The achievements of modern science allow us to solve many health problems, but do not forget about the reserves of our body. Sometimes, with the help of your own resources, you can correct a seemingly difficult situation. A striking example: a young but promising direction in the treatment of joints - PRP-therapy. It is a therapeutic procedure that uses the patient's own platelets to heal and regenerate tissues. In the last decade, a large number of publications on the use of PRP in orthopedics and sports medicine have appeared in both Russian and Western scientific literature. Researchers say the technique is promising because of its safety, simplicity, and results.
There are many synonyms for the technique - PRP (English platelet rich plasma), or platelet-rich plasma, autoplasma therapy, plasma-lifting, but in fact they all mean the same thing.
What is the essence of PRR therapy?
Back in 1905, surgeon August Beer described the property of a patient's own blood (hematomas) to help heal fractures. However, the reasons for this phenomenon remained unknown for a long time.
Our blood consists of a liquid part - plasma, and of cells - erythrocytes, leukocytes and platelets. All of them are involved in tissue regeneration. Platelets - the smallest of blood cells - contain granules with a huge amount of proteins, enzymes and biologically active substances. If platelets are activated (for example, if a vessel is damaged), then the contents of the granules enter the surrounding space. The active substances of platelets promote collagen synthesis, cell division and the formation of new tissue.
In order to obtain platelet-rich plasma, either special systems or a conventional laboratory centrifuge are used. During centrifugation, heavier cells (erythrocytes) settle to the bottom, while platelets remain in the blood plasma.
On a note
Plasma is considered to be enriched if it contains at least 1 million platelets per microliter (3-5 times the usual concentration).
The PRP method is actively used in dentistry and maxillofacial surgery to restore bone areas, in dermatology and cosmetology to increase tissue elasticity, as well as in cardiology, ophthalmology and burn patients. Let's take a closer look at how the PRP procedure can be used in orthopedics.
PRR-therapy in orthopedics: features of joint treatment
Plasmolifting of joints: all about the procedure
The mechanism of action of platelets when they enter the affected area can be compared with the construction process. Thus, “construction supervision” in the form of growth factors influences many processes:
Formation of the base, or "reinforcement". There is an increase in collagen synthesis, which makes tissues elastic and elastic, which is especially important for muscles and ligaments.
Attracting special building cells (for example, fibroblasts), thanks to which new durable tissue is formed.
Establishment of supply - improving microcirculation due to the growth of new vessels allows the delivery of nutrients and "building materials" to the affected area.
PRP plasma therapy can be used for various joint lesions. For example, PRP therapy of the knee joint helps with patellar tendinitis and lesions of the ICS (medial collateral ligament) of the knee. It is not uncommon for tennis or golfers to suffer from epicondylitis, and PRP elbow therapy is one of the solutions. The PRP-therapy technique is also used in surgical interventions, for example, in operations on the shoulder joint. For patients with coxarthrosis of varying degrees, PRP therapy of the hip joint may be useful.
Indications and contraindications for autoplasma therapy
The main indications for PRP therapy in orthopedics:
- damage to the cartilage tissue of the joint (arthrosis, arthritis, osteochondritis, chondromalacia);
- damage to ligaments, tendons and muscles (tendinitis, myositis);
- damage to the spine (osteochondrosis, damage to the intervertebral disc);
- incomplete ruptures of ligaments, tendons, joint capsules;
- inflammatory processes;
- application during and after joint surgery to accelerate healing.
- Side effects of the procedure include soreness at the injection site, especially with injections into the tendon. To eliminate this effect, provide rest and apply cold to the affected area on the first day after treatment. Bleeding, nerve damage, or infection may also occur with the injection. To eliminate such risks, it is necessary to carry out the PRP-therapy procedure in a reliable medical center and with a qualified specialist.
Contraindications to PRP therapy:
- acute infectious diseases;
- exacerbation of chronic diseases;
- diseases of the hematopoietic system;
- systemic connective tissue diseases.
- PRP-therapy procedure: stages and nuances
Medication blockade: how are injections done for pain in the joints and spine?
When carrying out PRP therapy, the preparation of the patient consists in examining a doctor, if necessary, additional studies can be prescribed.
- To obtain platelet-rich plasma from a patient, 20-50 ml of blood is taken from a vein with special prp tubes. This procedure is practically painless. The blood mixed with the anticoagulant is placed in a centrifuge for fractionation. Platelet-rich plasma is then isolated from the treated sample.
- The resulting sample is injected into the affected area using a special very thin needle. Before that, local anesthesia is performed in the injection area, so that the procedure itself is no more painful than a regular injection. The patient is sitting or lying on a couch. The schedule of administration is indicated by the doctor, and if necessary, the accuracy of the PRP injection is monitored using ultrasound. The procedure itself takes place quite quickly, on average 20 minutes.
- There is no need to recover from PRP therapy, and the patient can immediately return to daily activities. In rare cases, a rest mode may be prescribed. However, it is necessary to exclude intense loads and weight lifting.
The result of the procedure: feel the difference
After PRP therapy, the results can be felt after a few weeks, and long-term effects are noted after 6-12 months. Immediately after the therapy, it is possible to increase inflammation, stiffness and pain, which is associated with the activation of regeneration. However, in the future, patients note a decrease in pain and inflammation, an improvement in joint mobility, an improvement in the elasticity of the ligaments and an increase in the protective properties of cartilage tissue.
The effect is achieved on average after 3-5 injections (sometimes up to 7). The duration of remission depends on the stage of the disease and can range from several months to several years.
The cost of a course of treatment with platelet-rich plasma
Treatment with the PRP method in orthopedics is widespread abroad, as well as in the central regions of Russia. In other areas, this method is still less represented. The cost of one injection ranges from 550 to 2500€.
Many clinics offer several types of joint treatment with platelet-rich plasma at once, which differ in price. First of all, it depends on the method of obtaining the plasma. The use of certified European systems to obtain PRP increases the cost. Some clinics offer a whole course of PRP therapy at once, which is slightly cheaper than paying for each injection separately. For the treatment, you will also need a specialist consultation and, possibly, additional research, which are not included in the price of the injection.
In any case, the use of PRP for the treatment of joints is now becoming more and more available. Thanks to the experience of foreign colleagues, this procedure is gaining more and more fans in the medical community. And even if this is not a panacea, then one of the safest paths to the long-awaited freedom of movement.