Platelet-rich plasma (PRP) has become an increasingly accepted procedure within the past decade in the orthopedic community as a technique to improve tissue healing.
The term platelet-rich plasma refers to any fraction of autologous blood comprising a higher concentration of platelets relative to the baseline
In recent times, PRP has been used for various musculoskeletal conditions such as patellar tendinopathy, rotator cuff repair, lateral epicondylitis, knee osteoarthritis, and osteochondral lesions of the talus among others.
Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan, provides orthopedic surgery to patients in Los Angeles, Century City, CA, and surrounding locations.
Healing Effects of PRP
PRP brings about musculoskeletal healing in multiple ways. PRP improves the mobilization of circulation-derived cells as a treatment modality for tendon healing.
This mobilization may include inflammatory cells that release growth factors and cytokines, and fibroblast-like cells that synthesize matrix. In comparison to serum, PRP has been proven to substantially enhance the deposition of collagen-rich extracellular matrix, with a higher level of collagen in comparison to placebo.
Notably, research has shown that PRP-treated tendon tears actually comprise fewer blood vessels in comparison to placebo, potentially indicating a more physiological process of healing.
The Role of Growth Factors
Compared to whole blood, PRP consists of higher concentrations of specific growth factors. Therefore, PRP may be able to replace hematoma with a higher concentration of growth factors and platelets to enhance healing. In addition, PRP has been proven to encourage angiogenesis through activation of PRP-releasate.
PRP may be used as a conservative treatment or as adjunctive therapy during surgery, depending on the pathology. PRP may be able to improve upon tendinopathic changes or partial tendon tears in which the tendon ends are not retracted when used as conservative treatment.
PRP injections are used most often as adjunct conservative treatment. For chronic tendinopathy or osteoarthritis patients, PRP is usually recommended when first-line treatment (rest, physical therapy) is ineffective.
Professional athletes may benefit from in-season PRP to mitigate pain and enhance function as an interim treatment until offseason when they can undergo a surgical procedure. In the case of hip labral tears and chronic tendinopathies, this is especially true.
PRP injections can help enhance healing when there is tendinosis without retraction or partial thickness involvement. Surgical repair is the best treatment for complete tears, especially if these tears are retracted and chronic.
Hip Osteoarthritis, Acute Inflammation, and Labral Tears
The conservative treatment of osteoarthritis (OA) of the hip joint usually involves hyaluronic acid (HA) or intra-articular injections of corticosteroids.
But PRP has shown promising results in the reduction of early-stage OA symptoms more successfully than HA. While there is limited availability of research on the effectiveness of PRP on hip OA, the concept and mechanism of action are the same as in the case of knee OA.
PRP injections are effective in cases of OA as well as for professional athletes who have acute hip inflammation because of intra-articular pathology.
In such cases, PRP addresses the symptoms of inflammation and allows the athlete to quickly return to play without the potential adverse effects of steroids.
Some innovative and established applications of PRP are available for the treatment of hip and pelvic pathologies. While the results of many of these applications have not been elaborated by researchers, the experience of doctors indicates that symptomatic and functional results are successful in most patients.
Board certified orthopedic surgeon Dr. Tigran Garabekyan receives patients from Los Angeles, Century City, CA, and nearby areas for orthopedic surgery.
Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:
Century City / Los Angeles: 310.595.1030
Serving patients in Encino, Sherman Oaks, Van Nuys, North Hollywood, Burbank, Glendale, West Hollywood, Century City, Beverly Hills, Santa Monica, Los Angeles, and other neighboring cities in the greater Los Angeles, California area.
Also visit http://www.drgorthopedics.com/