PRP therapy for musculoskeletal diseases

Medical science is developing rapidly and is updated with new discoveries. One such innovation is plasma therapy for the treatment of joints (PRP). The method has proven itself as an effective and safe option for the treatment of pathologies associated with metabolic disorders and the synthesis of cartilage tissue.

The essence of the method

The name PRP is an abbreviation for Platelet rich plasma (blood plasma enriched with platelets). We are talking about a substance with a high platelet content. But where do they get this composition and how do they use it? This will be discussed further below.

Some historical facts

The method is essentially not new. Active searches were conducted back in the 20th century. The first sources on the topic of using platelet-rich plasma to eliminate pathologies of the musculoskeletal system appeared in the 70s of the last century.

More recent articles by American researchers were published in 1997-1998. They talked about the use of the enriched composition in maxillofacial surgery. The new technique quickly moved to Europe. In the 21st century, it is used in almost all areas of medicine, as well as cosmetology.

What is PRP therapy

Treatment of joints with the PRP method is based on the functional properties of human blood platelets. The elements are known as clotting factors. They promote the formation of a blood clot when a blood vessel is damaged. Thanks to them, wounds stop bleeding.

But the main feature is that these blood elements help the regeneration of connective tissue cells. This fact became the reason for their use in the treatment of joint diseases. They stimulate fibroblast cells to actively synthesize collagen and elastogen. These substances are part of the bone and cartilage system, skin, and ligaments.

Enriched blood plasma contains up to 1000–2500×1009/l. platelets. In their usual form they are no more than 180–320×109/l. Venous blood is used for manipulation. Its separation and enrichment is achieved using a centrifuge.

Blood components have different weights and sizes. As a result of centrifugation, the biomaterial in the test tube is stratified. The heavier, red elements settle to the bottom, and the enriched plasma forms the top layer. The result is a concentrated composition.

Blood plasma prepared for the procedure

Growth factors

These blood cells contain bioactive substances - growth factors. They have a protein structure. There are several of them, which explains the multifaceted effect of the medicine.

• insulin-like IGF
  – regulates cell growth, migration and development;
• platelet PDGF
  – ensures cellular regeneration (survival);
• transforming TGF
  – inhibits tissue necrosis, suppresses inflammation, stimulates collagen production;
• endothelial f.
  R. blood vessels VEGF – affects vascular permeability, increases blood supply to organs;
• epidermal EGF
  – triggers self-healing at the cellular level. Stimulates cell division and renewal;
• f.r.
  fibroblasts FGF – increases the concentration of fibroblasts, accelerates the development of blood vessels.

The destruction of cartilage is difficult to stop. They do not contain blood vessels through which nutrients are delivered. Everything you need comes from the synovial fluid that fills the joint cavity. Therefore, administering the medicine directly to the diseased organ is the most effective method of treatment.

What is this?

PRP is platelet-rich plasma. The patient's own plasma is used during the treatment process. It is prepared from autologous blood immediately before injection into the knee.

Platelets are the formed elements of blood that perform the function of forming a blood clot. By gluing, they initially form a “plug” in damaged vessels. This happens immediately after the injury. Then platelets provide their surface for the formation of the main reactions of plasma blood coagulation.

Not long ago, another important function of platelets was established. It turned out that they secrete a large number of growth factors and take part in regenerative processes.

Normally, the concentration of platelets in the blood ranges from 180 to 360 thousand cells per μl. Even this amount is enough to somewhat speed up the regenerative processes. But they occur faster and more intensely if a lot of platelets are injected into the joint. Therefore, the plasma is pre-prepared. Other formed elements of blood are removed from it. The platelet concentration increases 5 or more times.

It has been established that the maximum regenerative potential of tissues is achieved when they are exposed to plasma containing at least 1 million platelets per 1 μl. Further increases do not provide significant benefits. If the platelet count exceeds 1.8 million, inflammatory reactions may be enhanced. Therefore, too high a concentration of these cells is not recommended for use for intra-articular administration.

How is plasma therapy used in orthopedics?

The introduction of a concentrate of one’s own plasma reduces symptoms and restores joint mobility. Lost functions are restored 2-3 times faster than with conventional drug therapy.

The use of prp therapy in orthopedics is based on the ability to initiate the process of regeneration of cartilage and ligaments. This is a proven fact. Therefore, the duration of the effect after the course exceeds the period of remission from traditional methods.

