Platelet rich plasma is an autogenous (meaning that it is produced by the patient’s own body) fluid concentrate composed primarily of platelets.
How is PRP created?
Platelet rich plasma can be generated at “point-of-care” by centrifugation of autologous blood followed by separation and extraction of the buffy coat. Several systems are available for the creation of PRP, but not all PRP is alike. We specifically use the Companion Regenerative Therapy System because this system maximizes the number of healing platelets and minimizes the numbers of certain inflammatory white blood cells in the PRP, resulting in the best possible clinical outcome.
How does PRP work?
PRP works by concentrating platelets and other factors into a fluid that is introduced directly into the joint space to promote healing and decrease inflammation of the joint tissues.
Platelets are among the first cells to migrate to sites of tissue trauma, and in addition to their role in hemostasis (blood clotting), they contain numerous growth factors that stimulate tissue healing. These growth factors include:
- platelet-derived growth factor (PDGF)
- transforming growth factor-β1 (TGF-β1)
- transforming growth factor-β2 (TGF-β2)
- vascular endothelial growth factor (VEGF)
- basic fibroblastic growth factor (bFGF)
- epidermal growth factor (EGF)
Other factors contained in platelets which may affect tissue inflammation and healing include antibacterial and fungicidal proteins, metalloproteases, ADP, ATP, calcium ions, histamine, serotonin and dopamine.
Platelet rich plasma and regenerative medicine
PRP has been widely used in human dentistry, orthopedics and plastic surgery for its ability to enhance healing. Unlike many other treatments, there is extensive evidence in published literature regarding the science and efficacy of PRP treatments (search platelet rich plasma at pubmed – the NIH library website).
Applications of PRP in Tendons and Ligaments
Studies have demonstrated increased tendon callus production and stronger healing when the tendon repair sites were treated with PRP. Growth factors found in PRP increase type I collagen production and tenocyte proliferation.
Human clinical studies support the theory that PRP may aid in the treatment of tendonitis. Patients receiving PRP treatment for elbow epicondylar tendonopathy reported a 93% reduction in pain after a single injection.
PRP has been used extensively in horses for tendon and ligament injuries. In small animals we are using PRP as an adjunct to surgery in the treatment of diseases such as Achilles tendon ruptures, shoulder injuries, and collateral ligament ruptures and hyperextension injuries.
PRP and osteoarthritis
The use of growth factors that might aid in the production of hyaline cartilage is very attractive because of the high incidence of osteoarthritis in humans and animals and because of the limited healing ability of articular cartilage. Platelet-derived growth factor increases chondrocyte proliferation and proteoglycan synthesis. PRP has been shown to slow the progression of osteoarthritis and has also been reported to result in decreased pain and improved function in humans with degenerative cartilage disease. A recent unpublished study from the University of Missouri College of Veterinary Medicine has demonstrated decreased lameness scores in dogs with elbow arthritis following PRP injections.
PRP and bone
Protein rich plasma may aid in fracture repair and healing by providing additional growth factors that are critical to bone formation. PRP has been used for bone formation most extensively in human dental and maxillofacial applications. Laboratory studies have demonstrated a significant increase in bone formation attributable to PRP when PRP was combined with other osteoinductive treatments. PRP is also being used in delayed and non-union fracture cases to accelerate healing.
For more information about or if you have a case that may benefit from PRP treatments, please contact us.