The controversy around platelet-rich plasma (PRP) injections continues. And it’s bound not to disappear any time soon.
The controversy centers on the lack of systematic studies on a treatment that continues to rise in use and application. That popularity is fed by what’s called the Orthopedic Triad: a famous athlete treated by a famous doctor with a suspect treatment.
The famous athlete in this case is Tiger Woods. His doctor gave him an injection and within a day Tiger claimed to be able to jump up on his kitchen table.
Pittsburgh Steelers wide receiver Hines Ward–who sprained a ligament–is another famous athlete with a claim to a successful PRP treatment, namely that he was to play a pivotal role in helping the Steelers win the Super Bowl after his injury.
His teammate Troy Palamalou–who strained his calf–underwent the same treatment and played on with a superior level of performance in the same Super Bowl.
LA Dodgers pitcher Takashi Saito said PRP injections let the pitcher avoid surgery, which would have put him out of commission for about a year.
From the Elite Professional to the Average Person
The list of celebrity anecdotal evidence is long. And this is having an incredible impact on just about everybody, not just professional athletes.
Seniors who want to get their swagger back on the golf green, the amateur tennis pro and the Miami construction worker. They all suffer from an injury–tennis elbow, knee ligament pain–and want a cure for it.
The problem is in the lack of systematic, large-scale studies on the proven effectiveness of PRP injections. Those studies are in progress, but it will be awhile before results are available.
What makes a conclusive answer about the effectiveness of plasma injections difficult to get has to do with the variety of treatments. Not all PRP treatments are the same.
In fact, one particular treatment and it’s methodology have been proven as effective as an injection of saline, but those results are quarantined to a particular treatment method. The general public isn’t sure which one, making it easier for PRP injection vendors to sweep aside objections by saying, “Well, that’s a different treatment. There is no downside.”
Why You Should Always Proceed with Caution
One of the factors to the treatments success is it’s intuitive appeal. For whatever reason it just makes sense that by drawing oyur own blood, spinning it into a concentrate of growth factors and then injecting that serum into the injured area couldn’t hurt. Indeed, it’s pretty much agreed upon that it couldn’t hurt. But could it help?
I think yes. I’ve seen too many positive outcomes after PRP injections. However, I agree that without the conclusive , systematic cohort studies we should proceed with caution. I do not like seeing this treatment rise to the sort of fame it has. The hype is outdistancing sports medicine, which is why I always recommend that if you are considering PRP injections, make sure you’veexhausted all other opportunities. Only when you’ve done that should you consult your doctor.
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.