Definition
Platelet rich plasma
Concept
2 main components
1. Platelets
- contain PDGF, TGF, VEGF
2. Growth factors
- ILGF
- FGF
Formed from the separation of whole blood into plasma and RBC
- separation usually achieved with centrifugation
Platelet concentration
- whole blood 150 - 400 x 106 / ml
- up to 8 x higher in PRP
- region of 600 000 to 1000 000 platelets per ml
Technique
Draw 2 amounts of blood
- 60 mls to be centrifuged to PRP, mix with anticoagulant
- 8 mls to provide thrombin, mix with anticoagulant
Sit for 60 minutes
Centrifuge for 15 minutes
PRP
- draw off plasma
- take PRP
Thrombin
- remove from small tube
Use premade injection device as required
Possible Indications
Lateral epicondylitis
Peerbooms et al Am J Sports Med 2010
- RCT PRP v HCLA
- improved outcomes at 6 months and 1 year in PRP
Rotator cuff tears
Muscle Tears
Tears
- hamstring
- adductors
- iliopsoas
- gluteus
- abdominal oblique
- gastrocnemius
No Level 1, 2 or 3 evidence
Acute Tendon / Ligament Injuries
Acute Injuries
- MCL tear
- lateral ankle ligament rupture
- achilles tendon rupture
Chronic Tendon / Ligament Injuries
De Vos et al JAMA 2010
- RCT in achilles tendinopathy
- PRP v saline
- no difference in outcome