Ashmore Osteopathic Group

Platelet Rich Plasma (PRP) Information Sheet and Procedure Care Instructions.

      Ashmore Osteopathic Group        ph: (07) 5597 5711    

email: receptionostpath@gmail.com

Common questions answered:

1. What is Platelet Rich Plasma and how does it work: PRP is an area of regenerative medicine that has been proven to be beneficial in halting degenerative change and improving tissue regeneration in certain conditions. The treatment accelerates the body’s natural healing process by using the patient’s own cells to promote healing of bone, tendon, cartilage, ligaments, muscle and skin tissue. PRP works by delivering powerful growth factors that stimulate and improve blood supply to the injured area and amplify the nutrients needed for cells to regenerate damaged tissue.

2. Is PRP guaranteed to heal my injury or degenerative tissue: There is no current medical technique, product or device that can 100% guarantee PRP can ‘cure’ injured or degenerative tissue, nor is there any guarantee of the PRP therapy providing the desired healing outcome in every case. However, there have been over 4000 published research articles on PRP to aid patient healing. When best practice and protocols are followed, the patient’s own healing ability should be improved at the injection or application site – hopefully leading to a shorter recovery time or reduced pain. It is recommended that PRP therapy is a reasonable alternative for you when compared with the options available, which may include – surgery, cortisone injections, oral medications and physiotherapy. The potential benefits of PRP outweigh the small risks.

3. What is involved: Generally, a small sample (60 mL) of your blood is taken, and then spun in a centrifuge. The blood draw, sample size and collection kit utilised is determined by the region to be treated. This centrifugation concentrates platelets from the whole blood sample, so that a highly concentrated form of your own platelets can be injected directly to the injured tissue. By injecting the platelets directly to the site of injury, the healing process can be boosted, leading hopefully to a reduced healing time and a stronger regenerative response. The procedure is completed under ultrasound guidance.

4. Does the procedure hurt: You may experience discomfort during and after the PRP injection. Every patient’s pain is unique due to the underlying symptoms. We are unable to predict the level of discomfort  you may experience.
• Please be aware that as the area we will be treating may already be painful, so when the needle is inserted in that vicinity, it can create further flare that is temporary and diminishes very quickly. Plan to rest for the remainder of the day after the procedure.

5. Why is it expensive: We utilise the EmCyte Pure PRP. This generation design has a method of viewing the various cellular component levels within the device post centrifugation that allows for high degree of accuracy and reproducibility of platelet concentration and leukocyte inclusion in the PRP. The Emcyte Pure PRP device and preparation protocol has demonstrated outstanding performance in extracting, separating, and collecting PRP from patient’s blood with documented platelet concentration of up to a multiple of 5-7x platelet concentration above physiological baseline level, and a platelet recovery efficiency of 88%.
This efficiency is significantly superior to other manual preparation PRP kits currently available in Australia. Unfortunately, medicare and private health insurance companies do not cover this procedure; therefore a rebate from them is not possible.

POTENTIAL COMPLICATIONS:

Major complications from the PRP therapy are extremely rare, as the injection substance consists of: your own plasma, rich in platelets & growth factors; and a very small amount of anti-coagulant. Minor complications of the PRP therapy may include: local bleeding/swelling/bruising/pain/itching at either the blood collection site or the injection site. The most common symptom after the procedure is an increase in pain and stiffness in the injected region similar to the feeling after a sports injury to that area. This can be a normal response with some patients experiencing moderate pain and others only mild discomfort. It is usually worst in the first 36 hours, settling down by days 3-5.

Other potential complications – When any needle is inserted into the body there is always a slight chance that there may be an injury to a muscle, blood vessel or nerve. The most likely event is a ‘needle stick flare’. The most unlikely, less than 1:10000 is infection. Post injection advice sheet will answer this concern. If local anaesthetic is used, there is a small chance that you may have a sensitivity to it. From the procedure generally, patients may experience dizziness or light headedness –simply from the anxiety associated with the procedure/blood collection etc.

Please seek advice from your GP prior to ceasing any medication for your PRP injection

You must inform us prior to the day of the PRP injection if you currently have had any of the following, as we may not be able to perform your procedure:

• Recent COVID Vaccination
• Platelet and blood disorders
• Cancer treatment
• Acute and Chronic Infections
• Severe systemic or metabolic conditions
• On oral corticosteroids within 10 days prior to PRP procedure
• Prior injection of long acting steroids within 3-5 weeks (at the PRP injection site)/Pregnancy or breastfeeding

10 days before the procedure:

• Request to cease oral corticosteroids (eg prednisone) for 10 days prior to the procedure, under the guided supervision of your medical practitioner.

