platelet rich plasma phoenix (PRP) treatment

What is Platelet Rich Plasma

PRP is a concentrate of blood plasma that contains a high concentration of . platelet rich plasma phoenix are cells in your blood. They contain a high reserve of bioactive proteins that are essential to the healing process of the body. Once injected, the platelets release these bioactive proteins (including several growth factors), which triggers the body’s repair cascade at the site of injury. The injection therefore serves to start the internal process of the body to heal.

Indications

• Osteoarthritis of a joint
  • Shoulder
  • Knee
• Tendinopathy
  • Lateral or medial epicondylitis (elbow)
  • Achilles tendinitis
  • Rotator cuff tendinopathy
  • Patellar tendinopathy
  • Plantar Fasciitis

Is PRP right for you?

When conventional treatments (physiotherapy, cortisone infiltration or viscosupplementation) have not given satisfactory results, PRP could be considered. You will need to have an initial evaluation with the sports physician who will determine if PRP treatment is a good option for you. Following this assessment, if PRP is not the best option for you, the doctor will advise you accordingly. dr gupta pain management

It is also possible, following this first visit, that additional radiology examinations will be prescribed to better understand your problem (radiology, magnetic resonance) and to assess whether PRP is the best treatment for you.

Steps to follow

1. A first meeting with a sports doctor will be necessary to assess your situation and thus determine if PRP could help you. During this meeting, the history of your problem, the treatments tried so far and the answer to these will be discussed. Previous complementary examinations carried out will also be analyzed. It is therefore important to bring, during your first appointment, the list of medications tried as well as all the imaging reports done so far (radiography, ultrasound, magnetic resonance, scan). The doctor will then perform a physical examination and an ultrasound of the area to be treated. At the end of this first meeting, the treatment options will be discussed with you. If PRP is the right treatment for you,

1. In anticipation of the procedure, it is important to stop taking any anti-inflammatory 1 week before. Indeed, anti-inflammatories block the action of the platelets that we will need for your treatment. The anti-inflammatories are (non-exhaustive list): Advil, Aleeve, Motrin, Celebrex, Naprosyn, Vimovo, Voltaren, etc. If in doubt, ask your pharmacist. If you are taking aspirin for a medical reason, you should NOT stop it.
2. The day of your appointment, come accompanied. Allow at least 1 hour. If crutches or walking boots were prescribed for you during your assessment appointment, you must bring them with you.
   • We start with a usual blood test (about 10ml will be taken)
   • The blood is then centrifuged to separate its components (red blood cells and plasma)
   • The area to be treated will be anesthetized locally using the usual analgesic (as at the dentist)
   • The injection of the plasma will then be done under ultrasound guidance for optimal precision.
   • Usage advice will be given to you.
3. A rest of 2 weeks is to be expected after the procedure. You can go about your business around the house but no physical exercise is recommended. A work stoppage may be necessary depending on the nature of your work and the area to be treated (this will be discussed with you during the first appointment).
4. After the procedure, transient discomfort is possible. Normally this happens during the first week. It is important not to take anti-inflammatories for 2 weeks after the injection. Also, ice is not recommended. A safe analgesic medication will be prescribed during your appointment that you can take if the Tylenol is not enough.
5. After the first two weeks, a physiotherapy rehabilitation program is essential for the optimal healing process of the treated area. Indeed, the body needs not only a chemical signal (the bioactive proteins of the plasma) but also a mechanical signal (exercises well adapted to the treated region) in order to increase the chances of the most optimal healing. possible.
6. Sports activities that specifically solicit the treated area are not recommended before the follow-up appointment 2 months after the procedure.
7. A follow-up appointment will be scheduled 2 months after the procedure involving the tendons. At this appointment, a physical examination and a control ultrasound will be performed to see how the healing is progressing. The progression of physical activities thereafter will be discussed according to the healing stage at which you are at.

What to expect after treatment

Transient pain lasting a few days to a week is possible after treatment. It is important not to take anti-inflammatories for 2 weeks after the injection. Also, ice is not recommended. A safe analgesic medication will be prescribed during your appointment that you can take if the Tylenol is not enough.

A rest of 2 weeks is recommended. Thereafter, you will have to do a rehabilitation program in physiotherapy for 2 to 3 months following the treatment.

During the first 2 months, it is normal for the pain to evolve into a roller coaster.

If your treatment is at the level of the foot or the Achilles tendon, a walking boot will have been prescribed for you for the 2 weeks following the treatment. This will be worn at all times when you walk, for 2 weeks, in order to immobilize the treated area. You can take it off for showering, sleeping and sitting. In these circumstances, it is important to monitor the symptoms of thrombophlebitis which will be explained to you at your appointment.

What are the expected benefits

The PRP procedure triggers the body’s internal healing process. This platelet rich plasma phoenix goes through an initial phase of inflammation then collagen proliferation and ends with a remodeling of the fibers of the treated tendon. It is therefore a gradual process that extends over several weeks. This explains why, during the initial phase, the pain may increase, then go through ups and downs before gradually improving. The relief is therefore not immediate (as is the case for example after a cortisone infiltration where the relief appears very quickly). After 2-3 months, more sustained and gradual relief is more consistent. Full improvement, however, can take up to 6 months to be achieved. The ultimate goal of PRP is to decrease your pain,

Like any medical treatment, unfortunately there are failures with this treatment. The relief obtained may also be partial. The success rate varies greatly from one area treated to another and this will be discussed with you during your assessment appointment.

For osteoarthritis, relief also sets in gradually and may take 1-3 months to be complete.

How many treatments are needed

For the treatment of osteoarthritis, the procedure could be repeated every 12-18 months depending on the duration of relief. As osteoarthritis is a chronic degenerative condition, the pain may return. Unfortunately, our current treatments cannot cure this condition for good. PRP does not regenerate cartilage affected by osteoarthritis. It provides pain relief through the bioactive proteins in PRP. Depending on the severity of the underlying osteoarthritis, relief following PRP treatment may vary. If the relief following an initial treatment has been significant, the procedure can be repeated when the pain returns.

For the treatment of tendinopathy platelet rich plasma phoenix, a second treatment could be necessary depending on the evolution. Normally it is not repeated for 4-6 months. Indeed, the time needed to see the full effect of a PRP treatment can take 6 months. The need for a 2nd treatment will be discussed with the doctor on a case-by-case basis.

Side effects and risks

• Temporary worsening of pain after injection
• Like any type of injection, there is a risk of infection (0.01%), bleeding, bruising, neurovascular damage, vagal shock
• Like any type of injection or medical treatment, it is possible to have THERAPEUTIC FAILURE. Indeed, some people unfortunately do not respond to PRP treatment. There are no certainties and no perfect signs that allow us to predict your response to treatment during the initial evaluation.
• Formation of scars or calcifications at the injection site
• Allergic reaction to xylocaine (local anesthetic)
• If you have to be immobilized (walking boot) following your injection, thrombophlebitis may form. It is important to follow the advice given and consult the emergency room if you have any suspicions. Signs to watch out for:
  • Severe calf pain
  • Redness in the calf
  • Swelling of the calf or foot
  • Breathing difficulty
  • chest pain
  • Breathing pain
• A temporary weakening of the injected site during the first weeks. It is therefore essential to follow the recommendations that will be given to you so as not to aggravate your condition.

Contraindications

• Presence of cancer or metastasis
• Active infection and antibiotic treatment
• Severe thrombocytopenia (significant lack of platelets)
• Significant anemia
• Utilisation anticoagulant (coumadin)
• Pregnancy
• Feeding with milk
• Infiltration of cortisone in the area to be treated in the previous 4 weeks