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Are All Platelet Rich Plasma Treatments the Same?

August 22, 2011

We have to be careful when talking about PRP because one treatment is not the same as another treatment. Procedures differ from doctor to doctor.

For every muscle, tendon or ligament, we first must understand the injury and healing cycling of that particular body part. Our goal is to lower the chances of side effects from platelet-rich plasma therapy and maximize the healing of the injury. A firm understanding of each pathology is a must.

Ways that PRP Treatments Differ

In other words, not every PRP treatment is the same. On a very basic level there are liquid forms and gel forms. For example, for repair to rotator cuffs and ACL reconstruction a platelet-rich fibrin matrix is being used.

In more complex ways, some treatments contain white or red blood cells. Others add calcium cholride or thombrin. The reason this is important is that when we are talking about the outcomes of PRP treatment, we need to make sure we are talking about similar comparisons.

We have to talk about the same type of PRP treatments. When one PRP procedure is shown to fail, that doesn’t mean that all procedures are failures.

Unfortunately, in a lot of the literature from both professional and lay journals and reports discuss PRP treatments as if they are all uniform. That’s just not the case. PRP Treatment and recovery from knee arthritis is going to be different than a hamstring injury therapy.

Furthermore, when we talk about PRP therapy, we need to talk about three issues: is there white blood cells present? What’s the concentration of platelets over the baseline? And what’s the need to activate it prior to using it?

Most people are asking questions like “Does it work?” “Where does it work?” and “When should we use it?” It’s my conviction that these are not the right questions we should be asking.

Instead, we need to explore and study the current preparations and the method in which they are applied. There is no doubt that there is a lot of work that needs to be done.

PRP Treatment and Recovery Differs Among Injuries

What you’ll find is that specific PRP therapies work better for specific situations. Think about it this way: what works for acute muscle injuries may be very different from the one that works for chronic tendinitis. They are very different injuries and conditions. Meticulous classification of each therapy needs to happen. Until that happens, we have singular evidence coming from individuals but no cohort studies.

The reason that there is so much interest in platelet-rich plasma therapy is that the factors used are all in our bodies. It makes sense if you think about it like speeding up the natural healing response of our own bodies. Still, PRP therapy should be of interest to people who have exhausted all other approaches and want to avoid surgery.

Dr. Rick Lehman is a distinguished orthopedic surgeon in St. Louis, Missouri and an articular cartilage reconstruction pioneer He owns U. S. Sports Medicine in Kirkwood, MO, and LehmanHealth. Learn more about Dr. Rick.


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