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BRADFORD J. BELLARD, M.D.photo of Dr. Bellard

GENERAL SPORTS MEDICINE, TEXAS SPORTS MEDICINE
DIPLOMATE, American Board of Emergency Medicine
ASSISTANT TEAM PHYSICIAN, Dallas Mavericks
Platelet-Rich Plasma (PRP) Specialist
Concussion Management

PLATELET RICH PLASMA THERAPY
The Patient’s Guide to Platelet-Rich Plasma (PRP) Therapy: A New and Innovative Method for the Treatment of Tendon Injuries

Frequently Asked Questions

Q: What is PRP?
A: PRP stands for Platelet-rich plasma. Plasma is the liquid portion of our blood responsible for carrying red blood cells, white blood cells, and platelets. Normally our blood is comprised of approximately 10% of platelets. However, in PRP, the platelet concentration is multiplied up to 4 times as much as normal blood in order to concentrate the healing properties of the platelets.

Q: What is PRP therapy?
A: PRP therapy is a new, innovative, and non-surgical approach to promote healing of tendinosis by taking advantage of the body’s own healing properties. PRP has been used in various other fields of medicine for more than 20 years to enhance wound healing. One of the roles of platelets is to release an abundance of growth factors to help speed up soft tissue and wound healing. With PRP therapy, we inject those concentrated platelets and healing factors directly into the site of injury to stimulate recovery of tendinopathies.

Q: What does PRP treat?
A: Currently PRP is a non-surgical treatment option for chronic tendinopathies. These include:
• Lateral epicondylitis (Tennis elbow)
• Medial epicondylitis (Golfer’s elbow)
• Patellar tendinitis (Jumper’s knee)
• Achilles tendinitis
• Plantar fasciitis

These conditions are often referred to as “tendonitis”. However, research has shown that chronic tendinopathies are usually a painful, non-inflammatory process that results as a consequence of a viscous cycle of injury, degeneration, abnormal remodeling/scarring, and reinjury of the tendon…better defined as “tendinosis”1. PRP works to actually heal the underlying problem because the healing factors promote the formation of a matrix within the tissue for proteins to create a more resilient tendon structure.

Q: How do I know if PRP is right for me?
A: An initial evaluation with Dr. Bellard will be needed to determine if you are a candidate for PRP therapy. Patients that have failed traditional treatment for chronic tendinopathies may be a candidate for PRP, once the appropriate workup has been done. If determined to be an option, PRP therapy will be scheduled for a future date.

Q: How does the process work?
A: The patient’s own blood is drawn. The blood is then centrifuged (spun down) to separate the plasma, platelets, and red blood cells in order to prepare the PRP. The PRP is then injected into the area of tendinosis and directly visualized under ultrasound guidance to ensure accuracy of placement. The entire process takes approximately 1 hour.

Q: What can I expect?
A: One of the goals of PRP is to heal chronic tendinosis without the need for surgery. There is evidence to suggest that PRP does just this and ultimately provides another non-surgical option for treatment. A study published in American Journal of Sports Medicine in 2006 showed that over 90% of patients undergoing PRP therapy for tennis elbow were “completely satisfied” with their treatment and were able to avoid surgery1. There are also other articles that suggest its validity as a treatment option for chronic tendinosis2-4. PRP does not provide instant relief. It does set the stage for a cascade of healing that takes several weeks to occur. Local anesthetic is used during the procedure and usually wears off approximately an hour after the procedure. Redness and soreness at the site of injection is expected. If done for a lower extremity (knee, ankle, or foot), the use of crutches and/or a walking boot will be used for the first couple of days. Typically, a physical therapy program will start soon afterward. Depending on the condition, it may take up to 3 injections to receive full benefit.

Don’ts:
• Do not take anti-inflammatory medication the week prior to the procedure
• Do not take anti-inflammatory medication for several weeks after the procedure

Do’s:
• Take Tylenol, or prescribed narcotic pain medication after the procedure for pain
• Apply cold compresses to area after the procedure
• Call your doctor if you experience fever, allergic reaction, or if unsure of any symptom

References
1 Mishra and Pavelko, American Journal of Sports Medicine, 2006
2 Filardo et al, International Orthopaedics, 2010
3 Peerbooms et al, American Journal of Sports Medicine, 2010
4 Barrett et al, Podiatry Today, 2004

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