Platelet Rich Plasma (PRP) is beginning to be incorporated by hospital systems and small clinics as there is now an acceptance that PRP is successful in terms of reducing pain and improving function by encouraging healing and repair. When choosing a provider to offer the service, it is difficult to know the treatment philosophy and/or the experience of the provider. The successful treatment of an injury with PRP, requires that injured ligaments and tendons (that support the joint) be treated, in addition to the joint. This is the concept of biotensegrity. If the person offering you the treatment does not know what biotensegrity is and how to apply those principles to treatment, get treatment somewhere else.

Is treating only the joint with PRP enough?

Treatment of PRP or “stem” cells into the joint is not enough. Often times the joint is not the primary pain generator. I have treated 4 or 5 patients after their total joint replacement for pain that existed prior to their major surgery. The surgery did not address the cause of the pain. This is not to say that they didn’t need surgery, but perhaps they needed a more comprehensive treatment plan that incorporated the treatment of ligaments, tendons, fascia, and joint capsule first, which can all be pain generators.

Additionally, there are many patients with awful looking joints, who don’t have pain. They have instability or functional loss. Instability or functional loss is a ligament, tendon, or fascia injury. Treatment of the soft tissue with a biologic, such as PRP, should offer them an improvement in function.

How to pick the right PRP physician in Camas and Vancouver?

Before treatment is offered, the joint or area injured should be evaluated by a physical exam, x-ray, ultrasound and/or MRI. The physician should correlate what is seen on the imaging with where your pain is. The allopathic model, which limits time spent with you, becomes dependent on studies to make diagnosis. Good physicians, use their hands to make a diagnosis, which they prove with imaging. If a physician does not touch you and do a full evaluation, relying instead on imaging only, get treatment somewhere else. The same physician who evaluated you should give you the treatment.

When treatment is proposed, ask where the PRP is going to be injected. Ask if US guidance will be done. At this point, anyone injecting, should be using ultrasound or fluoroscopy to ensure that the PRP is injected exactly where it is intended to go. There is no need to guess anymore. Additionally ask what the concentration of platelet will be after processing. The standard processing is a 2 phase centrifugation. The platelet concentration should be 7-10x the baseline platelet level of your blood. I typically take 180-240 ml of blood from a patient, ending up with a volume of 21-28 ml of PRP. I can adjust the platelet concentration for the joint and I can also manipulate the PRP to make other injectables that aren’t as inflammatory. Download my book for more information.