Aching joints and the athlete
Looking at platelet-rich plasma therapy ... what when and why
OSTEOARTHRITIS is a common chronic joint disease, causing large amounts of disability and pain.
There are a number of risk factors for osteoarthritis including joint injury, genetics, excess weight, repetitive kneeling or squatting and repetitive heavy lifting.
Platelet-rich plasma therapy, sometimes called PRP therapy, attempts to take advantage of the blood’s natural healing properties to repair damaged cartilage, tendons, ligaments, muscles, or even bone.
Although not considered standard practice, a growing number of patients are turning to PRP injections to treat an expanding list of orthopedic and sports medicine conditions, including osteoarthritis and tendinopathy.
It is most commonly used for knee osteoarthritis but may be used on other joints such as the hip. It may also be used for long-standing tendon degeneration that has not responded to other intervention.
The thoughts currently on PRP are that it may help to:
■ Reduce pain
■ Improve joint function
■ Possibly slow, halt, or even repair damage to cartilage
So, what is it?
Basically, we take a sample of your own blood and spin it down to extract the platelet rich plasma – the liquid component of blood. It is made up of mostly water but also includes proteins, nutrients, glucose, and antibodies, among other components.
Platelets alone do not have any restorative or healing properties; rather, they secrete substances called ‘growth factors’ and other proteins that regulate cell division, stimulate tissue regeneration, and promote healing.
Several good quality trials are emerging showing a trend with patients undergoing PRP injections for knee osteoarthritis having reduced pain at three, six and 12 months post injection when compared with placebo or other therapies.
Some MRI studies have even shown a halt in the progression of further cartilage.
In the clinic
While there is no silver bullet therapy that works for every joint or tendon problem, increasingly we are seeing the benefits of PRP for arthritic hip and knee patients who want to remain active.
Last week I received an email and phone call from a 55-year-old avid tennis player with hip arthritis who was so thrilled he wanted to shout from the rooftops after his PRP. He was completely pain free and back playing tennis and golf. His story is becoming increasingly common.
With tendinopathies, however,
the mainstay of treatment revolves around load management (reducing training load), increasing tendon strength and shockwave therapy. I will consider PRP when other methods have failed in longstanding tendon problems.
Staying active as we age is critically important, not just for cardiovascular well-being, but for bone health, joint health and mental health. PRP may be a beneficial adjunct to a comprehensive plan from your sports medicine team including strength training, activity modification, medication and rehabilitation to keep you active and achieving your goals.
Platelet-rich plasma therapy may be a beneficial adjunct to a comprehensive plan from your sports medicine team.