Platelet-Rich Plasma

Overview

What is platelet-rich plasma (PRP)?

Platelet-rich plasma (PRP) relies on platelets (cell fragments found in blood) to improve tissue function. Other names for some of these products include platelet-rich growth factors (GFs), platelet-rich fibrin (PRF) and platelet concentrates (PCs).

What does platelet-rich plasma (PRP) do?

Different types of PRP products are usually given as injections (shots) to heal and repair injuries. The job of platelets in the body is to help blood clot when there is an injury. The cytokines and growth factors that are in platelets can help repair injuries and encourage healing.

Studies have indicated that PRP is or may be useful to treat:

  • Tennis elbow (lateral epicondylitis).
  • Knee osteoarthritis (PRP is being combined with other options to lessen pain, improve function and possibly help repair cartilage. A certain type of PRP called leukocyte-poor PRP or LP-PRP has been suggested as the most useful for knee osteoarthritis.)
  • Sports injuries such as pulled muscles, joint sprains or ligament tears.
  • Wounds.
  • Hair loss.

Procedure Details

What can I expect during the procedure?

Blood is removed from the arm using a needle into the vein. Then the blood is processed in a centrifuge, equipment that separates blood components into different parts according to their density. The platelets are separated into blood serum (plasma), while some of the white and red blood cells may be removed. Therefore, by spinning the blood, the equipment concentrates the platelets and produces what is called platelet-rich plasma (PRP).

However, depending on the protocol used to prepare PRP, there are multiple different products that can result from putting blood into the centrifuge. Therefore, different PRP preparations have different number on platelets, white blood cells, and red blood cells. For example, a product called platelet-poor plasma (PPP) can be formed when most of the platelets are removed from the serum. The serum that is left contains cytokines, proteins and growth factors. Cytokines are emitted by immune system cells.

If the platelet cell membranes have been lysed, or destroyed, a product called platelet lysate (PL), or human platelet lysate (hPL) can be formed. PL often is made by freezing and thawing the plasma. PL has a higher number of some growth factors and cytokines than PPP.

Risks / Benefits

What are the risks of platelet-rich plasma (PRP)?

As with any type of injection, there are small risks of bleeding, pain and infection. When the platelets are from the patient who will be using them, the product is not expected to create allergies or have risks of cross infection. One of the main limitations with PRP products is that every preparation in every patient can be different. No two preparations are the same. Understanding the composition of these therapies required measuring numerous complex and different factors. This variation limits our understanding of when and how these therapies may succeed and fail, and the matter of current research endeavors.

Additional Details

Does insurance cover platelet-rich plasma (PRP)?

No. Most insurers do not cover this type of therapy.

Last reviewed by a Cleveland Clinic medical professional on 05/06/2019.

References

  • American Academy of Orthopaedic Surgeons. Platelet-Rich Plasma (PRP). (https://orthoinfo.aaos.org/en/treatment/platelet-rich-plasma-prp/) Accessed 5/9/2019.
  • American Council on Science and Health. Platelet-Rich Plasma is Profitable, But How Well Does it Work? (https://www.acsh.org/news/2019/02/12/platelet-rich-plasma-profitable-how-well-does-it-work-13806) Accessed 5/9/2019.
  • Piuzzi NS, Chughtai M, Khlopas A, Harwin, SF, et al. Platelet-rich plasma for the treatment of knee osteoarthritis: A review. (https://www.thieme-connect.com/products/ejournals/html/10.1055/s-0037-1603795#N68633) J Knee Surg 2017; 30(07): 627-633. Accessed 5/9/2019.
  • Lespasio MJ, Piuzzi NS, Husni ME, Muschler GF, Guarino A, Mont MA. Knee Osteoarthritis: A Primer. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5638628/) Perm J. 2017;21:16-183. Accessed on 5/9/2019.
  • Dohan ehrenfest DM, Rasmusson L, Albrektsson T. Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol. 2009;27(3):158-67.
  • Hussain N, Johal H, Bhandari M. An evidence-based evaluation on the use of platelet rich plasma in orthopedics - a review of the literature. SICOT J. 2017;3:57.
  • Martínez CE, Smith PC, Palma alvarado VA. The influence of platelet-derived products on angiogenesis and tissue repair: a concise update. (https://www.frontiersin.org/articles/10.3389/fphys.2015.00290/full) Front Physiol. 2015;6:290. Accessed 5/9/2019.

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