Treatments available?
Dr Inman is very experienced in the use of Platelet Rich Plasma injections (PRP), along with Corticosteroid (Cortisone), Synvisc (Hyaluronic acid), and Dextrose injections (Prolotherapy) and Shockwave therapy for the treatment of arthritic pain and tendon related pain.
Note that the efficacy of PRP likely varies in different pathologic conditions and body sites. Please see Dr Inman for the full available evidence and best treatment options for each specific site.
Note that the efficacy of PRP likely varies in different pathologic conditions and body sites. Please see Dr Inman for the full available evidence and best treatment options for each specific site.
What is PRP or Platelet Rich Therapy?
Platelet-rich plasma (PRP), is a natural component extracted from one's own blood. Platelets are cells within the blood stream that control the role of healing and scar tissue formation following an injury. They are full of growth factors and cytokines which play a crucial role in joint homeostasis and healing. PRP therapy is now a major player in regenerative therapy for tissue injury.
PRP has been proven to be effective in aiding the healing of tendon tissue, articular cartilage defects (the material that lines the joint surface) and significantly reduce pain and improve function in the conditions mentioned below, however nothing in the world as yet can restore articular cartilage once the damage is too far gone. In severe arthritis PRP can however significantly minimise pain, improve function and allow people to exercise, and reduce their reliance on daily medications and quite harmful continuous NSAID anti-inflammatory use, and through this combined effect protect the joint surface that remains. It's effect for pain relief in arthritis can last 12 months (as shown by the meta analysis below (1)).
PRP is not by any means for everyone. Please discuss with Dr Luke Inman whether it is the best option for you.
PRP has been proven to be effective in aiding the healing of tendon tissue, articular cartilage defects (the material that lines the joint surface) and significantly reduce pain and improve function in the conditions mentioned below, however nothing in the world as yet can restore articular cartilage once the damage is too far gone. In severe arthritis PRP can however significantly minimise pain, improve function and allow people to exercise, and reduce their reliance on daily medications and quite harmful continuous NSAID anti-inflammatory use, and through this combined effect protect the joint surface that remains. It's effect for pain relief in arthritis can last 12 months (as shown by the meta analysis below (1)).
PRP is not by any means for everyone. Please discuss with Dr Luke Inman whether it is the best option for you.
Evidence for PRP in the following conditions:
Current evidence shows positive effects of PRP on:
Bibliography
- Osteochondral defects and Arthritis of the knee, Meta analysis (1)
- Chronic tendinosis:
- 'Tennis elbow' (aka lateral epicondylosis, or forearm extensor tendinosis), Meta analysis, 2 RCT's (2)
- Patella tendinosis, 1 RCT (3)
- Periodontal and sinus bone grafts (1)
- Possibly for Hamstring tendinosis (4,5) and Greater trochanter syndrome (6), retrospective studies.
Bibliography
- Chang KV, Hung CY, Aliwarga F, Wang TG, Han DS, Chen WS. Comparative effectiveness of platelet-rich plasma injections for treating knee joint cartilage degenerative pathology: a systematic review and meta-analysis. Arch Phys Med Rehabil. 2014 Mar;95(3):562-75.
- Krogh TP, Bartels EM, Ellingsen T, Stengaard-Pedersen K, Buchbinder R, Fredberg U, Bliddal H, Christensen R. Comparative effectiveness of injection therapies in lateral epicondylitis: a systematic review and network meta-analysis of randomized controlled trials. Am J Sports Med. 2013 Jun;41(6):1435-46.
- Vetrano M, Castorina A, Vulpiani MC, Baldini R, Pavan A, Ferretti A. Platelet-rich plasma versus focused shock waves in the treatment of jumper's knee in athletes. Am J Sports Med. 2013 Apr;41(4):795-803. Epub 2013 Feb 13.
- Wetzel RJ, Patel RM, Terry MA. Platelet-rich plasma as an effective treatment for proximal hamstring injuries. Orthopedics. 2013 Jan;36(1):e64-70.
- Mautner K, Colberg RE, Malanga G, Borg-Stein JP, Harmon KG, Dharamsi AS, Chu S, Homer P. Outcomes after ultrasound-guided platelet-rich plasma injections for chronic tendinopathy: a multicenter, retrospective review. PM R. 2013 Mar;5(3):169-75.
- Mautner K, Colberg RE, Malanga G, Borg-Stein JP, Harmon KG, Dharamsi AS, Chu S, Homer P. Outcomes after ultrasound-guided platelet-rich plasma injections for chronic tendinopathy: a multicenter, retrospective review. PM R. 2013 Mar;5(3):169-75.