An exciting area where accelerated tissue healing has been demonstrated is wound healing with the use of platelet rich plasma (PRP). This substance is now being used to help accelerate the healing of conditions such as tendonitis, ligament strains, muscle injury, arthritis, and cartilage defects.

Platelet rich plasma is obtained from a sample of the patient’s whole blood. Blood is drawn from the patient into a special container and then processed in a specific fashion to allow the largest number of platelets to be harvested.

Platelets are cells that contain multiple healing and growth factors. These include the following:

• Fibrinogen: helps with clotting and framework making.
• Adhesion molecules: helps cells to bind to each other.
• Platelets: initiates clotting and inflammation.
• IL-1: promotes migration of macrophages.
• Platelet derived growth factor: helps with healing; stimulates growth of blood vessels; attracts macrophages.
• Transforming growth factor B: stimulates formation of collagen.
• Epidermal growth factor: stimulates connective tissue growth.
• Vascular endothelial growth factor: stimulates formation of new blood vessels; promotes healing.

All of these platelet-derived growth factors recruit undifferentiated cells to the site of injury and stimulate their growth. When PRP is injected (generally, using ultrasound guidance) into an area of tissue injury, it stimulates damaged tissue to grow in an accelerated manner.

Prior to the 2009 Super Bowl, Hines Ward, the Pittsburgh Steelers’ major receiving threat received a treatment of platelet rich plasma to help accelerated the healing of an injury. This treatment allowed Ward to play. While he didn’t make the huge impact he ordinarily had during the season, he was healthy enough to draw defenders to him which allowed players like Santonio Holmes to break free. Plus, the psychological edge it gave the Pittsburgh team to know that Ward was ready obviously also was an advantage.

Treatments such as platelet rich plasma and stem cells are introducing a new era of regenerative medicine which will permit the management of chronic degenerative conditions such as arthritis and tendonitis, as well as various acute injuries.

PRP needs to be prepared in a way to ensure a maximal number of platelets along with a high concentration of growth factors. Obviously, the more growth factors that can be delivered to the site of injury, the more likely tissue healing takes place.

While most people respond to one course of treatment, about 10-20 per cent of patients will require a second procedure. Whether a second procedure is needed is usually determined at 1-3 months following the initial procedure. Diagnostic ultrasound using Doppler to assess the amount of residual inflammation is useful for determining the need for another procedure.

Contraindications to the administration of PRP include platelet dysfunction, low platelet count, infection, and anemia.

Following the procedure, patients must rest the affected area to prevent leakage of the PRP from the site.

Pain at the injection site is common for a 1-2 day period following the procedure.

For more information on platelet rich plasma (PRP) and stem cell therapy, call the Arthritis and Osteoporosis Center of Maryland at (301) 694-5800