Mattalino Orthopaedic in Phoenix, AZ has been a leading provider of orthopedic treatment for over 25 years. As part of our commitment to providing the best possible treatment to our patients, we constantly seek out new ways to overcome injuries and damage caused by athletic activities and accidents alike. PRP injections are one of the newest tools at our disposal.
Platelet-rich plasma (PRP) has been in use for several decades, however, it has only become popular in the field of sports medicine in the last decade or so. PRP activates your body’s natural healing systems and makes it possible to recover faster. You may even be able to avoid surgery with PRP injections. So, how do we put PRP to use to treat orthopedic conditions, and how well do they work?
What Can PRP Injections Treat?
Elbow Pain
Elbow pain can be caused by several factors but is most commonly the result of repetitive athletic activities that put stress on the joint. The elbow plays a crucial role in a number of sports, however, some are more likely to put extreme stress on the ligaments and tendons of the elbow joint.
Several sports stand out as the leading causes of elbow damage. Tennis and golf both have conditions named after them, and baseball is another major source of elbow injury. Fortunately, platelet-rich plasma has been used to treat all of these conditions with high levels of success.
Tennis Elbow and Golf Elbow
Lateral Epicondylitis, also known as tennis elbow, is caused when tendons degenerate due to repetitive use. These tendons attach to the elbow and can experience micro-tears when the joint is put under stress. Several of the motions in sports, especially tennis, create torsion and impact pressure on the elbow joint and its parts.
Less common is medial epicondylitis, or golfer’s elbow. While it only affects about 1% of the population, this can be easily explained by the fact that there are simply fewer golfers out there and few other sports put pressure on the elbow joint in the same way. Due to its lower prevalence, there are fewer studies on PRP for golfer’s elbow, but some studies show positive results.
One report showed a 91% improvement in golfer’s elbow pain from a single PRP injection, while tennis elbow studies found that a PRP injection could achieve the same results as surgical intervention. Others even suggested that PRP worked better than the Nirschl procedure, the default surgical option for tennis elbow.
UCL Injuries
The ulnar collateral ligament (UCL) can be a career-ender for baseball players. Pitchers in particular are most vulnerable to UCL injuries given the high amounts of force placed on the elbow during the overhead portion of a pitch. Evidence suggests that PRP can be an excellent way to restore this ligament to full health.
One study noted that 73% of baseball players treated with PRP were able to return to action sooner and had good or excellent outcomes. Another case used two injections and 96% of the patients showed significant improvement in just two weeks.
There is one caveat to these cases. The sooner you act, the better. Patients who delayed treatment and exacerbated their injuries reported poorer outcomes. PRP works best when the body is already responding to an injury, so if you have had elbow pain for more than a few days, don’t wait to give us a call.
Shoulder Pain
The most common sports injury to the shoulder is the dreaded rotator cuff tear. The rotator cuff consists of tendons attached to your humerus (upper arm bone) and the muscles in your shoulder. These muscles and tendons work together to help you lift your arm above your shoulder level. A meta-analysis of various studies has good news for shoulder injuries and PRP.
Using the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), doctors evaluated the results of a PRP injection on rotator cuff patients. Patients who had received PRP injections showed a significant improvement 12 weeks after their treatment.
Another analysis of trials that covered a large sample of over 1,000 patients found that PRP use was more likely to result in a completely healed tendon. There were fewer incidents of repeat injury when PRP was used as well.
Knee Pain
Knees bear the burden of nearly all your body weight and take more punishment than any other joint. Knees can experience injury in nearly every sport and are also subject to significant wear and tear from life itself. There are several ways knees can be injured from athletic activity.
Osteoarthritis
Although we typically associate arthritis with advanced age, osteoarthritis can occur earlier in life. Early knee osteoarthritis (EKOA) can be seen in patients in their early 40s, and it’s more likely to occur when you have had a very intense athletic lifestyle or perhaps have dealt with significant obesity for a portion of your life.
Osteoarthritis is the result of repetitive damage to soft tissues such as cartilage in your knee joints. PRP has been shown to improve the quality of these soft tissues and even regenerate cartilage to a degree. In fact, a 2018 study claims that PRP should actually be the first choice for treating osteoarthritis.
