Dr. Gong has a long interest in regenerative medicine stemming from her 10-year doctoral and post-doctoral research experience in human mesenchymal stem cells, a type of adult stem cells that reside in your bone marrow with the ability to differentiate into multiple lineages.
Platelet-rich plasma (PRP) consists of two elements: plasma, or the liquid portion of blood, and platelets, a type of blood cell that plays an important role in healing throughout the body. Platelets are well-known for their clotting abilities, but they also contain growth factors that can trigger cell reproduction and stimulate tissue regeneration or healing in the treated area. Platelet-rich plasma is simply blood that contains more platelets than normal.
To create platelet-rich plasma, clinicians take a blood sample from the patient and place it into a device called a centrifuge that rapidly spins the sample, separating out the other components of the blood from the platelets and concentrating them within the plasma.
After creating platelet-rich plasma from a patient’s blood sample, that solution is injected into the target area, such as an injured knee or a tendon. In some cases, the clinician may use ultrasound or fluoroscope (a kind of Xray) machine to guide the injection. The idea is to increase the concentration of specific bioproteins or hormones, called growth factors, in a specific area to accelerate the healing process.
The mechanism behind PRP therapy is not completely understood. Studies show PRP has the ability to both increase stem cells and guide them in healing. In initial findings, PRP assisted stem cells in “figuring out” what they needed to be – whether a cartilage cell, or a bone cell, or a collagen cell for ligaments and tendons. PRP derived growth factors can induce stem cell differentiation, proliferation and adhesion. Also, the increased concentration of growth factors in PRP may stimulate or speed up the healing process, shortening healing time for injuries, decreasing pain and even encouraging hair growth.
PRP injections are used for a wide range of conditions from musculoskeletal pain from tendon, ligament, muscle and joint injuries, osteoarthritis, to hair loss, skin rejuvenation, etc.
A PRP injection is a low-risk procedure and does not usually cause major side effects. Because PRP injections are made up of your own cells and plasma, the risk of an allergic reaction is much lower than with other injectable medications like corticosteroids. Less common risks of PRP injections include bleeding, tissue damage, infection, nerve injuries, etc.
Because they use a person's blood and are not considered to be “drugs,” the treatments are not subject to FDA approval before they can be used by practitioners.
Oftentimes, PRP is not covered by insurance because many health insurance companies recognize PRP as an “experimental and investigational” treatment.
The cost of a single PRP treatment can vary depending on location, facilities, and the expertise of the doctor performing the treatment. The cost will typically be in the range of $ 800–2,500. Some people may also require repeat treatments depending on their age, health condition, severity and chronicity of the injuries, etc.
Contraindications for PRP therapy are a medical condition that could worsen or spread with injections (such as an active infection, a metastatic disease, or certain skin diseases), certain blood and bleeding disorders, anticoagulation therapy which cannot temporarily suspend treatment, or severe anemia.
Before PRP injection, you need to hold off any non-steroidal anti-inflammatory drugs (NSAIDs) for 5 days because their inhibition on platelet function. These NSAIDS are Advil, Aleve, Motrin, ibuprofen, Meloxicam, etc.
The procedure involves a blood draw, so you should make sure you are hydrated and have eaten beforehand to prevent feeling lightheaded. Avoid fatty or fried food before your PRP injection because the lipid contained in the plasma can affect the quality of platelet concentrate.
After the procedure, you may experience some soreness and bruising at the injection site which is usually the worst on the first 2-3 days after PRP injection. You may apply ice on the injection site for the first 2-3 days to help with the soreness which is usually very mild and you usually do NOT need to take pain medications.
Rest and avoid weight -bearing (for lower extremities) and weight-lifting (for upper extremities) for the first 2-3 days after PRP injection. For the first two weeks, avoid long distance (over one hour) driving or travel (airplane flight). For instructions after specific PRP injections, please consult Dr. Gong for detail.
Some of the top factors that weigh in when determining how long PRP injections last include the condition the PRP injection is being used to treat, the health of the patient in general, and the way the body responds to the initial PRP treatment. As with most things in medicine, each person will experience healing from treatment in their own way. The exact amount of time the PRP injections last will naturally vary from patient to patient. Additionally, overall outcomes from these treatments will vary from situation to situation.
74 yo female 2 months after PRP and 7 months after PRP plus AmioFix injection to the left knee joint