In basic terms, PRP involves the application of concentrated platelets, which release a supra-maximal quantity of growth factors which stimulate recovery in non-healing injuries. PRP causes a mass influx of growth factors, such as platelet-derived growth factor, transforming growth factor and others, which exert their effects of fibroblasts causing proliferation and thereby accelerating the regeneration of injured tissues. Specifically, PRP enhances the fibroblastic events involved in tissue healing including chemotaxis, proliferation of cells, proteosynthesis, reparation, extracellular matrix deposition, and the remodeling of tissues. In other words, tissues can heal faster with PRP.

How does PRP work?

Platelet-rich plasma (PRP) involves placing a small amount of the patient’s own blood in a filtration system or centrifuge that rotates at high speed, separating red blood cells from the platelets that release proteins and other particles involved in the body’s self-healing process, doctors said. A teaspoon or two of the remaining substance is then injected into the damaged area. The high concentration of platelets — from 3 to 10 times that of normal blood — catalyzes the growth of new soft-tissue or bone cells. Because the substance is injected where blood would rarely go otherwise, it can deliver the healing instincts of platelets without triggering the clotting response for which platelets are typically known. PRP regenerates ligament and tendon fibers, which helps shorten rehabilitation time and possibly obviate the surgery of extremity joints.

There is little chance for rejection or allergic reaction because the substance is autologous, meaning it comes from the patient’s own body; the injection carries far less chance for infection than an incision and leaves no scar, and it takes only about 20 minutes, with a considerably shorter recovery time than after surgery. It works great for tendinosis, menisci or labrum tears or degeneration, and ligament injuries not healing with other prolotherapy solutions and has the potential to revolutionize not just sports medicine but all of orthopedics accordingly.

Protein Rich Plasma - Longevity Medical Institute

What is the Mechanism behind PRP?

Platelets play a central role in blood clotting and wound healing. Tissue repair begins with clot formation and platelet degranulation, which release the growth factors & cytokines necessary for wound repair. This microenvironment results in chemotaxis of inflammatory cells as well as the activation and proliferation of local progenitor cells & growth factors. Platelet-derived growth factors are biologically active substances that enhance tissue repair mechanisms. After platelets are activated at a wound site, proteins are released that directly and indirectly influence virtually all aspects of the wound healing cascade. Studies have shown a direct correlation between the platelet concentration and the level of secretory proteins, as well as the amount of proliferation involved in the wound healing.

Many of these factors have been shown to enhance one or more phases of connective tissue growth & repair. Some (PDGF, EGF, and FGF-2) have been shown to stimulate proliferation of osteoblastic & fibroblastic progenitors while others (TGF-b) increase matrix synthesis (eg, type I collagen) and can potentially enhance early angiogenesis and revascularization (VEGF and FGF-2). One of the main growth factors in PRP is vascular growth factor which helps with new blood vessel formation.

How is PRP administered?

The preparation of therapeutic doses of growth factors consists of an autologous blood collection from the patient. The plasma is then separated (via a special centrifuge), and then application of the plasma rich in growth factors is injected into the damaged area. In other words, PRP is done just like any other prolotherapy treatment, except the solution used for injection is plasma enriched with growth factors from your own blood. Typically 2-3 treatments are necessary per area given every 4 weeks like other prolotherapy sessions.

Where is PRP used?

In scientific literature, reports of soft tissue injuries treated with PRP include: tendonopathies, tenonosis, acute and chronic muscle strains, muscle fibrosis, ligamentous sprains and joint capsular laxity, specifically in the extremities. PRP has also been utilized to treat intra-articular injuries such as arthritis, arthrofibrosis, articular cartilage defects, meniscal injury, and chronic synovitis or joint inflammation.

PRP has been used successfully to enhance surgical outcomes in maxillofacial, cosmetic, spine, orthopedic, and podiatric surgery. In regard to its use today, you will see that the majority of doctors using it apply it onto their current knowledge -base of prolotherapy. In other words, the doctors doing PRP are using it as a proliferant, much like they use other solutions in prolotherapy. In simple terms, PRP is a type of prolotherapy!