Particularly high results are achieved in the treatment of degenerative diseases of the joints and spine - arthritis, arthrosis, osteochondrosis, intervertebral hernia, etc. Injections are given once every 1-2 weeks for several months. If there are no contraindications, plasma therapy for joints is used without restrictions.

PRP for knee diseases

Knees are more often exposed to adverse effects - cold, injury and overload during long walking. Indications for use are:

1. Osteoarthritis, arthritis of the knee joint begins due to a decrease in metabolic processes. Due to the low supply of nutrients, cartilage tissue is destroyed. There is pain, stiffness and swelling of the knee.
2. Bursitis - damage to the synovial bursa is manifested by pain with swelling of the knee.
3. Injuries and fractures lead to damage to soft tissues, hematomas, wounds, and disruption of the integrity of bones and ligaments. This is accompanied by redness, swelling and acute pain.
4. After operations, the healing process can be accelerated if these injections are included in the treatment complex.
5. With atrophy (drying, deformation) of cartilage associated with various changes - inflammatory, degenerative, autoimmune, crunching, friction, and pain occur in the knee.

Treatment of joints with plasma therapy reduces pain, restores mobility and reduces the use of painkillers. But, a stable effect is achieved after 4-6 months of continuous course.

Plasma injection into the knee joint

The manipulation is unpleasant, but it can be tolerated. The sensations are comparable to a regular injection. Some patients feel bloating at the injection site. It is important to move your knee after administration so that the liquid is well distributed.

PRP for hip diseases

The largest bone joints in humans. They can withstand quite heavy loads. But, with age, their condition worsens. There is a crunching and stiffness, as well as pain when moving.

Progression leads to a decrease in the functions of the hip joint. Initially, this is associated with metabolic disorders, drying out of cartilage, and a decrease in the amount of synovial fluid.

Intra-articular administration of plasma concentrate is used for inflammatory and degenerative changes:

1. Coxarthrosis occurs mainly after 40 years. Caused by deterioration of nutrition of articular structures. As a result, they become deformed and destroyed, which leads to inflammation, pain, and immobility.
2. Injuries, including intra-articular fractures, are more often diagnosed in athletes and older people. They are associated with severe pain, prolonged limitation of movements, and increased body temperature.
3. Loss of mobility occurs due to inflammatory processes and injuries. Due to its structure, it quickly loses the ability to move freely. In severe cases, surgery is prescribed.
4. Recovery after surgery requires serious rehabilitation. To shorten this period, plasma therapy sessions are included in the therapeutic complex.

The manipulation is carried out in a lying position on the side opposite the injection site. A painkiller is injected at the puncture site. After the injection, the patient will be asked to move - raise, lower his leg and perform other movements.

The composition with bioactive components does not have analgesic properties. Therefore, one cannot expect an immediate effect. Like all natural remedies, plasma therapy will bring tangible results only after a few injections.

PRP for shoulder diseases

The use of the drug is indicated for the following conditions:

1. Arthritis and arthrosis are inflammatory diseases that become chronic. They are characterized by excruciating acute pain when moving the arm, a feeling of stiffness, swelling and redness.
2. Injuries, dislocations, and fractures are accompanied by damage to surrounding soft tissues, bones, muscles and ligaments. There is pain in the injured area, redness, increased body temperature, and numbness in the hand.
3. Bursitis - damage to the synovial bursa causes acute pain in the shoulder area and stiffness of movement.

Plasma injection into the shoulder joint

An injection into the shoulder is painful and unpleasant. It is carried out after preliminary anesthesia. The result of the course will be a rapid restoration of the motor ability of the hand.

PRP for elbow diseases

Some of the most mobile joints are rarely susceptible to disease. But they often suffer from injuries and sprains. The use of unusual injections is indicated for the following conditions:

1. Epicondylitis is a periarticular inflammation affecting the muscles and humerus. Manifested by acute pain and decreased mobility. If the situation drags on, it leads to atrophy of muscle fibers, sometimes to disability.
2. Inflammatory pathologies - bursitis, arthritis, tendinitis, are manifested by pain, increased body temperature, redness and stiffness.
3. Injuries, fractures, ligament ruptures are accompanied by acute pain, numbness of the hand, and impaired motor functions.

