Platelet Rich Plasma, or PRP Methode

Platelet Rich Plasma, or PRP, is blood filled with platelets. Serum (blood plasma is a liquid part of blood, composed mainly of water) for treatment is obtained by centrifuging the blood of the person performing the treatment. In this way, other blood components, leukocytes and erythrocytes are removed, and the serum prepared in this way has 5 to 10 times more platelets than is usual in the blood. They cause coagulation - blood clotting and contain proteins that help wounds to heal.

PRP serum contains growth factors, e.g. platelet-derived growth factor (PDGF-AA, BB or AB), insulin-like growth factor (IGFI and II), transforming growth factor beta (TGF-b), epidermal growth factor (EGF), vascular endothelial growth factor (VEGF), fibroplast growth factor (FGF 1 and 2). There are also bone morphogenetic proteins (BMP, especially BMP12 and BMP 13).

Growth factors can be locally produced by the cells in the area of ​​the injury, they can reach the bloodstream or during physiological repair. They have long been known to be modulators of cell growth and development, to influence migration, replication, matrix synthesis and cell transformation. They have a positive effect on various stages of healing of muscles, ligaments and tendons and accelerate the healing of wounds on the skin and subcutaneous soft tissues.

This therapy uses the body's natural ability to heal. When we cut ourselves, for example, the body's defensive reaction is to attract platelets to that place and thus speed up the wound healing process. The treatment has been used in medicine for more than 30 years, especially in orthopedics and cardiology, and as a form of rejuvenation since 2005.

What problems are treated with PRP?

PRP is applied when it is necessary to stimulate faster recovery and tissue regeneration. In aesthetic medicine, in degenerative problems with joints, in the treatment of chronic wounds, in injuries of the musculoskeletal system. Doctors initially used PRP to help people recover after jaw surgery and after plastic surgery. Tissues on which PRP has been used include tissues of tendons, ligaments and muscles. Ligaments take a long time and can be difficult to recover, so PRP is a good choice for those who have experienced an injury to that group of tissues.

How is it performed?

It all starts with an examination by a specialist doctor and after that he draws some of the patient's blood from which the serum is made. It contains active substances that stimulate platelets to release growth factors. Such a serum is applied to the skin with the mesotherapy technique with very thin needles.

Is it safe?

PRP treatment is safe because the patient's own blood is used and there are no immunobiological barriers to the risk of allergic reactions and transmissible diseases. Unlike corticosteroid injections, there is no risk of local tissue weakening and consequent ruptures of tendons, ligaments and muscles.

After application, short-term pain, redness and swelling are possible. The PRP method is not an omnipotent therapy that gives 100% results, but, applied in the right way, it is completely safe and without side effects. For the success of the therapy, it is necessary to prepare the PRP serum in the right way and apply it in the right indications. So to evaluate the application of orthopedic PRP treatment, it is best to contact experienced doctors.

How long does the treatment last?

It takes from fifteen minutes to half an hour from the blood draw to the application of the serum with prp tubes. If the procedure is more complex, then longer. After that, the patient can go immediately, it's that simple. Up to ten days after application, platelets release growth factors. They lead to better hydration and blood circulation of the skin, it is nourished and receives more oxygen. The treatment improves the complexion, tone, color and texture of the skin. Although it is known by the names "Draculin" or "Vampire treatment", it is recommended for people who want to avoid aggressive treatments. Also, if you have acne scars, you want to remove wrinkles and put aging skin under control.

Who is recommended for treatment and who is not?

Absolute contraindications for the use of PRP treatment are:

• malignant diseases
• acute infections
• systemic blood diseases

Relative contraindications for the use of PRP treatment are:

• use of corticosteroids 4-6 weeks before intervention
• anticoagulant therapy
• surgery a month before the procedure
• autoimmune diseases of the musculoskeletal system
• use of anti-inflammatory drugs one week before treatment (aspirin, diclofenac ()
• chronic kidney and liver disease

PRP: Instructions for behavior before the procedure

Before the therapy, the doctor will instruct you on what awaits you during the treatment. Anyway, you should remember a few things.

At least 3 to 4 days before therapy, stop taking anti-inflammatory drugs (NSAIDs - nonsteroidal anti-inflammatory drugs, aspirin, ibuprofen…, etc.)

One to two weeks before your procedure, stop using blood-thinning herbs, various supplements or vitamins.

Stop using systemic steroids one to two weeks before your procedure.

Stop using steroid injections at least a month before your procedure.

