Platelet Rich Plasma Injections
The use of platelet rich plasma (PRP) to treat chronic tendinopathies (the more accurate term for conditions commonly referred to as tendonitis) is an exciting, relatively new technique to treat these issues. A patient’s blood is drawn and then processed by spinning it at a high rate of speed in a device known as a centrifuge, causing the blood to separate into different layers. The layer containing platelets is withdrawn and injected near the injured tendon. A healing response is stimulated through the effect of several growth factors (chemicals that can help tissue to heal).
PRP injections are typically performed in the office. Because there is some preparation prior to a PRP injection, a separate appointment for performing the injection is often necessary. Common problems treated with PRP injections include patellar and quadriceps tendinopathy of the knee, hip bursitis, rotator cuff tendinopathy and bursitis of the shoulder, tennis and golfer’s elbow, and achilles tendinopathy.
Because the patient’s own blood is used in the PRP injection, this treatment is felt to be very safe. A small risk of infection is the biggest known side effect. The injected area may be sore following the injection; the injection site is typically numbed with an anesthetic injection prior to the platelet injection. Occasionally, a repeat injection may be necessary if the first one does not work. Currently, there is little clinical research strongly in favor of or opposed to PRP injections. They may be considered in patients who have not shown improvement from other conservative treatment techniques and who may be considering surgical treatments.
PRP may also be used for "augmenting" repair of tissues at the time of surgery. No proven clinical benefit exists at this time to support such a use. Recently, two clinical trials showed no difference in rotator cuff healing after surgery with or without PRP (Link: PRP does not improve rotator cuff healing).