PRP for Patellar Tendinopathy – Is it Your Best Option?
The patella tendon (PT) (also known as the patella ligament, because it connects bone to bone) is a ligament that connects your kneecap (patella) to your shin bone (tibia). Damage to this ligament is common in running and jumping athletes. Here let’s discuss pathologies in this tendon, symptoms, and the best treatment options that currently exist.
What Is a Platelet-Rich Plasma (PRP) Injection?
Platelet-rich plasma (PRP) is prepared through a relatively straightforward process that involves the collection and concentration of platelets and growth factors from a patient’s own blood. Here are the general steps involved in making PRP:
A medical professional typically begins by drawing a small amount of the patient’s blood, usually from a vein in the arm. The amount of blood collected can vary but is typically in the range of 15 to 60 milliliters, depending on the specific treatment and the PRP preparation system being used.
The collected blood is then placed into a specialized centrifuge machine. The centrifuge rapidly spins the blood at high speeds, separating its components based on their density. Blood consists of several components, including red blood cells, white blood cells, plasma, and platelets. The centrifugation process separates these components.
Separation of PRP:
After centrifugation, the blood will be separated into distinct layers. The layer containing the concentrated platelets and growth factors is the PRP layer. It is typically a straw-colored fluid located just above the layer of red blood cells.
Using a syringe or a specialized collection system, the PRP layer is carefully extracted from the centrifuge tube. This concentrated PRP is what will be used for the treatment.
In some cases, an activating agent such as calcium chloride or the enzyme thrombin may be added to the PRP to initiate the release of growth factors from the platelets. Activation can enhance the therapeutic properties of PRP, but it’s not always necessary, and its use can vary depending on the medical practitioner’s preference and the specific treatment.
The prepared PRP is then ready for injection or application to the target area. This may involve the use of ultrasound or other guidance techniques to ensure precise delivery of PRP to the injured or affected tissue.
The resulting PRP is rich in platelets, which contain a high concentration of growth factors and bioactive proteins that are thought to promote tissue healing and regeneration. These growth factors, such as platelet-derived growth factor (PDGF), transforming growth factor-beta (TGF-β), and vascular endothelial growth factor (VEGF), play a key role in the regenerative properties of PRP.
Not all PRP is created equally – to understand how Regenexx is different and how we are able to customize your platelets to maximize your outcome, visit here: Regenexx Difference: How We Customize PRP.
It’s important to note that the specific PRP preparation methods and equipment used can vary among healthcare providers and medical facilities. The exact composition and concentration of growth factors in PRP may also differ, depending on the technique and equipment used. The choice of PRP preparation method can be influenced by the specific medical condition being treated and the preferences of the treating physician.
When Is a PRP Injection Recommended?
With any musculoskeletal condition, best practice is always to start with simple and basic therapy to see if a simple solution to the problem can be found. This is typically physical therapy. Its goal is to identify any biomechanical factors that are adding additional stress to the patella tendon and start strengthening the tendon through eccentric exercises.
Doing this for four to six weeks and progressing to a home exercise program is the first step. If you are not seeing any improvement of symptoms and getting stronger over time, then the next step would be to seek alternative treatment that will help your tendon heal.
PRP has many advantages and is typically a good next step when the above physical therapy fails to improve the symptoms. If a physician suggests any type of corticosteroid injection into the tendon, it is important that you avoid this at all costs.
High-dose steroids have the potential to cause further damage and in some cases cause rupture to the tendon. So please avoid!
PRP is a regenerative medicine treatment that has gained popularity for its potential to aid in the healing of various tissues, including tendons. PRP contains a concentration of growth factors that can stimulate tissue repair and regeneration. Some of the growth factors found in PRP that play a role in tendon healing include:
Platelet-derived growth factor (PDGF): PDGF is a growth factor that stimulates cell proliferation and collagen production. It plays a crucial role in the early stages of wound healing and tissue repair, helping to recruit and activate cells involved in tissue regeneration.
Transforming growth factor-beta (TGF-β): TGF-β is involved in the regulation of cell growth and differentiation. It can promote the synthesis of extracellular matrix components, including collagen and proteoglycans, which are essential for tendon tissue integrity.
Vascular endothelial growth factor (VEGF): VEGF stimulates the formation of new blood vessels, a process known as angiogenesis. Adequate blood supply to the injured area is crucial for delivering oxygen and nutrients to support tissue repair.
Insulin-like growth factor (IGF): IGF promotes cell growth, proliferation, and differentiation. It plays a role in tissue regeneration and can enhance the synthesis of collagen and other extracellular matrix components.
Fibroblast growth factor (FGF): FGF stimulates the growth and activity of fibroblasts, which are cells responsible for producing collagen and other structural proteins in tendons. FGF can contribute to the formation of a strong and functional tendon matrix.
Epidermal growth factor (EGF): EGF supports the proliferation and migration of various cell types involved in tissue repair, helping to create a conducive environment for healing.
When PRP is administered into an injured tendon, these growth factors are thought to enhance the natural healing process by promoting cell recruitment, proliferation, and tissue regeneration.
However, it’s important to note that the specific composition of PRP can vary based on the preparation method and individual factors, which can influence its effectiveness. PRP treatment for tendon injuries should be performed under the guidance of a medical professional who can determine the appropriate concentration and application technique for the specific injury and the particular patient.
Benefits of PRP Therapy for Patellar Tendinopathy
PRP therapy has been used as a treatment option for various musculoskeletal conditions, including patellar tendinopathy (also known as jumper’s knee). Patellar tendinopathy is a painful condition that affects the patellar tendon, which connects the patella (kneecap) to the shinbone.