Total knee arthroplasty, or a knee replacement, is one approach. But nearly 20% of patients experience a poor outcome from TKA and approximately a third experience chronic pain after. In contrast, PRP injections have had no serious side effects and slow down the development of osteoarthritis. If you have mild case of knee pain, it could be the start of osteoarthritis, so take action now.
Ligament Injuries
The most commonly injured ligaments in the knee are the ACL and MCL, with the former being more difficult to treat. Every sports fan has experienced the deflation of watching a star player be lost for the season due to an ACL tear. PRP has been used on knee ligaments for nearly 20 years and numerous high-profile athletes have used it to get back on the field faster.
Partial tears heal faster when PRP is applied and surgery may be avoided. In the case of full ACL tears, surgery is still the most recommended option, but PRP can make that surgery much more effective. Several studies support the use of PRP in knee ligament reconstruction surgery.
An analysis of eight different studies showed that ACL grafts were improved by 20-30% with the use of PRP. These reconstructed ligaments were significantly stronger and larger, making them less likely to get injured again. Another study found that patients returned to their baseline levels much faster with PRP. 100% were back to full health in 6 months, while only 78% of the control group could say the same.
Meniscus Tears
The same review also found several studies that confirm that PRP can improve meniscus healing and restore synovial fluid levels more quickly. MRI scans one year after PRP treatment showed that 75% of patients had healed completely, while only 40% were back to full strength. Clearly, PRP speeds up recovery and helps to ensure a complete restoration.
Bursitis
Bursas are fluid-filled sacs that contain a synovial fluid which acts as a lubricant inside the joint. Bursas make joint motion easier and also provide cushioning from impacts. Over time, these can wear down or become damaged due to repetitive motion. The most common cause of bursitis is distance running, with the hip being the most affected area.
A review of several studies showed that PRP treatment had a significant advantage over other options. 82% in the PRP group saw improvements versus only 56.7% who received corticosteroid injections. These differences were visible 12 weeks after treatment.
Back Pain
Back pain in sports is often the result of repeated impacts combined with the awkward postures that sports call for. Given how important your spinal cord and your back muscles are for just about every sport, back pain can be quite debilitating. Most commonly, the discs between your vertebrae become injured as they bear the brunt of the forces exerted on the spine.
Discs can become inflamed and bulge out of place. This can pinch nearby nerves and cause tingling sensations or chronic pain, especially when moving in a particular way. Alternatively, discs can wear down and thin out, causing vertebrae to endure greater pressure and possibly lead to serious injury.
PRP injections have been proven to work wonders for discogenic back pain. A 2017 study showed that 71% of the patients treated with PRP showed a 50% drop in pain symptoms. Physical disability scores were reduced significantly in 79% of the patients. Only 2 had recurring back pain after treatment. Other studies reported similar results.
How Do PRP Injections Compare to Other Treatments?
All of the conditions we’ve discussed so far can be treated by other means. So why should you consider PRP over those options? PRP offers several advantages that other treatments cannot promise.
Cost
While the cost of PRP treatment can vary from location to location, it is significantly more affordable than surgery. Getting a PRP injection takes less than a couple of hours and therefore requires fewer resources. There’s no need for an anesthesiologist or for a hospital stay, which further reduces total expenses.
Even when insurance does not cover PRP injection, it still works out to be more affordable than surgical options.
Safety and Side Effects
None of the studies we have cited nor any others have been able to find any dangerous side effects or risks associated with PRP treatment. Since PRP is derived from your own blood and produced in FDA-approved devices, you essentially have nothing to worry about. PRP simply concentrates and relocates components that are already found in your bloodstream.
In contrast, surgeries carry small yet potentially significant risks that you need to take into consideration.
Recovery Time
As we have noted, PRP typically reduces recovery time. Since the actual process of getting an injection is so simple and minimally invasive, PRP treatment does not create additional wounds that need to heal. You won’t need stitches and can, in some cases, resume physical activity and therapy faster compared to surgery.
This reduced recovery time courtesy of PRP is the reason why many professional athletes opt to try PRP treatment before going under the knife.
Competitive Concerns
Several of the studies we mentioned contrasted PRP with corticosteroid injections. Several of these steroid-based injections are prohibited by the World Anti-Doping Agency, while PRP is completely safe for competitive athletes to use.
Schedule an Appointment
If you are still unsure if PRP is the right treatment for you, call Mattalino Orthopaedic in Phoenix, AZ today. We’ll examine your case and determine the best course of treatment to get you back into action as soon as possible.