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PRP Prolotherapy

PRP Prolotherapy is a regenerative injection procedure very related to regular Prolotherapy. This means that is helps to regenerate damaged tissue. This injection treatment is a safe non-surgical approach for chronic injuries, pain and arthritis using injections to stimulate healing and repair of damaged tissue.

Common conditions treated with PRP Prolotherapy include: osteoarthritis and instability of joints in many areas of the body but the most common include the knee and shoulder joints and their related weakened ligaments and tendons. PRP Prolotherapy is a relatively new addition to regular Prolotherapy treatments. Please read my Prolotherapy handout for the basics of this treatment. In this treatment, not a glucose solution but your own blood is used to stimulate healing. When I collect your blood and separate it in the in centrifuge the “PRP” layer or “platelet rich plasma” layer contains activated platelets, these platelets attract stem cells from your bone marrow to the areas injected. Therefore this is a type of “stem cell” therapy treatment!!

No one knows exactly yet but most of us doing this think that each PRP Prolotherapy injection is about three times the strength of a single regular Prolotherapy injection. Therefore, instead of needing about 6 treatments for a good result, you may only need one or two about 6 weeks apart.

What about the procedure itself?

There are several different types of PRP systems out there. The type I have currently chosen to use is the Arthrex system. I am looking at other kits to use for smaller joints such as hand osteoarthritis. What you can expect is that I will ask you to come in and then I will take your blood. When I have the blood, I will spin it down in a special centrifuge and then I will commence to marking the sites on you I will be injecting. I usually get about 5-6 mL of platelet-rich plasma per kit, and if this is not enough for the whole treatment then I usually supplement it with 15% dextrose injections, the same that are used with regular Prolotherapy treatments.

Please see the attached for more information of the Arthrex system:

Arthrex ACP® Double Syringe System

ACP – A Patients Guide to Natural Healing

Autologous Conditioned Plasma (ACP) – Animations – Patient Education

Arthrex ACP® Double Syringe System – Autologous Conditioned Plasma – Presentation Slides

Remember, like regular Prolotherapy, anti-inflammatory drugs should not be taken during the treatment at least 5 days but preferably for two weeks before and after each treatment because they will increase the risk of bleeding and interfere with the intention of the treatment. Anti-inflammatory medications include Advil or Ibuprofen, full strength Aspirin (325 mg), Aleve or Naproxen, Prednisone, steroids, other NSAIDS such as Celebrex, Voltaren or Arthrotec. Some herbal supplements which also have anti-inflammatory properties should also not be taken such as Cercumen, and arnica.

Treatments occur at intervals usually every 6 weeks.

What are the major risks of PRP Prolotherapy?

  1. Infection due to the needling. Therefore do not go into public swimming pools, hot tubs or lakes for 3-5 days after each treatment. Showering the day of or the next day is fine.
  2. Pneumothorax or puncture into the lung, very rare ( I am very careful)
  3. Bruising – temporary
  4. Nerve irritation – this is temporary
  5. Allergic reaction – if you are allergic to corn or xylocaine

What can I expect right after a treatment?

PRP Prolotherapy will not result in immediate pain relief, just as regular Prolotherapy. However, there is often more aggravation for a few days after the treatment than with regular Prolotherapy. Otherwise the cautions are the same as with regular Prolotherapy.