Treatment with Platelet Rich Plasma (PRP, popularized as "growth factors") consists of the infiltration of a derivative by centrifugation of peripheral blood itself in certain anatomical locations. With 20-25cm3 centrifuging peripheral blood obtained by a standard blood collection 3-5cm3 PRP are achieved by the layering of the various blood components (the uppermost to the lowermost layer: poor plasma platelets, platelet rich plasma, buffy phase or white cells and red cells or hematocrit). This procedure can be carried out in the same medical consultation, since systems have been developed in which closed handling blood does not contact at any time with the environment, while remaining sterile conditions.
Detail layering peripheral blood after the centrifugation process.
Detail of the aspiration of the leukocyte band to prove its existence. This portion of the centrifuged blood is not used in PRP infiltrations. We observe a thin white layer which are deposited so-called white blood cells (leukocytes).
Positive effects of platelet - rich plasma to tissues
The biological effect of PRP is in the rich content bioactive molecules of platelet granules, which are released upon activation of platelets minutes prior to infiltration. Thus, platelets are deposited in the tissue for the release of molecules of these granules, which exert multiple biological effects that positively influence the anti - inflammatory mechanisms and healing processes.
Summary of results of a systematic review of what exists published in basic science studies about the effects of PRP on tendon pathology models both in vitro in vivo com. (Nikolas Baksh BS, Charles P. Hannon et. Platelet Rich Plasma in tendon models: a systematic review of basic science literature. Arthroscopy 2013; 29 (3): 596-607).
How platelet rich plasma given?
The PRP is administered by infiltration in both tissues as peritendinous inside joints. So far there have been no reported complications of this treatment, beyond the pain after injection for 2 to 4 days. To control the initial pain after injection is advisable to take paracetamol and avoid conventional or similar anti-inflammatory drugs since the latter could interfere with the biological effect of PRP own. The local cold in the area infiltrated may also be a physical aid measure to control pain postinfiltración.
Detail infiltration technique tennis elbow or epicondylitis (peppering technique).
Tendon and tendonous diseases treatable with PRP
Patellar tendinitis, Achilles tendon or short radial extensor carpi (elbow tennista) are tendinosas pathological conditions which have been shown in scientific studies (in vivo and in vitro) that the PRP has beneficial effects: improved the capacity and quality of tissue healing, increased speed the healing process, with the resulting greater resistance scar tissue.
Articular pathologies treatable with PRP and effects on joint
As for articular pathology PRP, reduces pain and inflammation of the articular membranes in the context of joint wear arthritis, significantly improving joint effusion osteoarthritic. However, it is important to clarify that the PRP has no regenerative properties, so it does not restore the articular cartilage or other body tissue; it can improve articular or periarticular functional comfort while more aggressive treatments are not required.
Other therapeutic indications PRP
It has started using PRP as a biological factor added to bone graft for the treatment of delays or nonunion fractures consolidation. It is also described as an adjuvant biological treatment after suture sleeve (shoulder tendon injuries in) or after the completion of certain arthroscopic knee treatments, although there is still no consensus protocol for widespread use. Although there are many studies about these new indications of PRP, you will require more research in the future to outline in detail the beneficial effects of this treatment in each of the indications of it.