Treatments
Platelet-rich plasma therapy, also called PRP therapy, uses the natural healing properties of blood to repair damaged cartilage, ligaments, muscles and even bones. Although not yet considered a standard treatment, PRP therapy is increasingly used to treat a variety of orthopaedic conditions including arthritis, particularly knee arthrosis (gonarthrosis).
In the treatment of arthritis with PRP, the doctor injects plasma directly into the affected joint with the aim:
– To reduce pain,
– To improve joint function,
– To slow down the degradation, preserve or even repair cartilage
The plasma is collected from the patient and contains an increased concentration of platelets much higher than is normally found in the blood.
Plasma is the liquid component of the blood, it is the transport medium for red and white blood cells traveling in the bloodstream.Plasma is made up mostly of water but also contains proteins, nutrients, glucose and antibodies.
Like white and red blood cells, platelets are components of the blood. Platelets alone do not have healing capacity, but they secrete substances called growth factors and other proteins that stimulate cell division, stimulate tissue regeneration and promote healing. Platelets also help to clot the blood, so people with low platelet counts or poor platelet function will bleed excessively after an injury.
Treatment may vary from patient to patient due to:
The most common method of making PRP is by centrifuging, at an increased speed, a quantity of blood from the patient. Centrifugation causes the blood to separate into layers:
Normal blood contains between 1500000 and 4500000 platelets per microliter. In PRP, the number of platelets increases from 2.5 to 9 times, depending on the amount of blood collected and the centrifugation process.
The immune system depends on white blood cells but their role in PRP is not fully known. Some researchers claim that they decrease the ability of tissues to heal, stimulate inflammation and scar tissue, but this has not yet been proven.
A study published in 2013 on 78 patients with bilateral gonarthrosis receiving PRP treatment versus placebo (saline infiltration).
The conclusions were:
But the effectiveness of PRP varies in effect depending on the method of preparation, the frequency of injections, the degree of arthrosis.
– Conditions such as infections, bone metastases or skin diseases
– Blood diseases
– Anticoagulant treatment that cannot be stopped
– Anemia
– Pregnancy
– Avoiding cortisone drugs 3 weeks before.
– Avoid anti-inflammatory medication 1 week before.
– Avoid anticoagulant treatment 5 days before.
– Drink water before harvesting.
– Venous blood is collected from the patient in a special test tube containing separating gel and centrifuged for 10 min at 3500 rpm.
– Using a sterile syringe, platelet-rich plasma is collected and injected into the joint.
– You should not take anti-inflammatory drugs.
– We can use the splints for a few days to avoid putting pressure on the injected joint.
– Cold local applications for 15 min, several times a day, reduce pain and inflammation.
Patients who are not physically active at work can return to work the next day.
Days 1-3:
Avoid excessive walking and standing (lower limb disorders)
As much rest and ice applied to the infiltration area
Days 4-7:
Return to daily activities
Stretching without straining at the onset of pain (specific exercises)
Use of the medicine bike, no tension applied, 20-30 minutes per day
Days 7-14:
Continue the cycling program and increase the applied tension, but without overstraining
Weeks 2-8 :
Specific recovery program
The use of anti-inflammatory medications or ointments is prohibited 5 days before and 5 days after the procedure. Pain relievers may be used to reduce pain after the procedure.
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