PRP Injections for Tendon Disorders
A Platelet-Rich Plasma (PRP) injection is a regenerative medicine treatment where we take a patient’s blood – peripheral blood from the arm, let’s say – and we spin it down in a high-speed centrifuge. From that, we actually get this concentration of platelets and growth factors that, in theory, will help repair tissues or induce a healing response at the site of the injection.
We’re basically trying to create a healing-rich environment for the tendon to stimulate the healing process and to try to repair itself. The advantage really is to avoid surgery, and in a situation where we have a diseased tendon that surgical excision and repair would work for, we may be able to avoid that process or, for a lack of a better word, kick the can down the road so you can try to delay a surgical process.
As an orthopedic surgeon specializing primarily in foot and ankle conditions, I use most of these injections with tendon disorders such as tendonitis and tendinopathy that are not healing from physical therapy, activity modification, anti-inflammatories, bracing, and those kinds of treatments. Likely before I’d be doing this, I would have already tried physical therapy and non-invasive management. If it doesn’t get better, I’m probably going to order an MRI, or at least get an ultrasound picture of that tendon. If the tendon looks incredibly diseased where, let’s say 80 percent of the tendon does not look healthy, I would probably recommend not doing the injection because it probably wouldn’t be very useful. But for patients with 10, 20, even 50 percent disease of that individual tendon, I think they would be good candidates to get some relief from this non-surgical and minimally invasive procedure.
After a PRP injection, I will usually immobilize patients for 1-2 weeks to allow their inflammation to resolve. After you inject something in a site, you’re going to get natural inflammation from that area. It’s also going to be swollen because of the amount of fluid that I put in there, and that can be painful, so I immobilize patients for 1-2 weeks. I see them back in clinic, see how they’re doing, and then start either a home therapy or formal physical therapy program to get their healing process started.