Platelet Rich Plasma

Dr. Tanner offers platelet rich plasma (PRP) injections that harness your own body's healing potential to accelerate the healing process for various ailments including post traumatic arthritis, tendinopathies, injuries and other inflammatory processes.

Platelet-rich plasma therapy is a form of regenerative medicine that can harness your own body's healing potential to accelerate the healing process for various ailments including post traumatic arthritis, tendinopathies, musculoskeletal injuries, and other inflammatory processes.
In PRP, the platelet is used as the initiator to the repair cascade. Platelets can release a multitude of signaling proteins, growth factors, chemotactic factors which stimulate tissue repair, vascular remodeling, and even recruit stem cells. This cascade of events allows the tissue to potentially return to normal structure and improve function and pain. PRP therapy shows great promise in restoration of normal soft tissue architecture and regeneration of tissue such as tendons, ligaments, muscles, and joints.
Patients can expect to see significant improvement in symptoms and may eliminate the need for other treatments such as cortisone injections, medications or even surgery.

Platelet-Rich Plasma (PRP) Injections

Plasma is the liquid portion of whole blood. It is composed largely of water and proteins, and it provides a medium for red blood cells, white blood cells and platelets to circulate through the body.
Platelets, also called thrombocytes, are blood cells responsible for the clotting cascade and play important roles in necessary growth and healing functions. Platelet activation plays a key role in the body's natural healing process.

What is plasma and what are platelets?

What are PRP injections?

PRP injections are prepared by taking one to two tubes of your own blood. We then process the blood in a closed system utilizing a special centrifuge designed for the proprietary system.
This process concentrates the platelets, plasma, as well as some white cells depending on if it's a tendon injection vs a joint injection. The PRP solution with activated platelets is then injected directly into your injured or diseased tissue. This releases growth factors and cytokines that stimulate and increase the number of reparative cells your body produces at the site of the injection. Ultrasound or DDR(Dynamic Digital Radiography) is sometimes used to guide the injection.
Some of the major advantages of PRP injections are that they can reduce the need for anti-inflammatories or stronger medications like opioids. In addition, the side effects of PRP injections are very limited, since the injections are created from your own blood, your body will not reject or react negatively to them. Utilizing a closed system, the infection rate after a PRP injection is extremely low, even lower than a standard cortisone injection.
PRP can be utilized to aid in the healing process following surgery, or even avoid surgery altogether.
PRP can contain 5-10x the normal amount of platelets which in turn has 5-10x the concentration of growth factors.
PRP can help treat various orthopaedic diagnoses including chronic tendon injuries (tennis elbow, achilles tendonitis, rotator cuff tendonitis, hip tendonitis, plantar fasciitis), acute ligament and muscle injuries, arthritis (post traumatic, osteoarthritis, inflammatory arthritis), fractures, and promote healing following surgery.

What are the risks?

As stated before, risks of this procedure are limited since we are utilizing your body’s fluid.
As with any injection, there are small risks. They include bleeding, bruising, infection, post injection pain, nerve pain, and rarely a syncopal episode (passing out).
Please inform us if you have had a previous syncopal episode after injections or while giving blood.

What is the process?

Prior to injection day, please avoid aspirin, NSAIDs, or other platelet inhibitors/ blood thinners for one week. Usually only 3 days for aspirin or NSAIDS. If you are taking prescription blood thinners please bring this to our attention so we can contact your PCP to see if holding them will be safe. Please drink plenty of water to maximize your hydration and increase the amount of plasma we are able to obtain. You can eat as you normally do and take all regular medications except as mentioned above.
We utilize a special “closed system” to harvest PRP. This means that the PRP obtained is never exposed to the non-sterile environment. From start to finish, the system is protected from outside contaminants.
The procedure takes approximately 30-45 minutes in its entirety. After checking in, Dr. Tanner will review and answer any questions you may have. Dr. Tanner will then draw a vial of your blood using specialty tubes (images from regenlab.com).
The whole blood is then processed to yield a plasma with the desired platelet concentration as well as white blood cells (if for tendons) or no white cells (if for joints).
The area is typically anesthetized with a local anesthetic (usually for tendons) prior to the PRP injection to make the process as comfortable as possible. Next, the PRP is then injected directly and sometimes with the aid of ultrasound or dynamic digital radiography (Micro C) depending on the location.
It is not unusual to have injection pain for a day or two after the procedure. Please try to avoid taking aspirin or NSAIDs for this pain. NSAIDs may lessen the effect of platelets. Continue to refrain from aspirin, NSAID, or other platelet inhibitors for a total of 2 weeks. Tylenol is a better option for post injection pain as long as you have no contraindications with taking Tylenol. Please seek approval by your primary care physician. It is not unusual to notice some bruising around the injection site which will resolve over several days.
Maximal benefit may take as long as 3 months. Repeat injections may be given, if adequate pain relief is not achieved by that time. Injections do have an additive effect which will maximize your healing potential. It is not uncommon to only require one injection. From an activity standpoint, try to take it easy and let "pain be your guide" on the extremity injected and ease back into activities as pain improves.
Continue to move the extremity normally to avoid any post injection stiffness. Normally you will experience slow steady improvement in pain and dysfunction. It has a slower onset than one is used to with steroid injections, but a longer duration of symptomatic relief.

Contraindications: Please let us know if you have any bleeding disorder, platelet disorder, low platelets, current infection/illness, cancer, or use of aspirin, NSAIDs, or platelet inhibitors (Plavix/Clopidogrel) in the last week.