On the day of your treatment, eat a hearty breakfast of healthy food and be sure to drink plenty of water

If you are taking chronic oral steroids, it is advisable to consult your doctor about abruptly stopping taking them as this can lead to side effects. If you are taking any medications, consult with the person who prescribed them.

How to behave after PRP treatment

After PRP therapy, resting throughout the day is recommended. In the next two days, limited use of the part of the body in which the injection was received is recommended. But, movement is also advised, because it helps the joint to recover - the injection is adopted in the tissue that surrounds the injection site.

0 to 3 days after injection

After the treatment, there is a possibility that you will feel mild to moderate pain in the treated area. This is a normal sign that your body is recovering and adapting to the injection. It is best to drink plenty of water to facilitate recovery.

It is very important that you do NOT take ANY medications after the procedure unless your doctor recommends it. This is because any drug can affect the recovery process and have various side effects.

Therefore, stop taking any of these medications after treatment so that you can get the best possible results:

Do not take anti-inflammatory drugs for at least two weeks after treatment (aspirin, diclofenac, ibuprofen ()

Do not take herbs that dilute blood, supplements or vitamins for at least 3-4 days after treatment

Systemic steroids for at least two weeks after treatment

Other important instructions to follow after your treatment are:

Do not put ice on the injection site for at least 72 hours

Do not bathe in hot water or go to the sauna for the first few days after the treatment

Do not consume any alcoholic beverages for at least a week after treatment

Do not shower for the first 24 hours

Avoid smoking

Instructions for behavior of 3-14 days:

In this part of your recovery, you should gradually increase your daily activities. Now you can start with the exercises. Proper exercise is the key to long-term results and you should consult a doctor about the ones that would suit you best before PRP therapy itself.

Ice can be applied three to four times a day for 15-20 minutes if you feel the need.

Anti-inflammatory drugs can be taken as directed to relieve any residual pain.

Still avoid alcohol, smoking or excessive amounts of caffeine

Instructions for behavior 3-4 weeks after treatment

At this point in your recovery, it is advisable to start physical therapy to make your recovery effective in the long run. Now is the time to see a doctor who will assess the progress of your recovery. It is important to do this even if your recovery is going great. If something needs to change in your treatment plan, there is a time when your therapist will be able to assess it.

PRP therapy in orthopedics

PRP therapy has proven to be an excellent type of treatment for numerous conditions and injuries of the knees, hips, shoulders, elbows, joints, cartilage, tendons and ligaments.

We will try to explain why PRP might not work and how just one injection will lead to unsatisfactory long-term results.

There are many treatments for pain in e.g. knee. Cortisone injections, hyaluronic acid and "gel" injections. But cortisone injections, although they cause immediate relief in most people, are not without danger. The harmful properties of corticosteroids have long been known in medicine. It is generally given when the patient needs to prepare for joint replacement. Cortisone only reduces the pain caused by chronic inflammation. And nothing heals. PRP leads to recovery despite inflammation. When the tissue regenerates, the inflammation disappears.

Cortisone is a short-term solution, and PRP is a long-term solution. Cortisone will eventually suppress the body's natural power and lead to knee replacement. PRP will rebuild and recover the tissue in the knee and help you avoid knee replacement or arthroscopic surgery.

A single use of PRP therapy causes an inflammatory response, while a cortisone injection causes a completely opposite, anti-inflationary effect. People here are often confused when the inflammation gets worse after PRP therapy and then say that they know that PRP does not work. And it is very difficult to fix what has been accumulating over the years with one injection. Degenerative disease does not occur during the night, nor does its cure.

Doctors say, after the experience of working on thousands of patients, that PRP is much less effective as a 1-dose treatment. They realized that it was much more successful as a multi-dose program. They see PRP treatment in cooperation with Prolotherapy (technique 1 injection of hyper dextrose) as a solution for strengthening the hip ligaments and its stability.

According to their experience, when someone has a degenerative disease of the hip and the cartilage wears out and disappears, you simply cannot fix the condition with the cartilage without seeing what causes its damage. This is erosion or irreparable joint damage that you have probably heard about many times. This manifests as instability in the hip, with the feeling that your hip is shaky, loose and insecure.

Prolotherapy uses hypertonic dextrose, in addition to some other simple ingredients that are individualized for each person, in order to initiate localized soft tissue regeneration. For the hip, the treatment is used to repair, tighten and strengthen the ligament that holds the hip bones in place.

