Platelet-rich plasma (PRP) injection is a non-operative, injectable management option for a number of musculoskeletal problems, including osteoarthritis. Research is now revealing that PRP is now significantly more superior compared to other injectable options including hyaluronic acid and steroids.[i],[ii],[iii],[iv] Furthermore, given its autologous nature, PRP has very small risk and adverse reaction profile. With these facts in mind, PRP has attracted an increasing amount of interest.
Our blood is predominantly comprised of red blood cells, white blood cells, platelets and plasma. Activated platelets have the natural ability to accentuate healing and anti-inflammatory effects by releasing a number of growth factors and alter pro-inflammatory pathways.[v] By concentrating the number of activated platelets, we can concentrate their natural abilities to manage suitable musculoskeletal conditions.
There are a number of PRP preparation and administration systems currently available on the market. This may be a reason for its variable results.
At Pro Health Care, we have conducted research and found that Arthrex currently produces one of the most cost-effective systems. Utilising Arthrex’s double syringe mechanism, blood is withdrawn from the patient in a closed fashion. The double syringe is run through a centrifuge which separates the PRP from other blood constituents. The PRP is then extracted and injected into the pathological area.
A single injection of PRP can make a positive difference in pain control and activities of daily living for patients with osteoarthritis.[vi] There is also early evidence to suggest that three injections, four weeks apart is more superior than a single injection for mild osteoarthritis.[vii]
The injection should take approximately 15-20 minutes to prepare and administer. You may return to your normal activities as tolerated, immediately after the injection.
Your musculoskeletal symptoms should improve within three to six months after the first injection. The symptom improvement can be variable and in some rare instances, there may be no improvement.
Side effects from PRP include infection and a temporary increase in pain after the injection. This post-injection pain should subside within 1-2 weeks. With this in mind, it is recommended that Panadol be taken 1 hour prior to injection and as required post-injection. It is also important to abstain from alcohol and anti-inflammatory medications (e.g. Neurofen/Mobic/Celebrex) from at least 48 hours prior to injection.
PRP injections are currently being offered at our Mitcham clinic by Dr. Grant Baker. Appointments can be arranged online or by calling our clinic on 8271 2222.
Please be aware that an appropriate assessment of the area will need to be performed before administering the PRP which may require new tests and/or imaging scans. PRP will be administered on a subsequent consultation as opposed to the initial assessment. For this reason, it is advisable that any scans or test results be bought along to assist with your consultation.
There is no need for a referral and the initial consultation is fully Medicare rebatable.
Cost of the first PRP Injection is $200. The injection is not rebatable from Medicare. Should you decide to trial subsequent injections three weeks apart, a discount will be applied.
[i] Cole BJ, Karas V, Hussey K, et al. Hyaluronic Acid Versus PlateletRich Plasma: A Prospective, DoubleBlind Randomized Controlled Trial Comparing Clinical Outcomes and Effects on Intraarticular Biology for the Treatment of Knee Osteoarthritis. Am J Sports Med. 2017 Feb;45(2):339346.
[ii] Meheux CJ, McCulloch PC, Lintner DM, et al. Efficacy of Intra-articular Platelet-Rich Plasma Injections in Knee Osteoarthritis: A Systematic Review. Arthroscopy. 2016 Mar;32(3):495-505.
[iii] Mi B, Liu G, Zhou W, et al. Platelet rich plasma versus steroid on lateral epicondylitis: meta-analysis of randomized clinical trials. Phys Sportsmed. 2017 May;45(2):97-104.
[iv] Raeissadat SA, Rayegani SM, Hassanabadi H, et al. Knee Osteoarthritis Injection Choices: Platelet- Rich Plasma (PRP) Versus Hyaluronic Acid (A one-year randomized clinical trial). Clin Med Insights Arthritis Musculoskelet Disord. 2015 Jan 7;8:1-8.
[v] Xie X, Zhang C, Tuan RS. Biology of platelet-rich plasma and its clinical application in cartilage repair. Arthritis Res Ther. 2014 Feb 25;16(1):204.
[vi] Muchedzi TA1, Roberts SB2. A systematic review of the effects of platelet rich plasma on outcomes for patients with knee osteoarthritis and following total knee arthroplasty. Surgeon. 2018 Aug;16(4):250-258.
[vii] Glynn LG1, Mustafa A1, Casey M1, Krawczyk J, et al. Platelet-rich plasma (PRP) therapy for knee arthritis: a feasibility study in primary care. Pilot Feasibility Stud. 2018 Jul 4;4:93.