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Robert J. Berkowitz, MD
John K. Krebs, MD
Robert M. Zanotti, MD
Daniel J. Zanotti, MD
Stay informed
Platelet-rich plasma (PRP) injections:
A natural way to treat knee arthritis
- Do you have early-stage knee osteoarthritis?
- Have you tried cortisone injections and still have pain?
- Have you had arthroscopic knee surgery and are still hurting?
You should know about PRP injections.
What is PRP?
PRP is platelet-rich plasma—a non-surgical healing treatment that uses components of your own blood to promote your body's ability to heal itself. Although PRP is relatively new to orthopedics, it has been used for years in plastic surgery, cardiothoracic surgery and dentistry.
What do blood platelets do?
Blood platelets help coordinate repair and regeneration of your body's soft tissue by releasing powerful healing proteins called growth factors.
How is PRP made?
PRP is made by drawing blood from the patient, then putting the blood in a machine called a centrifuge. The centrifuge takes several minutes to spin the blood down, separating the platelets from other blood components such as red and white blood cells. This process increases the concentration of platelets up to 1,000%.
"PRP is a form of Regenerative Injection Therapy, an emerging treatment approach that helps stimulate the body's natural healing powers."
How is a PRP treatment done?
After the patient's blood is spun down in the centrifuge, PRP is injected into the precise areas of the knee affected by osteoarthritis. "There are a couple of techniques to do it," says Robert Zanotti, MD. "You can inject into the knee, or sometimes you can actually inject directly into the bony defect."
Dr. Robert Zanotti answers
questions about PRP injections
Who is a good candidate for PRP injections?
"PRP isn't for someone who's 80 with advanced osteoarthritis. Ideal candidates for PRP are individuals with early-stage knee osteoarthritis who have:
- Good knee alignment
- Small arthritic areas in their knees
- Unsatisfactory results from cortisone injections
- Knee pain and stiffness even after lubricating gel injections such as Synvisc
"If you've had a knee scoped and cleaned out and were told you have small arthritic spots or OCDs—osteochondral defects—you're probably a good candidate for PRP injections."
How is PRP different from cortisone injections?
"PRP is a form of Regenerative Injection Therapy, an emerging treatment approach that helps stimulate the body's natural healing powers. Inflammation is part of this healing response. PRP helps start the body's inflammation and tissue regeneration cascade.
"Cortisone injections treat arthritis symptoms by getting rid of inflammation in and around the affected joint. PRP aims to address the cause of arthritis; cortisone treats the effect."
How does PRP work in treating knee arthritis?
"Think of early knee arthritis as little potholes—nickel- or quarter-sized areas on the bone where the cartilage is wearing out. Those are the areas that have a chance to scar over with PRP treatment.
"No one is sure yet exactly how and why PRP works. The platelet-rich plasma is probably recruiting some cells to go into those open areas of the bone and put some scar tissue or fibrocartilage down.
"I don't think anybody is going to suggest PRP is going to re-grow normal cartilage, but it may promote formation of a clot or a scar that forms a little scab. If that area toughens up and gives you a little bit of cushioning, it's like re-soling a shoe-PRP gives you a little bit of tread in that area of your knee instead of having a raw, bony spot.
"I think PRP may help the body grow some fibrous tissue, some cartilage-like tissue over smaller, contained areas of osteoarthritis."
Are there other uses for PRP in orthopedics?
"Yes. Results are mixed, but some research shows PRP works well in treating soft-tissue injuries such as tendon, ligament and muscle tears. The use of PRP has expanded over the last couple of years due to its popularity with pro ball players.
"Tiger Woods was getting PRP injections in his elbow; Hines Ward, wide receiver for the Pittsburgh Steelers, had it in his right knee when he sprained his medial collateral ligament or MCL.
"The idea is to help the body heal where ligaments attach to bone. PRP is also used occasionally for treating Achilles tendon injuries. It might also help in wound healing."
Does insurance cover PRP injections?
"PRP injections are considered an off-label use of an FDA-approved product, which happens every day. At present, this product is not billed through insurance—it's offered on a fee-for-service basis. For more information on PRP injection pricing, please call 440.329.2800."
Research shows PRP is effective in treating knee osteoarthritis
A pilot study published in the December 2010 American Journal of Physical Medicine and Rehabilitation found that PRP injections produce significant improvements in pain and function in patients with primary and secondary knee osteoarthritis. Most patients in the study expressed favorable outcomes 12 months after PRP treatment.
What injectable treatments are available for knee arthritis?
- Cortisone: An anti-inflammatory steroid medication. "Cortisone produces a good immediate effect because there's novocaine mixed with it," says Dr. Zanotti. "It gets rid of the inflammation in and around the joint, which may decrease the amount of fluid and pressure in the joint and make you feel better."
- Synvisc: A lubricating gel made out of the comb and wattle of chickens. "It's essentially a jelly that smoothes out the knee joint and mixes with your body fluids," Dr. Zanotti explains.
- Orthovisc: A lubricating gel that works in the same way as Synvisc, but is safe for people allergic to chicken or chicken products.
- PRP: Platelet-rich plasma, a concentrated form of your own blood platelets. "PRP is potentially a healing enhancer to promote your own body's cells to come in and put some fibrous tissue down on the arthritic spots," says Dr. Zanotti.
Considering PRP injections?
This information is simply an introduction to PRP injections. To have your knee pain evaluated, we invite you to schedule a consultation
Call 440.329.2800 for an appointment
| Westlake Office 2211 Crocker Rd. Westlake, OH 44145 |