This position statement was developed by the surgeons of the Bone and Joint Institute of Tennessee after collectively reviewing the most up-to-date scientific studies of biologic therapies. There is an increasing interest in the use of biologic products, including PRP therapies, as modalities for treatment of the musculoskeletal system. As orthopaedic surgeons, we must critically analyze the scientific basis for these therapeutic options, including the benefits, risks, efficacy, and the regulatory pathways for approval. Currently many emerging biologic therapies lack a clear demonstration of safety and effectiveness for traditional orthopaedic treatments.
PLATELET-RICH PLASMA (PRP)
WHAT IS PRP?
Blood is made of a liquid called “plasma” and small solid components including red blood cells, white blood cells, and platelets. Platelets contain hundreds of proteins referred to as growth factors, which signal the body’s healing response. PRP contains concentrations of platelets 5-10 times greater than what is found in normal blood.
HOW IS A PRP TREATMENT PERFORMED?
Similar to a lab draw, a sample of blood is taken in the clinic. The platelets are separated from the other cellular components and the concentration of platelets is increased through a process called centrifugation. The concentrated sample is then injected into an area to facilitate healing.
HOW EFFECTIVE IS PRP FOR ORTHOPAEDIC CONDITIONS?
It is hypothesized that the increased localization of concentrated growth factors may potentially speed up the healing process. Research studies are currently being conducted to evaluate the effectiveness of PRP treatment for a variety of conditions, but presently the results of the available studies are largely inconclusive.
- Conditions where PRP shows the most promise and scientific evidence: tendinopathy (such as tennis elbow and chronic patellar tendonitis). Conditions with possible but unproven benefit: osteoarthritis, muscle strain (such as hamstring injury), augmentation of rotator cuff repair.
- Conditions with no demonstrated benefit: ligament tears, meniscus tears, labral tears.
WHAT ARE THE RISKS OF PRP?
- Increased pain at the injection site, infection, tissue damage, and nerve injury due to injection.
- Potential lack of effectiveness.
HOW MUCH DOES PRP COST?
Currently the charge for PRP at Bone and Joint Institute of Tennessee ranges from $350 to $800, depending on the type of PRP injection. You will need to check your eligibility with your health insurance carrier as very few insurance plans provide even partial reimbursement for the treatment. Therefore, this is typically handled as a self pay treatment option.