Allan Mishra, a California orthopedic surgeon, is credited with being one of the first to use PRP (platelet-rich plasma) as part of treatment for an Achilles tendon rupture on San Francisco 49ers quarterback Steve Bono. This marked the beginning of the use of PRP in sports medicine. The concept of PRP began in the 1970s in the field of hematology, which is the study of blood. This term was coined so that hematologists could define blood that had a higher platelet count than normal blood.
This platelet-rich blood was mainly used for blood transfusions for people suffering from a low platelet count in their blood. Regenerative medicine is at the forefront of modern science and PRP therapy is one of the most novel treatment modes in this field. It has attracted the attention of specialists in various areas of medicine, such as rheumatology, orthopedics, rehabilitation and physical medicine. Despite the fact that PRP has not been the subject of a significant number of clinical trials and remains controversial in some circles, patient demand continues to drive its use and related ortho-biological modalities.
For many patients, especially those suffering from serious illnesses and injuries associated with severe musculoskeletal injuries, PRP and similar non-surgical techniques offer many benefits.The future of PRP is based on more research to gain credibility in academia and the insurance industry. Clinical trials that offer results based on double-blind methodologies and positive, repeatable results will go a long way to making PRP a fully accepted treatment within the medical community and among patients seeking non-surgical options.Thousands of years ago, humans first learned the medical principle that intentional creation of inflammation could initiate the healing process. The Roman writer Celso was probably one of the first to document this phenomenon. In fact, about 2,100 years ago, doctors routinely treated excess testicular fluid by inducing a healing process through saltpeter injections.Beginning in the 1950s, Dr.
Robert Ehrlich used similar techniques to strengthen ligaments, tendons, and herniated regions. He injected several substances and recorded the subsequent strengthening of previously weak areas. Other recent advances in PRP-like treatments occurred in the early 2000s among plastic surgeons and during oral reconstructive procedures, when PRP treatments were administered only to reduce blood loss. Doctors noticed that bones healed more quickly and efficiently after these treatments, leading them to suspect that the platelet-rich substances they had injected played a key role in strengthening bone tissue.Blood platelets contain several important growth factors that increase multiple types of tissue repair in the human body.
Platelets not only contain cytokines and mitogens, two crucial components of mesenchymal cell attraction and mitosis stimulation, but they also increase fibroblast production. In animal studies, platelet therapy effectively helped repair and rejuvenate injured tendons soon after injection. PRP therapy not only helps bring healthy blood to the site of injury, but it also helps with the recruitment of new cells, it also promotes beneficial metabolic action, stimulates the growth of blood vessels, and generally improves the nutrition of the injured area.Perhaps the biggest problem facing PRP today is the lack of standardization. Currently, for example, there are no accepted universal protocols for any of the preparation processes, such as growth factor activation techniques, selection of specific injection sites, and other procedures that take place immediately before or after injection.
This lack of common standards for PRP makes it difficult to establish evidence to evaluate effectiveness. The result is a low level of acceptance by the academic research community and, therefore, the insurance industry.With so many different procedures existing among PRP professionals, it is almost impossible to make objective evaluations of comparable clinical trials. For example, a recent study found that, although PRP injections in a group of subjects with tendinopathy showed promising results, non-standardized procedures hampered the search for significant trial conclusions. This unfortunate state of affairs can be remedied by working towards standardization of PRP preparation procedures and technique.
Universal PRP protocols are also needed so that trials can be fully evaluated and begin to contribute to a broader literature on PRP research.When it comes to the treatment of musculoskeletal injuries with PRP, recent advances have led to its more frequent use as a promising technique. Today researchers understand more clearly the important relationship between the body's immune system and injured tissue masses. Platelet-rich plasma has been found to significantly improve the healing process and its use for shoulder pain caused by rotator cuff tears, Achilles tendon ruptures, and other soft tissue injuries is becoming more common.
Prp injectionsare prepared by taking one to a few tubes of your own blood and passing them through a centrifuge to concentrate platelets.
Back pain is one of the biggest medical problems in the United States and PRP injections may be a viable solution to this problem. Although PRP has many theoretical functions and some clinical application value it is not used as the main treatment in practice. It is prepared by drawing blood from a person and then subjecting them to two centrifugation steps designed to separate PRP from platelet-poor plasma and red blood cells. In this way PRP injections use each patient's own healing system to improve musculoskeletal problems.
Some of the main advantages of PRP injections are that they can reduce or eliminate anti-inflammatory drugs or stronger medications such as opioids. Both groups that received PRP injections showed improvement but those who received treatment immediately showed more promising results. It can be injected directly into an affected area or “activated” by adding calcium chloride or thrombin which degranulates activated platelets and releases growth factors and differentiation factors. Studies have shown that it can improve healing processes while reducing infection risk.
We hope that this review will serve as a basis for future research on PRP injections, so that more researchers can pay attention to safety issues related to its use.