After using PRP, pain and inflammation gradually disappear, and functions are completely restored. The earlier treatment is started, the better the result. The procedure is carried out in any position - sitting, lying down. Then the patient is asked to move his elbow - straighten and bend. Usually, 3-5 sessions are enough.

PRP for ankle problems

Large joints that support body weight. If one of them is damaged, the second suffers from increased stress. Without timely measures, the patient will develop disease in both legs. The technique is used to eliminate the following ailments:

1. A sprained ligament in the ankle area is accompanied by prolonged aching pain and lameness.
2. Inflammatory diseases - arthritis and arthrosis, are associated with degenerative changes. In this case, the ability to move is lost.
3. Bone necrosis is accompanied by severe pain, swelling, and limited mobility.
4. Destruction of cartilage for various reasons - chondromalacia provokes excessive friction of the joint structures. This causes nearby tissues to become inflamed and swollen.

The PRP therapy technique is also used to prevent joint damage. This is true for athletes and people engaged in heavy physical labor.

REVIEWS FROM OUR PATIENTS

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Inna 16.11.2021 17:15:03

Thank you, Andrey Sergeevich! Do you need to get tested? I have mine on my hands) I want to pierce the joints of my hand. Fingers. They are swollen, painful, and do not bend normally. How many tubes are needed? Is the price indicated for one procedure?

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LITVINENKO Andrey Sergeevich 11/16/2021 18:00:09

You can take yours and we'll take a look. Price for one procedure. Consultation 2000 rub.

Inna 11/15/2021 23:34:29

Good afternoon I have stage 2 arthrosis of the fingers. Will PRP help and do you inject plasma into your arms and finger joints? Thank you!

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LITVINENKO Andrey Sergeevich 11/16/2021 11:17:14

Good afternoon Inna! The procedure helps reduce inflammation, swelling, pain, and improve joint mobility and function. But, unfortunately, it cannot be cured completely and permanently, as long as there are no such technologies.

Vasilisa 09.28.2021 18:42:48

Hello! I have grade 1 arthrosis of the ankle joint. How painful is the procedure? Will I be able to go to work the next day? I have a very flexible job.

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LITVINENKO Andrey Sergeevich 09.30.2021 16:07:20

Hello Vasilisa, the procedure is carried out under local anesthesia, you can walk on the same day, it is recommended to avoid running, jumping, and lifting heavy objects in the first 3-4 days.

Valeria 07/16/2021 22:19:59

Good afternoon I have arthrosis of the ankle joint. Will PRP therapy help avoid joint replacement? How effective is the treatment?

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LITVINENKO Andrey Sergeevich 07/21/2021 11:04:02

Good afternoon Valeria! PRP therapy is used as a highly effective and modern method of treatment, but it is carried out according to strict indications. It all depends on the stage of arthrosis; as a rule, the procedure is used for stages 2-3. Injections alone will not help avoid joint replacement; here you need to adjust your lifestyle, weight, loads, etc. more than 100 parameters in total.

Tatyana 02/26/2021 19:18:30

This is the second month that my elbow joint has been hurting. He began to hurt after I fell on him. Tell me, the elbow joint tends to recover on its own and I just need to wait a little? If not, please let me know if I can come to you for an appointment on Saturday, when I have a day off?

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LITVINENKO Andrey Sergeevich 02/28/2021 09:54:00

Good afternoon Tatyana! We recommend that you consult a doctor and undergo further examination, X-ray or MRI of the joint. A simple bruise goes away within 1-2 weeks; if you have pain for 2 months, more serious damage is possible.

Victoria 02/26/2021 13:38:56

Hello! Is it possible to undergo PRP therapy with low hemoglobin levels?

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KHOLIKOV Timur Vyacheslavovich 03/01/2021 12:51:00

Hello! It all depends on the numbers, if hemoglobin is below 100, it is not worth doing, only lifelong indicators.

Marina 02/26/2021 09:22:35

Hello, I would like to know how old people tolerate PRP therapy? My mother is 64 years old, I’m wondering for her if it’s possible for her to do this?

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LITVINENKO Andrey Sergeevich 02/27/2021 10:44:00

Marina Good afternoon! Age is not a barrier, it is the patient’s own plasma. We have many years of experience in using it in older patients 70-80 years old. Very comfortable and with good results. Call to make an appointment.