PRP therapy is considered a potential treatment for this condition due to its regenerative properties and ability to stimulate tissue healing. Here are some potential benefits of PRP therapy for patellar tendinopathy:
Promotes Tissue Healing
PRP contains a concentrated amount of growth factors and cytokines that can promote tissue repair and regeneration. When PRP is injected into the affected area of the patellar tendon, it may stimulate the body’s natural healing mechanisms, helping to repair damaged tendon tissue.
One of the primary symptoms of patellar tendinopathy is pain, especially during activities that involve jumping or kneeling. PRP therapy has the potential to reduce pain by addressing the underlying tissue damage and inflammation. Many individuals experience pain relief after PRP treatment.
PRP therapy is a minimally invasive, non-surgical treatment option for patellar tendinopathy. This can be particularly attractive to individuals who want to avoid surgery or have not responded well to other conservative treatments, such as rest, physical therapy, and anti-inflammatory medications.
Low Risk of Allergic Reactions
Since PRP is derived from the patient’s own blood, there is a low risk of an allergic reaction or an adverse immune response. This makes it a safe treatment option for most individuals.
Potential to Improve Function
PRP therapy may not only reduce pain but may also improve the function of the affected tendon. Enhanced healing and tissue regeneration can contribute to better tendon strength and function over time, allowing individuals to return to their normal activities.
PRP injections typically involve minimal downtime, allowing patients to resume their daily activities relatively quickly. However, it’s essential to follow post-treatment guidelines provided by your healthcare provider to optimize the healing process.
It’s important to note that the effectiveness of PRP therapy can vary from person to person, and not all individuals with patellar tendinopathy may respond favorably to this treatment. The success of PRP therapy may depend on factors such as the severity of the condition, the patient’s overall health, and the specific protocol used for PRP preparation and injection.
Our Regenexx PRP Injections for Patellar Tendinopathy
The Centeno-Schultz Clinic is the clinical HQ for Regenexx. Our physicians are in the top 1% of all interventional physicians, continue to publish research yearly, teach other physicians within the Regenexx network, and have the most experience in treating musculoskeletal injuries.
Achieving the Best Results from Our PRP Knee Injections
To maximize your outcome, our physician will do a detailed examination, checking everything from nerve activation/function to hip/knee/ankle stability, and will utilize a diagnostic ultrasound. Together, at the end of your hour-long evaluation, the physician will come up with a complete treatment plan.
There are multiple ways to improve the symptoms of your patella tendinopathy. If you have been dealing with this or any other nagging injury, connect with us to get set up for an evaluation so we can help you get back to the things you want to do faster!
Having doubts about what treatment path to follow? Consult with us and get a second opinion.
Christopher J. Centeno, M.D. is an international expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate in orthopedics. He is board-certified in physical medicine and rehabilitation with a subspecialty of pain medicine through The American Board of Physical Medicine and Rehabilitation. Dr. Centeno is one of the few physicians in the world with extensive experience in the culture expansion of and clinical use of adult bone marrow concentrate to treat orthopedic injuries. His clinic incorporates a variety of revolutionary pain management techniques to bring its broad patient base relief and results. Dr. Centeno treats patients from all over the US who…
John R. Schultz M.D. is a national expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate for orthopedic injuries. He is board certified in Anesthesiology and Pain Medicine and underwent fellowship training in both. Dr. Schultz has extensive experience with same day as well as culture expanded bone marrow concentrate and sees patients at the CSC Broomfield, Colorado Clinic, as well the Regenexx Clinic in Grand Cayman. Dr. Schultz emphasis is on the evaluation and treatment of thoracic and cervical disc, facet, nerve, and ligament injuries including the non-surgical treatment of Craniocervical instability (CCI). Dr. Schultz trained at George Washington School of…
Dr. Pitts is originally from Chicago, IL but is a medical graduate of Vanderbilt School of Medicine in Nashville, TN. After Vanderbilt, he completed a residency in Physical Medicine and Rehabilitation (PM&R) at Emory University in Atlanta, GA. The focus of PM&R is the restoration of function and quality of life. In residency, he gained much experience in musculoskeletal medicine, rehabilitation, spine, and sports medicine along with some regenerative medicine. He also gained significant experience in fluoroscopically guided spinal procedures and peripheral injections. However, Dr. Pitts wanted to broaden his skills and treatment options beyond the current typical standards of care.
Post-residency, Dr. Markle was selected to the Interventional Orthopedic Fellowship program at the Centeno-Schultz Clinic. During his fellowship, he gained significant experience in the new field of Interventional Orthopedics and regenerative medicine, honing his skills in advanced injection techniques into the spine and joints treating patients with autologous, bone marrow concentrate and platelet solutions. Dr. Markle then accepted a full-time attending physician position at the Centeno-Schultz Clinic, where he both treats patients and trains Interventional Orthopedics fellows. Dr. Markle is an active member of the Interventional Orthopedic Foundation and serves as a course instructor, where he trains physicians from around the world.
Dr. Money is an Indiana native who now proudly calls Colorado home. He attended medical school at Kansas City University and then returned to Indiana to complete a Physical Medicine and Rehabilitation residency program at Indiana University, where he was trained on non-surgical methods to improve health and function as well as rehabilitative care following trauma, stroke, spinal cord injury, brain injury, etc. Dr. Money has been following the ideology behind Centeno-Schultz Clinic and Regenexx since he was in medical school, as he believed there had to be a better way to care for patients than the status quo. The human body has incredible healing capabilities…