1 week before the procedure:

• Do not take any blood thinning medications. Aspirin or medications containing aspirin for 5 days prior to the procedure.

• Supplements that are known to increase bruising should also be ceased – Garlic, Ginko, Ginseng, Green Tea, Vitamin E, Multi-vitamins, Omega and fish oils.

2 days prior to the procedure:

• Discontinue any non-steroidal anti-inflammatory medications, (eg, Aspirin, Nurofen, Voltaren, Celebrex), or any other anti-inflammatory medications, for 2 days prior until 10 days after the PRP therapy.

• Have minimal caffeine, fatty food, or alcohol. We encourage you to be well hydrated with water.

Day of procedure:

• Aim to be well hydrated with water.
• Be showered (we advocate the use of Sapaderm soap), clean, no perfumes and wear loose comfortable clothing.
• Bring any prior imaging or scans and the radiology reports related to the area of concern.

•You will experience discomfort from the PRP injection, so limit your post the procedure activities.
• You will not be able to take anti-inflammatory medication for up to 10 days after the procedure. We recommend having some Panadol/Panadeine available in case you need some mild pain relief.

Following the post procedure instructions below is so that you can maximise the results from your PRP Procedure. We may encourage you to use a pain chart so that you are able to monitor your healing progress.

POTENTIAL COMPLICATIONS:

Post PRP injection:

Please take the time to read this information and follow the guidelines so that you can gain maximum benefit from the PRP therapy.

• The PRP injection is a natural substance extracted from your blood. Because of this, it is fragile, and needs to be treated carefully, especially in the first 36 hours so that it can do ‘its work’.

• The PRP injection with its delivery of an abundance of growth factors to the injected site works by stimulating your body’s normal healing response to an injury. However as the growth factors are more concentrated, the inflammatory and healing response is exaggerated, which can create a ‘flare’ of symptoms.

• The site may feel as if it has just been injured, potentially with a feeling of soreness, swelling, aching and stiffness. These symptoms can last for up to 3-5 days and then they should begin to ease.

Note: If you treat these symptoms with anti-inflammatory medications, the growth factors cannot fully complete their healing function and the regenerative ability of the injection may not be as effective. The use of an ice-pack as an analgesic is recommended.

To maximise healing benefit from the PRP therapy we recommend:

Week 1:

• Following your procedure, rest for the remainder of the day if possible. Typically your activities of daily living are fine, but strenuous exercise and activities should be avoided for up to 3-5 weeks post procedure.

• Ideally ice packs as an analgesic can be be used. But if rest, elevation and pain relief are not effective for controlling discomfort then an ice pack wrapped in a cloth can be applied to the area for 3-5 minutes, 4 times per day for the first 36 hours post injection.

• If you need further pain relief, please use Panadol or Panadeine only.
• Please do not use any anti-inflammatory medication (eg: Aspirin, Nurofen) or topical gel (eg:Voltaren) for 10 days post procedure, or longer if possible.
• Please do not take any oral steroids such as Prednisone for 10 days post procedure.
• For patients who regularly take aspirin, you may resume it 48 hours after the procedure, unless otherwise directed by your medical practitioner for your procedure.
• Minimal alcohol, coffee, caffeine; and nil supplements that may increase bruising for 3 days.

Week 3 – 5:

• Physical therapy may be recommended following the procedure to help support the newly forming tissue and improve mobility of the affected area.

• A supervised protocol of gentle stretching exercises in weeks 1-2, followed with mild strengthening in weeks 3-5 may be recommended.

• Week 3 – It is recommended to seek a review by practitioner so your progress and improvement can be assessed. Most patients will require a follow-up procedure at 5-7 weeks, and some patients may require up to 3 procedures, and this is dependent upon the initial injury type and severity.

Although infections are rare, please contact us if you experience progressive swelling, redness, skin oozing or changes, or fever, during business hours on (07) 5597 5711 / SMS +61 412 546 162 or you may wish to seek review by your GP, or local Accident & Emergency if after-hours.

If you have questions regarding the procedure please contact our reception. You may also wish to read information available on our website, www.goldcoastosteopathic.com.au, titled “A Non-surgical Option to help Repair Degenerative Tissue and Injury”.