for a proven therapy.
Same as Wingnut here. Patellar tendinitis (several micro tears). Lots of pain running before the injection.
One injection in early March 2011. 2 weeks off training. Lots of pain after the injection, better after.
PT, patience, increasing training regimen and voilà.
End of June for my first sprint tri since the injection. No pain, great run (for me). Feeling great.
3 years of pain free right knee (front part that is, now I have popliteus - back of the knee- issues)
Now, this is for me. Heard it does not work for everyone.
Good luck.
I’m biased on this subject because I do various forms of prolotherapy (dextrose, PRP, stem cells, etc) as a large part of my practice. We see great results with this type of therapy. One thing to note is that there are many ways to do PRP which directly affect the outcome. So, knowing what structures need to be targeted (not just the injured tissue) and having good platelet numbers will dramatically improve results.
I also inject steroids, prescribe PT, medications, refer to surgeons, etc. as well, but I like to promote the body’s healing cascade through prolotherapy. Not a lot of great literature out there on this (or anything else for that matter). Many reasons for this, but it’s gaining a lot of traction in the literature. From what I have seen, it’s often times the best tool I have in my bag.
Cochrane is one of the top levels of evidence in the medical world and this is their summary of trials to date:
http://summaries.cochrane.org/...soft-tissue-injuries
Full text here: http://onlinelibrary.wiley.com/...58.CD010071.pub3/pdf
*edited for full text link
.
Cochrane is one of the top levels of evidence in the medical world and this in their summary of trials to date:
http://summaries.cochrane.org/...soft-tissue-injuries
Full text here: http://onlinelibrary.wiley.com/...58.CD010071.pub3/pdf
*edited for full text link
Thank you for the new resource!
To the OP, please check out the link.
I had PRP for torn plantar fascia in both feet and I am very glad I did it and would say it was definitely successful. I have had issues with my feet for about 2 years and tried everything else short of surgery. I also had Tenex FAST procedure in January to remove the damaged tissue, but that still didn’t help the tears heal, so at the beginning of May I gave PRP a shot. I was able to start pool running 3 days later and easy spinning on the bike 5 days later. I wasn’t able to swim until about 1.5 weeks after since it hurt to try to push off the wall before then. By the second week post PRP I was back to my usual bike and swim workouts. I was able to start running on the Alter-G treadmill 2.5 weeks after I had the injections and weeks 3-6 post PRP I was putting in 25-30 miles per week on the Alter-G (with at least one hard interval workout and one tempo workout). I was able to start running 6 weeks post PRP, which was mid-June and I just finished Ironman Chattanooga with a big PR just over 1 week ago. I was able to ramp up my running fairly quickly since I had been running on the Alter-G. I was also doing a lot of pool running and Alter-G running between January after I had Tenex and May after having PRP. In my case I also had some muscle imbalance issues and some issues caused by Mortons’ Toe in both feet, so I also got since metatarsal lifts to help with the Morton’s Toe issue and have been doing strengthening exercises daily to correct the muscle imbalances. So while I think the PRP definitely helped the torn fascia heal, I strongly believe that being able to run now and ramp up my mileage quickly was in large part due to the strength work I have been doing since I’ve been back running. From what I understand, PRP is more successful in muscle/tendon injuries versus joint injuries. I think it also really depends on your doctor since there is no standard protocol for PRP right now. So make sure you find a doctor who has a lot of experience and success with PRP.
My brother also had prolotherapy for his knee a few years ago. I believe he had multiple injections over a year’s time, and he swears by it. I wasn’t able to run due to his knee pain and he’s been pain free since.
I had my first PRP treatment yesterday. The Dr did a single injection strait into the medial joint for starters and will look at injecting some of the soft tissue around/outside the joint in January. I have had no official diagnosis but I do have a torn meniscus, 1/2 thickness lession on the left MFC, and two presvious plica resections. I believe the true problem is a torn Medial Retinaculum which is TBD. My question… how long does it usually take to notice if there is going to be some improvement or not with PRP?
I am not doing much for the next few weeks to let the process run it’s course. He said the growth factors will be really active for the first 4 weeks.
Appreciate your input/ So from your experience when (if any) was there some improvement. I am hoping for a 50% improvement through this process.
I generally repeat PRP at about 4-6wk intervals and tell patients not to expect results before about 3 sessions because it takes 12-16wks for tissue growth/regeneration. Sometimes people report improvements much sooner, but I like to set expectations a little lower. Also, when performing any type of prolotherapy, it’s ideal to treat the surrounding structures that support the joint in order to provide stability as well. So, hopefully you’ll get good results, but I think people get poorer outcomes in general when only having solution injected directly into the joint.
Thanks for the response thaiguy. Have you seen any positive results using prp to treat patella retinaculum or plica problems?
Tim T
yes to both. I think that is very straight-forward with the caveats that it is critical to inject all of the important structures, not just squirting some in the joint. Another important aspect of successful PRP is good platelet collection. For example, we have our own lab that allows us know our platelet numbers specifically and we can taylor the concentration to each individual situation. Many clinics use PRP kits that oftentimes don’t produce good platelet numbers or quality solutions.