Does Platelet Rich Plasma (PRP) Really Work?

by Dr. Brian Halpern
PRP Injection for Tendon Tear

Platelet rich plasma (PRP) continues to be the buzz when treating various musculoskeletal problems. It stimulates the body’s healing response for tissue repair at the site of injury. While the best applications so far are for chronic tendinosis and osteoarthritis, a recent national orthopaedic meeting presented even more positive studies on the effect of PRP in arthritis.

Initial studies demonstrated positive effects of PRP on horse tendons by stimulating gene expression and improved tendon synthesis. Multiple clinical studies reinforced this data by showing significant improvement in cases of chronic tennis elbow. Our study of 114 patients treated with PRP for either tennis or golfer’s elbow (tendinosis) showed a significant decrease in pain scores and a simultaneous increase in functional and sports/recreational activity scores at six months, one year and two years from treatment baseline. MRI in a limited number of patients compared to baseline demonstrated an improvement in appearance of moderate and severe tendinosis (58%) and partial tears (44%). Other studies have also showed the benefit of PRP in chronic patellar and achilles tendinosis.

In early research investigating PRP treatment for severe arthritis, clinical improvement is seen, as well as a positive effect on cartilage cells. In addition, multiple studies have followed patients for up to one year post treatment. We studied 22 patients treated with PRP for knee osteoarthritis, finding that pain scores significantly decreased, while functional and clinical scores increased at six months and one year from baseline. MRI evaluations demonstrated no progression of arthritis/compartment in at least 73% of the cases at one year. This is in contrast to some studies that suggest an annual decrease of up to 4-6% of cartilage volume (a worsening of arthritis) in knee osteoarthritis if left untreated.

Dr. Brian Halpern, Sports Medicine Physician

Dr. Brian Halpern, Sports Medicine Physician

So with PRP intervention perhaps we can delay some of the progression of arthritis. We have now treated over 350 patients with knee osteoarthritis with PRP and continue to see good results.The future looks bright for PRP and regenerative medicine. Tapping into your body’s healing response continues to be an exciting frontier.

Dr. Brian Halpern is a sports medicine physician at Hospital for Special Surgery. He pioneered the non-operative approach to acute and chronic musculoskeletal problems. 

Topics: Featured, Orthopedics, Rheumatology
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The information provided in this blog by HSS and our affiliated physicians is for general informational and educational purposes, and should not be considered medical advice for any individual problem you may have. This information is not a substitute for the professional judgment of a qualified health care provider who is familiar with the unique facts about your condition and medical history. You should always consult your health care provider prior to starting any new treatment, or terminating or changing any ongoing treatment. Every post on this blog is the opinion of the author and may not reflect the official position of HSS. Please contact us if we can be helpful in answering any questions or to arrange for a visit or consult.

Comments

MAZHAR JAMIL says:

I suffer from Artheritis in both knees. I have been under treatment of Dr. Goldstein of New York Hospital for Joint Diseases. He gave me physical therapy and a course of some type of injection with zero improvement. I do not want to go for knee replcement surgery. I would like to be treated with PRP at Hospital for Special Surgery by Dr. Halpern or any ither Doctor. I know that this treatment may not be covered by my insurance AETNA HMO offered by NYCity Deartment of Transportation. I am ready to pay on my own, if need be. Please informme what should I do to get treated at this Hospital? Thanks

HSS on the Move says:

Hi Mazhar, We’re sorry to hear you’re suffering. If you’d like to make an appointment with an HSS physician, please contact our Physician Referral Service at +1.877.606.1555 or https://www.hss.edu/secure/prs-appointment-request.asp?pageid=6463.

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Hospital for Special Surgery
May 23, 2013 at 3:41 pm

True or False? Sciatica is a common diagnosis where a herniated lumbar disc presses on the sciatic nerve and pain radiates down the leg.

That’s FALSE. Physiatrist Dr. Paul Cooke says, “Sciatica is not a diagnosis, but is a term that describes symptoms that occur in the distribution of the sciatic nerve. That large nerve is made up of smaller nerve roots that join together after they exit the lower lumbosacral spine. The sciatic nerve then travels to the buttock, back or outside of the thigh and calf, and to the foot. The symptom(s) may be pain, numbness and/or tingling and may exist anywhere along the course of the sciatic nerve. There are several possible diagnoses that can cause sciatica symptoms, most commonly a herniated lumbar disc causing impingment of one of those spinal nerve roots. A lumbar disc cannot actually press on the sciatic nerve since the sciatic nerve is formed after the roots exit the spine. However, there are other conditions where the sciatic nerve is compressed in the pelvis or upper leg and can mimic a herniated disc. Your physician can help to arrive at a definitive diagnosis of the cause of sciatica symptoms with a good history-taking and physical examination, supplemented by imaging studies if needed.” Learn more at http://www.hss.edu/animation-spine-sciatica.htm.

Spine - Sciatica

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Spine - Sciatica

Hospital for Special Surgery
May 23, 2013 at 3:23 pm

"Thanks, Norma!" on their own photo.

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