PRP definition
Platelets are blood platelets (thrombocytes) that enable blood clotting. These coagulation platelets also contain factors involved in wound healing. When there is damage anywhere in the body, many substances are secreted from the blood platelets that travel there through the blood. These factors, also called growth factors, increase vascularity around damaged tissue, increase and regulate collagen production, and reduce edema and inflammation. This process takes approximately 3 weeks in the first stage. The purpose of PRP treatment is to initiate a wound healing process by intensively delivering blood platelets to the damaged area and to ensure the repair of damaged tissues and the removal of harmful substances that cause pain from the environment. In this respect, PRP application is based on the principle of triggering inflammation rather than suppressing it, unlike traditional treatments. For this reason, it is appropriate to wait at least 3 weeks for the effectiveness of PRP.
How is PRP applied?
For this purpose, 15-20 ml of blood is taken from the patient's arm into special tubes. It is then centrifuged in centrifuges suitable for the tube. After centrifugation, blood cells and blood serum are separated. A visible white layer (buffy coat) forms between blood cells and serum, where blood platelets are densely collected. PRP is obtained by carefully pulling this layer with an injector. After PRP blood is drawn and prepared, it is applied in the area where it will be applied, following the rules of asepsis and antisepsis. It is injected intra-jointly, around the tendon and intramuscularly.
Blood platelets normally number 150,000 to 450,000 per microliter of blood, and through the centrifugation process, at least one million blood platelets are clustered in a certain area in the tube. Studies indicate that for PRP treatment to be beneficial, at least one million blood platelets must be administered to the area. For this reason, one of the most important aspects of PRP treatment is to use the correct tube.
PRP application can be performed under ultrasonography guidance or blindly. Blind method can be applied in knee, shoulder, elbow, ankle and muscle applications, but it is recommended to perform it under ultrasonography guidance, especially in hip applications.
PRP should be applied by a physician who knows the application technique well. Although it varies depending on the area treated, it is generally mildly painful. is. A slight burning sensation is felt at first application, but it passes quickly.
Where is PRP applied?
The most commonly used areas are knees, shoulders and hips. It is a highly preferred method for knee calcification, meniscus problems and ligament problems due to its constructive and restorative effects. Studies have shown that it is effective for up to 12-18 months. Compared to joint fluid supplements (hyaluronic acid) applied to the knee,
Other uses of PRP are; They can be listed as lateral epicondylitis (tennis elbow), medial epicondylitis (golfer's elbow), and foot ligament injuries.
There have been recent publications about intramuscular applications in low back and neck pain, and according to our clinical experience, they are effective. For this reason, PRP can be applied in cases of waist and neck strains, waist and neck hernias, and calcification.
Does PRP have any side effects?
Since PRP uses the patient's own blood, it is one of the applications with the least risk of side effects. is one. During the application, 1 cc of medication that prevents blood clotting is placed into the syringe. Of course, there may be unpredictable sensitivity to this drug, but it is very rare.
Another very rare situation is swelling in the joint following an extreme reaction after the injection. For this reason, after PRP application, it is recommended that the patient stay under the supervision of a doctor and not do excessive activities (3 days).
In addition, after PRP application, there may be a slight increase in joint pain, which is seen in as little as 10%, and the patient should be informed about this. If there is no accompanying swelling and warmth, the patient is advised to wait for 5 days, avoid using heat or ice, and use simple painkillers (paracetamol). For this reason, it is appropriate for the patient to remain under the follow-up of the doctor.
How many times and at what intervals should PRP be applied?
Although there is no definitive answer to this question, in our clinic, before and during PRP application to the patient, the applied shoulder or Neural therapy is also applied to increase blood flow to the knee. Depending on the patient's clinical condition, additional treatments (such as acupuncture, electroacupuncture, neural therapy) are also performed and 3 weeks are waited. If the patient's complaints persist, the treatment is terminated, and if the pain continues even though it has decreased, a second PRP application is performed. 3rd application it It is required in very rare patients.
Can PRP be performed on everyone?
PRP can be performed on everyone. Situations where it cannot be done are as follows;
- However, in case of using drugs that impair the functions of blood platelets (blood thinners, aspirin, clopidogrel, if there is no harm in stopping the drug, the drug is stopped for 1 week, PRP application is applied, and the next drug is started again. However, if it is not possible to stop the blood thinner application is not performed)
-Inflammatory joint rheumatism and other connective tissue diseases
-Cancer patients
-Presence of acute infection (in the joint or another area)
-The presence of a disease that causes dysfunction in platelets
Are PRP and stem cells the same thing?
No, stem cells are made with material obtained from primitive cells obtained from fat or bone tissue. , PRP is based on the principle of obtaining growth factors from blood platelets.
Is additional treatment required with PRP?
After PRP is applied, treatment can be performed with physical therapy agents depending on the patient's condition. However, it would be appropriate not to use deep heaters or apply ice. In order to control the pain more easily, TENS or electroacupuncture is also applied in our clinic for patients who need it. After controlling the pain, patients should definitely add an exercise program. It is recommended to wait at least 10 days after PRP application for exercise. Afterwards, the muscles around the joint should be strengthened by starting the exercise and increasing the intensity and intensity. Exercise must be performed to support the reparative process provided by PRP within the joint, reduce pain and increase function.
The patient should also be taught about lifestyle changes according to the affected area. In the presence of problems in weight-bearing joints such as knees, hips and ankles, the patient should be informed that weight should be lost to reduce the load on the joint. In case of shoulder problems, the patient should not be trained by lifting the arms up, and the patient should also be educated about joint protection techniques.
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