Doctors often use PRP to treat hip pain and restore its function and range of motion. During the treatment, they clean the skin from your hip and use ultrasound to see inside your body. This helps them guide the needle. The goal is to inject the PRP infusion directly into the injured part of the hip. The whole process takes 45 to 90 minutes. After the procedure, you may feel pain in your hip and the doctor may give you crutches to relieve it.

Magnetic resonance evidence that PRP rebuilds cartilage

A January 2020 study, published in the Journal of Pain Research , investigated the effect of PRP therapy on cartilage characteristics through special magnetic resonance imaging of patients with osteoporosis of the knee. All patients were women about 58 years of age.

It was a study of 46 knees from 23 patients.

23 knees were in the control and 23 in the group that received PRP therapy.

In the PRP group, all radiological variables (patellofemoral cartilage volume, synovitis, and medial and lateral meniscus disintegration) with the exception of subarticular bone marrow abnormalities, had significant improvements. In a comparison of the two groups, patellofemoral cartilage volume and synovitis changed significantly in the PRP group.

The University of California in the “ Tissue Building ” study claims that PRP injections cause positive healing cell changes in the joint environment. These changes help the knee to move from a degenerative to a recovered and regenerated state of the joint environment. Healing involves the regeneration of articular cartilage, increasing the amount of natural knee lubricants, and awakening existing stem cells in the knee that help transform them into a healthy environment.  

In that study, the researchers wrote: PRP modulates the repair and regeneration of damaged articular cartilage in the joints and delays cartilage degeneration by stimulating the migration and proliferation of stem cells and their differentiation into cartilage cells.

In addition, PRP reduces pain by reducing inflammation of the synovial membrane, and pain receptors are located there. The synovial membrane is a protective layer of connective tissue that is also responsible for creating a synovial fluid that lubricates the joints.

That said, PRP injections really help reduce knee pain and restore function in patients with osteoarthritis.

LASER AND PRP THERAPY

If you do not like needles, you can decide to perform the procedures in combination with laser rejuvenation. The effect of these two methods gives a strong effect because it combines the effect of stimulating regeneration with the help of blood plasma and laser rejuvenation.

The laser makes micro-holes in the skin into which the blood serum is placed. It is certainly more comfortable for the patient. This combination is also good for removing scars. Also, PRP gives excellent results in combination with hyaluronic fillers. Laser therapy and PRP are also used in combination with mesotherapy to rejuvenate and remove scars. They also significantly contribute to slowing down skin aging. Laser and PRP use the cumulative effect of both methods in removing acne scars. Laser peeling evens out the skin, achieves the formation of new collagen, and in addition has an anti-inflammatory and regenerative effect, so it improves the quality of the skin. The PRP method additionally uses the production of collagen, so after the treatment, the structure of the skin is improved, the indentations are filled, that is, new, young tissue is created.

User experiences

Many top athletes (eg Tiger Woods , golf champion) are happy to resort to PRP therapies in order to get in competitive shape as soon as possible after injuries and painful conditions. It is often combined with arthroscopy of the knee, shoulder or ankle in sports injuries. It should be noted that under current regulations, the WORLD ANTI-DOPING AGENCY (WADA) PRP is permitted and is not on the doping list. But, you probably belong to ordinary people, so it can be thought with some certainty that you do not belong to those who dream of an Olympic medal.

Research studies on PRP include:

One was published in 2015 in Stem Cells Translational Medicine and it is claimed that people who had the treatment sprouted more hair of much higher density than those who did not. However, the study included a small group of only 20 people.

Another, published in 2013, in the American Journal of Sports Medicine , found that PRP injections reduced pain in osteoarthritis of the knee compared to salt injections. The study again included a relatively small number of 78 participants.

An article published in 2014, again in the American Journal of Sports Medicine , confirmed that three rounds of PRP injections reduced symptoms in people with chronic patellar tendinopathy of the knee. The researchers used 28 athletes in the study.

General about PRP treatment

PRP treatment is absolutely safe. Plasma obtained from the patient's blood is used, so there is no danger of allergic or immune reactions of the organism. So there are no limits when it comes to the number of injections that can be obtained within a year.

What about recovery time? If you lead an active, working life (like most people), then you may not be able to devote enough time to recovery. The great thing about PRP injections is that the recovery time is short. Studies have shown that the positive effects of injections can improve the quality of life and reduce pain for patients suffering from osteoporosis, not to mention the quality of life of people who came for other, aesthetic reasons.