WHAT IS PRP?

PRP (Platelet Rich Plasma), also known as Platelet Rich Plasma, is a method prepared from the person's own blood and used to stimulate and regulate healing in many areas of medicine. With the help of dozens of PRP preparation kits in use, 10-60ml of blood is taken from the patient, this blood is separated with special disposable filters and centrifuge devices and unwanted parts are removed. The separated 2-6 ml portion contains platelet-rich plasma and has found application in many musculoskeletal injuries. The main function of platelets is to form a clot that stops bleeding when an injury occurs. In addition, they contain dozens of growth factors that contribute to the repair and healing of tissue. When these growth factors are introduced into the environment, they help repair damaged tissues by supporting the body's own healing mechanisms.

PRP Preparation

Preparation of PRP

IS PRP A MEDICINE? ?

PRP is not a medicine. It does not contain any substance other than the person's own blood. Unlike drugs, its effect is limited to the area where it is applied. It does not cause side effects in the kidney, liver and stomach. It does not contain cortisone. PRP contains growth factors that enable the body's healing response cells to reach the area and multiply. These factors also have positive effects on the formation of new vessels, prevention of infections and production of tissue proteins. In recent years, forms containing hyaluronic acid have also been developed for some intra-articular PRP applications. In this type of injection, PRP is first prepared from the blood taken from the patient, then mixed with hyaluronic acid and injected into the joint.

ARE THERE STEM CELLS IN PRP?

Contrary to popular belief, there are very few stem cells in PRP. Stem cells are found in small numbers in many tissues in the musculoskeletal system, such as muscle, bone marrow, fat tissue, and synovium (the thin membrane layer lining the joint). In order to use stem cells for therapeutic purposes, either the tissue taken from the bone marrow must be concentrated with special techniques, or the cells obtained from the above-mentioned tissues must be produced in a laboratory environment and applied in a second session a few weeks later. PRP application kits and bone marrow concentrate application kits are different.

One of the PRP preparation devices

On the left is the patient's blood before PRP preparation, on the right is the view after the PRP is filtered off

On the left is the patient's blood before the PRP preparation, on the right is the view after the PRP is filtered off

CAN PRP BE APPLIED TO OTHER PEOPLE?

Although blood products can also be applied to other people in times of need, PRP can only be applied to the person himself. Thus, the risk of transmitting diseases such as hepatitis and AIDS is eliminated. PRP should be used within a few minutes after preparation, its effect will decrease significantly after the 10th minute.

HOW MANY TIMES AND HOW IS PRP APPLIED?

How many times should PRP be applied? There is no conclusive evidence that it should be done twice. While a single application is sufficient in some cases, it can be repeated every 2 or 3 weeks depending on the response of the disease. PRP application should be done under sterile conditions. Today, PRP can be applied in several ways. The most common method of application is injecting into the target tissue with the help of a needle. Another application method is the effect of PRP prepared in jelly form during surgery. It is placed in the desired area. Finally, PRP can be used by impregnating these implants during surgery to increase the effectiveness of implants placed for cartilage repair.

IN WHICH DISEASES IS PRP EFFECTIVE?

PRP is general surgery, plastic surgery. It has been applied in different fields of surgery and orthopedics. Among these, their orthopedic uses can be summarized under a few headings.

Chronic tendinopathies: 79-93% successful results have been achieved with PRP applications in tennis elbow. This rate is slightly better than the results obtained with cortisone application, and the disadvantages of cortisone application are avoided. Similarly, around 80% successful results have been reported with PRP applications in Achilles tendon diseases, chronic patellar tendon injuries and plantar fascitis disease. In this patient group, PRP should be preferred in cases where adequate results cannot be obtained with rest, medications and physical therapy methods.

Knee ligament injuries: After internal collateral ligament injuries, which are common in athletes, PRP injections allow faster recovery and return to sports in a shorter time. There are studies showing that.

Muscle injuries: A faster return to sports has been reported with PRP injections in cases of muscle pulls or intramuscular bleeding seen in athletes.

Osteoarthritis: In the early stages of osteoarthritis in the knee joint. It has been reported that patients' pain decreased and their functions improved for 6 months with PRP injections. However, PRP treatment does not change the natural course of the disease and cannot reverse existing wear and tear. Comparative studies have shown that PRP injections are slightly superior to hyaluronic acid injections.

It helps in cartilage repair. As support: Treatment of cartilage injuries in young patients still remains an important problem. Today, it is not possible to recreate damaged articular cartilage with its original architectural structure and biological properties. PRP applications have come to the fore to improve the quality of the repair tissue created by many treatment methods. Biological covers, called matrix, used in cartilage repair, are synthetic and dissolvable structures that provide a suitable environment for cells to develop and turn into cartilage. It has been shown that a higher quality repair tissue can be obtained by applying PRP or bone marrow concentrate together with these matrices. Today, this is the most studied and exciting area of PRP.

As an aid during surgery: In various studies, the jelly-shaped form of PRP has been used in knee prosthesis, repair of shoulder muscle ruptures and anterior cruciate ligament repairs. Although it reduces postoperative bleeding, it has not been shown to have a positive effect on the results.

WHAT SHOULD I DO AFTER PRP APPLICATION?

After PRP is applied Afterwards, it is appropriate to apply ice and use paracetamol-derived painkillers for pain. Non-steriod anti-inflammatory drugs (such as voltaren, napr oksen, majesik) are not recommended as they will reduce the effectiveness of PRP application. Rest is an important part of recovery and therefore strenuous exercise and sports are not recommended after PRP application. Simple stretching exercises can be done, but weight training against resistance should be avoided. Bandages and simple wristbands can be applied. Return to sports and training may vary between 3-6 weeks. During this period, it is necessary to avoid the use of non-steroidal anti-inflammatory drugs. It would be appropriate to ask your doctor about the medications you can use afterwards and the time it takes to return to sports.

ARE THERE COMPLICATIONS AND SIDE EFFECTS OF PRP APPLICATION?

After PRP application, there is a low rate in the injection area. There may be increased swelling and pain. This pain may persist for a few days, but this problem can be resolved with simple painkillers and ice application. Apart from this, PRP has no side effects on internal organs such as kidney, liver and stomach. Since the person's own blood is used, there is no risk of allergic reactions. There is no information about its use during pregnancy.

DOES PRP AFFECT DOPING TESTS?

The use of PRP as an injection in the musculoskeletal system is recommended by the International Olympic Committee. World Anti-Doping Agency (WADA) has excluded banned substances and practices from the scope and is not considered doping. Since it is not a drug excreted in urine, it is not possible to identify it in doping tests. PRP injected intravenously is still prohibited.

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