PLATELET RICH PLASMA (PRP) WHAT IS IT?

 Blood contains many components. White cells, red cells, platelets and plasma. When the white cells and red cells are removed, the separated layer contains platelets and plasma. This platelet rich plasma is known to contain more than 5000 proteins. Some of these bio proteins are growth factors and cytokines.

HOW DOES IT WORK ?

PRP injections are able to alter the biological microenvironment inside the wrist joint. PRP affects local and infiltrating cells, mainly synovial cells, endothelial cells, immune cells and cellular components of bone and cartilage. PRP is believed to reduce the inflammatory process and alter the joint homeostasis of anabolism and catabolism in cartilage. PRP injections are simply an injection of one’s own blood after it has been separated.

WHAT IS IT USED FOR?

The Food and Drug Administration (FDA) has approved the use of PRP within the field of hand surgery. PRP injections are being studied for their ability to enhance tissue and bone healing in cases of osteoarthritis (OA) and tendonitis. Early results are promising, however at the current time these injections are considered “Off Label” use. However, this is not an artificial or manufactured product that requires long-term evaluation/investigation.

 PROCEDURE: HOW IS IT DONE? 

 PRP injection is an office base procedure. 10cc of blood is drawn from the patient’s arm. It is then placed into a tube with a specially formulated compound. The tube is then spun in a centrifuge, which separates the blood cells from the plasma/platelets. The platelet rich plasma is then drained off into a syringe. 

The area to be injected is prepared using sterile technique. The area is then anesthetized with a Xylocaine/Marcaine injection. The platelet rich plasma is then injected into the affected area. There will be an aftercare injection protocol to follow. Follow up appointment will be made for three weeks post injection. Refraining from sports or very physical activity is recommended for at least six to eight weeks.

CANDIDATES FOR INJECTION: WHAT CAN IT BE USED FOR?

• Osteo Arthritis of the wrist CMC Joint/ Hand Joints
• Lateral Epicondylitis (Tennis Elbow)
• Long standing problems with tendonitis

 CONTRAINDICATIONS TO INJECTION: WHO IS NOT A CANDIDATE FOR INJECTION?

• Patients on blood thinners who are unable to stop their medication for PRP Injection
• Patients who are unable to remain off aspirin or other anti-inflammatory products before or immediately after the procedure.
• Patients who will not allow removal and injection of blood products into their bodies
• Patients who are allergic to Xylocaine/Marcaine anesthetic agent

OUTCOMES

There can be no guarantees of success with PRP injections. Recent studies show a series of 2 injections approximately 4-6 weeks apart have a more favorable outcome than a single injection.

If one does not see any benefit at all, there is no guaranty that a second injection will help. Neither can there be any guaranty with cortisone injections, splints, physical therapy or surgery.

BENEFITS OF PRP

• It contains entirely natural products from a patient’s own blood
• Traditional treatments for OA and tendonitis are unreliable
• Repeated cortisone injections into tissue can weaken it and possibly destroy it
• Cortisone injections into tendons can lead to rupture
• Long-term anti-inflammatory medications only mask symptoms, do not heal tissue and may have gastrointestinal side effects
• There is little if any risk for injecting one’s own blood product back into their body

 FINANCIAL CONSIDERATIONS

At this time, insurance companies consider this an “unlisted” procedure. Insurance companies do not typically cover procedures without known procedure codes. 

The cost of the procedure covers the procedure for obtaining the blood and the injection, as well as, follow up visits for the injection for 90 days, which will be on a cash only basis. Formal physical therapy treatments after the injection, subsequent diagnostic studies, further injections, medications or future surgery are not covered by the procedure fee. We will provide all documentation needed to help you obtain reimbursement through your insurance company. This may or may not be successful. All patients considering this procedure must be seen in the office for examination, proper medical and medication history taking and have diagnostic studies as needed (often just x-rays). An informed consent for the procedure must be signed.