There has been a surge in the use of platelet-rich plasma in regenerative medicine, especially in orthopedics. Platelet-rich plasma is a solution that is prepared from the patient’s blood and by the centrifugation process platelet is concentrated. This solution contains platelets along with various growth factors in the amount more than what normally is present in the blood and is well known to modulate the ongoing inflammatory process in the tendons, ligaments, bone, and muscles, helping them to heal.

How is the platelet-rich plasma solution prepared?

It is important to remember that PRP is an autologous solution. First of all, the blood is drawn from one of a superficial vein and is centrifuged. The centrifugation process separates the blood components into various layers. The layer of platelet cells is taken, mixed with a small amount of plasma, and is then ready to be injected into the site of injury.

What are the shoulder disorders where PRP can be used?

There is a range of shoulder pathologies where PRP has been used clinically. It is even used as an alternative to surgery in some cases owing to its role in tissue healing and minimal side effects. The shoulder pathologies where PRP solution has been successfully used are:

  1. Rotator cuff tears.
  2. Calcific Tendonitis.
  3. Subacromial bursitis.
  4. Rotator cuff tendinopathy.
  5. Biceps tendinopathy.
  6. Labral tears.

Recently, PRP solution has been used as adjunctive in cases where surgical rotator cuff repair, arthroscopic acromioplasty has been done. Studies suggest the use of PRP is successful in reducing post-operative pain, improving the healing of the surgical repair, as well as reducing the incidence of re-tear.

What are the risks of PRP injection?

Because PRP is an autologous solution, prepared from the patient’s blood, there is no risk of new disease transmission. There is no risk of overdose either because the platelet is the body’s own cell and their local rise will not affect tissue function. Theoretically, there is a risk of infection of the joint due to the injection, equivalent to a steroid injection, but the risk is low.

Is it better than steroid injection?

Steroid injection, in a few cases, has been found to cause tissue atrophy, muscle tears, tendon rupture as well as articular cartilage damage. There are no such risks with PRP injections.

 

At the Doral Orthopedic Center, we administer the PRP injection with ultrasound-guided accuracy.  We employ the McGinley Augmented Reality system.  This allows the clinician to visualize the image and the treatment site simultaneously.   The patient is completely awake and does not require sedation. Ergonomic and functional benefits are the result.   The ultrasound image can be overlayed on the physical anatomy of the patient.    No longer does the clinician need to turn their head away to look at the ultrasound screen.

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