Platelet-rich plasma: what is it?

Platelet-rich plasma/ PRP, when to consult?

Before starting a treatment based on PRP (platelet-rich plasma), it is necessary to identify the injury and its evolution. A specialist in sports traumatology, Dr. Julien Lopez has extensive expertise in the management of serious and benign ankle sprains in Nice and Cannes. In case of injury or pain, it is necessary to consult a professional as soon as possible and not to let the lesion worsen or risk seeing complications.

This foot and ankle surgeon makes every effort to receive his patients as soon as possible and ensure premature management of the condition. To ensure the effectiveness of the platelet-rich plasma method on the ankle, the doctor makes an accurate diagnosis of the lesions and identifies the various injured fibers. It is the severity of the injury that will dictate the course of action.

In which case should I use Platelet Rich Plasma?

In case of muscle, tendon, ligament or joint injury, Dr Julien Lopez can propose a treatment with Platelet Rich Plasma to promote healing and accelerate the recovery process.

PRP is a part of the blood that is free of certain cells, from which it derives its healing and cell regeneration capabilities from its high concentration of platelets.

It is frequently used in muscle tears, tendon lesions, ligament lesions or in joint damage such as osteoarthritis. In some cases, an injection of PRP is performed at the end of the surgical procedure to accelerate the healing of the tissues. The sample is taken by the nurse a few minutes before the procedure and the surgeon will inject it at the end of the procedure in the surgical area (chronic tendinitis for example). Its use in tendon and ligament lesions showed faster recovery without significant adverse effects.

Injuries treated with platelet-rich plasma: osteoarthritis, sprains, etc.

There are several types of injuries treated with Platelet Rich Plasma: osteoarthritis, sprains, tendinitis, etc. Each of these injuries has different symptoms.

Muscle damage

There are many muscle injuries. Extrinsic muscular lesions (lesions involving an external factor such as a blow or fall) are distinguished from intrinsic muscular lesions (which occur without an external factor). Among the various muscular lesions, we find curvature, elongation, breakdown, tearing…

Joint injuries

The most common joint injury to the ankle is osteoarthritis of the ankle. Osteoarthritis is premature wear and tear of the ankle cartilage causing intra-articular pain and effusion.

Osteoarthritis of the ankle causes various symptoms such as:

• Joint swelling
• Pain when the joint is stressed (walking, running, cycling, etc.)
• Ankle stiffness
• Reduced mobility
• Cracking or blocking of movement
• Ankle instability

Ligament injuries

Ligament lesions of the ankle are usually related to a sprain. The latter is caused by a sudden and violent movement of the ankle, accompanied by the torsion of the joint.

The main symptoms of ankle sprains are:

• Swollen ankle
• Painful walk
• Difficult foot movement

The use of Platelet Rich Plasma in case of ankle sprains ensures very good results.

Tendon lesions

Tendon lesions refer to tendonitis in the ankle. Tendonitis is an inflammation of the tendon or its sheath that causes severe pain.

Tendinitis are usually caused by repetitive gestures leading to the weakening of tendons. The injection of Plasma Rich in Platelets in case of tendonitis of the foot allows to relieve the pain felt considerably.

How does it work?

The PRP is obtained after centrifugation of your blood taken from the arm (autologous blood). It is a real concentrate of platelets, that contains 5 times more than normal blood. Centrifugation removes certain blood cells (red and white blood cells) and concentrates the platelets, thus recovering the plasma. It is then recovered in a syringe: it is ready to be injected.

Platelets contain growth factors such as platelet-derived growth factor (PDGF), transforming growth factor beta (TGF beta), etc stimulating bone cells, cartilage cells, tendon or muscle repair. In contact with the lesion site, they will release more than a dozen of these growth factors and be responsible for the tissue regeneration process.

How’s the injection work?

Platelet Rich Plasma is injected either by the surgeon or when the lesion is deeper, by the radiologist under ultrasound control. Local anesthesia is sometimes necessary. In some cases, painful or very painful effects can be seen immediately after the injection. In this case, we recommend that you take medication and apply ice to the painful area. Then you have to rest for a week and the rehabilitation can be resumed afterwards.

Is it considered a doping product?

Regarding doping, the World Anti-Doping Agency (WADA) and the French Agency for the Fight against Doping (AFLD) had decided to regulate this practice by banning injections of PRP by intramuscular routes in February 2010 (decree no. 2010-134 of 10 February 2010). Other routes of administration, including the intratendinous route, were subject to a Therapeutic Use Authorization (TUE) issued by the AFLD. Due to a lack of valid data, this ban was lifted in 2011.

When can a treatment be implemented?

Platelet Rich Plasma injection in the foot can be done as part of the treatment of several injuries:

• muscle damage
• tendon lesions
• cartilage lesions (osteoarthritis)
• meniscal lesions
• operations coupled with surgical gesture

However, this treatment has certain contraindications sometimes preventing its use:

• Presence of autoimmune diseases, blood diseases or infections
• Anticoagulant or anti aggressor treatments (aspirin, kardegic, plavix, previscan, simtrom)
• Taking corticosteroids or NSAIDs in the week before and up to 2 weeks after
• Taking certain antibiotics or antidepressants

In the case of a platelet-rich plasma injection, the price may vary from surgeon to surgeon.