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PRP injections are being used for a growing number of orthopedic injuries and conditions.  What is PRP?  What are the different types of PRP?  Are there precautions after PRP injections that should be followed?  Let’s dig in.

 


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What is PRP?

PRP stands for platelet-rich plasma.  This is a concentration of the patient’s own blood platelets in their serum.  Blood is drawn from a peripheral site such as the arm or hand and then spun down in a centrifuge concentrating the platelets.  Platelets contain growth factors and chemical mediators which can reduce inflammation, pain, improve blood flow and turbocharge the natural healing process.  Current indications for PRP include patellar, hamstring and  Achilles tendon injuries, golfer’s elbow, and mild knee osteoarthritis (1).

Different Types of PRP Regenexx PRP vs Standard PRP = Precautions before and after PRP injections

Did you know that there are three different types of PRP?  Yes, and which one is used is critical to your clinical improvement.

Red PRP

The PRP is actually red in color as it contains both red and white blood cells.  This was the first type of PRP available and is produced by older, less advanced centrifuges.  A centrifuge is a small tabletop machine that spins the blood which allows for separation and concentration of the blood. Red PRP is typically concentrated to lower levels.

Lower Concentration Amber PRP

This PRP is actually amber in color and contains few white and red blood cells.  It is typically concentrated to lower levels and causes less tissue reaction and swelling.

HIgher Concentration Amber PRP

This PRP is also amber in color and contains few white and red blood cells.  It is concentrated to a higher level which is not possible at most clinics as they use bedside centrifuges.  At Centeno-Schultz Clinic we understand the importance of having different PRP concentrations to treat different conditions.  We have a state of the art laboratory with stem cell scientists that can super concentrate PRP to ensure for your best clinical outcome.  Our current publication demonstrates that higher concentrations of PRP are useful for tendon injuries (2).

 

To better understand PRP and how it functions please click on the video below.

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Should You Ice After PRP Injection?

Despite what many websites and clinics recommend,  ice should not be used after PRP injections.  Inflammation is an important part of the healing process.  Ice reduces inflammation and swelling and therefore may compromise the healing process (3).  Ice also prompts the blood vessels to get smaller thereby restricting blood flow.  Blood flow is critical to healing.  One of the precautions after PRP injections is to avoid ice.  To learn more about the ligament healing after PRP or stem cell injections please click on the video below.

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How Long Should You Rest After PRP Injections?

Rest and healing are important after PRP injections.  It is important that the injected PRP be given the opportunity to heal the affected area.  In order of this to happen the PRP must be given the opportunity to set in place. Platelets release important growth factors and proteins that promote tissue regeneration and healing.  It takes up to seven days for the growth factors to be released from the platelets (4)   Exercise may displace and move the PRP  from injected site thereby compromising healing and outcome.  For example, if your kneecap tendon was injected, running or heavy weightlifting immediately after the injection may result in the PRP being pushed out of the tendon.  Rest for the first two weeks followed by the gradual return to normal exercise is ideal closely monitoring pain and swelling.  One of the precautions after PRP Injection is to avoid vigorous exercise and weightlifting and rest which will allow the PRP work and promote healing.

Can I Drink Alcohol After PRP Injections?

Alcohol can negatively affect platelet function.  Specifically, it can decrease its platelet activation and aggregation (5) and response to other proteins and enzymes. (6).  Alcohol can also affect stem cell numbers and function which may compromise healing.   The effectiveness of PRP  is based on your own body’s ability to heal.  Commit yourself to healthy foods, good sleep and no alcohol for maximal healing.  One of the precautions after PRP injections is to avoid alcohol.

In Conclusion

PRP  is a concentration of the patient’s own blood platelets in their serum.  Platelets contain growth factors and mediators that reduce inflammation, improve blood flow and turbocharge the natural healing process.  There are different types of PRP which are available in different concentrations. Precautions after PRP injections include avoiding the use of ice, limiting exercise and alcohol.  For the best clinical outcome use heat, rest and adopt a healthy lifestyle.


1. 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. doi:10.1051/sicotj/2017036

2.Berger DR, Centeno CJ, Steinmetz NJ. Platelet lysates from aged donors promote human tenocyte proliferation and migration in a concentration-dependent manner. Bone Joint Res. 2019;8(1):32–40. Published 2019 Feb 2. doi:10.1302/2046-3758.81.BJR-2018-0164.R1

3.Hsu SL, Liang R, Woo SL. Functional tissue engineering of ligament healing. Sports Med Arthrosc Rehabil Ther Technol. 2010;2:12. Published 2010 May 21. doi:10.1186/1758-2555-2-12

4.Golebiewska EM, Poole AW. Platelet secretion: From haemostasis to wound healing and beyondBlood Rev. 2015;29(3):153–162. doi:10.1016/j.blre.2014.10.003

5. Mukamal KJ, Massaro JM, Ault KA, et al. Alcohol consumption and platelet activation and aggregation among women and men: the Framingham Offspring Study. Alcohol Clin Exp Res. 2005;29(10):1906–1912.DOI: 10.1097/01.alc.0000183011.86768.61.

6. Olas B, Wachowicz B, Saluk-Juszczak J, Zieliński T. Effect of resveratrol, a natural polyphenolic compound, on platelet activation induced by endotoxin or thrombin. Thromb Res. 2002;107(3–4):141–145.DOI: 10.1016/s0049-3848(02)00273-6.