Advantages of plasma therapy in orthopedics

The new technique has gained popularity due to its special properties:

• no allergic reaction;
• guarantee of sterility of the biomaterial, exclusion of foreign infections;
• the drug acts only at the injection site, without entering the systemic bloodstream;
• recovery occurs 2-3 times faster than with drug treatment;
• minimum complications;
• no side effects.

PRP therapy for joints differs significantly from the effects of non-steroidal, hormonal drugs. Glucocorticoids, which effectively relieve inflammation, have a destructive effect on cartilage and the body as a whole. PRP therapy restores their structure without affecting the internal organs.

Plasma therapy and transplantation

Will the new technique help cancel or postpone the operation? What do doctors say about this?

The operation to implant a prosthesis is far from a harmless procedure. Like any surgical intervention, it requires preparation and long postoperative rehabilitation. The process does not always go without complications and repeated interventions.

In addition, replacing a joint will not always completely solve the problem. Surgeons are usually silent about this

— after replacing one hip joint, due to the difference in load, there is strong pressure on the second joint. As a rule, within a year or two, the patient will need to replace the second joint.

If the disease is not advanced, a course of plasma therapy along with other methods will eliminate the need for surgery. In advanced severe cases, injections will help postpone transplantation for a certain period. Whether a replacement is needed or not in such a situation is decided by the attending physician.

Any joint disease has serious complications, so you should not delay treatment.
Read more about joint treatment in our clinic

For people who have contraindications to surgery, PRP joint therapy provides a chance to reduce symptoms for a long period. The safety of the method has been proven - according to WHO, more than 20 thousand patients are treated every year around the world.

How is the procedure performed?

The manipulation is simple and safe. It is carried out in a medical center. Venous blood is taken from the patient, approximately 20–1000 ml. The test tube with the biomaterial is placed in a centrifuge for 20 minutes. As a result of centrifugation, the composition in the test tube is stratified.

The result is an enriched and purified substance. It is drawn into a syringe and injected directly into the inflamed area. All actions are carried out under sterile conditions, which eliminates infection. The injected substance is also sterile.

Stages of preparing PRP substance from the patient’s blood

The patient will be asked to move - bend, straighten the limb. This is done to ensure that the medicine is evenly distributed in the cavity. Then, the patient is sent home. Such introductions will be needed from 3 to 7.

Contraindications

Despite the good tolerability and absence of side effects, the new method has contraindications.

Absolute

Conditions for which PRP treatment is strictly contraindicated:

• pregnancy;
• lactation;
• period of menstruation;
• oncological and autoimmune diseases;
• violation of the blood clotting process;
• low platelet count (thrombocytopenia);
• hemoglobin level is less than 90 g/l;
• state of immunodeficiency.

If the patient has one of the listed conditions, the course is either postponed or cancelled.

Relative

These are passing phenomena, after which you can begin procedures. In this list:

• acute infectious and viral diseases - FLU, ARVI, herpes, intestinal infections, etc.;
• high body temperature exceeding 38C;
• taking medications that affect clotting.

After recovery or drug withdrawal, a person has the opportunity to use plasma therapy.

Compatibility with other therapeutic procedures

In our clinic, plasma therapy is combined with other non-surgical methods of treating the musculoskeletal system:

• acupuncture;
• manual therapy;
• different types of massage – acupressure, classic, Thai, etc.;
• hirudotherapy - treatment using leeches;
• exposure to vacuum cans;
• kinesiotherapy under the influence of loads;
• kinesio taping (using cotton tapes);
• blockades with painkillers and anti-inflammatory drugs.

A comprehensive course of joint treatment, using prp therapy and other methods, gives the fastest and most lasting effect.

Themes

Joints, Treatment methods Date of publication: 12/09/2019 Date of update: 06/08/2020

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Indications for PRP therapy

1. Deforming arthrosis, especially in combination with aseptic bone necrosis (destruction of bone under the cartilage due to age and poor circulation);

2. Humeroscapular periatrosis, especially with partial damage to the supraspinatus muscle;

3. Epicondylitis – reconstruction of the elbow joint at the site of muscle attachment;

4. Replenishment of the Achilles tendon;

5. Heel spur – PRP therapy is more effective than shock wave therapy and hormonal injections;

6. Various sports injuries;

7. Rehabilitation after arthroscopic operations;

8. Treatment of osteochondrosis as part of complex therapy.