PRP Article

[Erik Lineberry]

APTA In-Motion just sent out this synopsis of an AJSM meta-analysis on the effectiveness of PRP injections for tendinopathy. I have had a handful of patients receive and/or seek out PRP injections over the last year for tendinopathy as well as other condition. I was wondering if anyone else has had patients that have received PRP and what your patients results were with it. I can see this becoming a more popular procedure in the future. Have any of you had patients that asked about it or its defectiveness? Has anyone had to correct a patient to ensure them their MD did not inject them with PCP?

I have attached the AJSM article in reference as well.

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[Michael McMurray]

Thanks for posting Erik

My experiences with patients is variable; as the techniques of preparation/injection are variable.

I’ve had patients with success at the patellar, hamstring, lateral elbow, Achilles – but as many failures as successes.

My recommendation to patients when they ask; is to be an educated consumer; understanding that the evidence is conflicting.

There are a handful of practitioners in our area injecting. So I’d encourage you to contact and query those practitioners on injection procedures, as this article had some conclusion on the best concentration and injection method (which is what is needed for outcomes to be more consistently measured).

It is out of pocket typically – so patients are paying $300-$500 per injection.

Biologics is the future of orthopedics – but the specificity for concentration of components and specific growth factors is not there yet.

But stay educated and up to date, so you can counsel your patients accurately.

Have a great weekend all.

[Justin Bittner]

I have not really had any experience with patient’s having these injection or asking about them. I know the literature is somewhere in the middle regarding its effectiveness and it’s the latest buzz as far as injections are concerned.

I can tell you that my brother did a sports medicine rotation with the team doc for the Pirates/Steelers and he said he gave them out like candy (4-6 patients/day getting PRP injections). He verbalized how effective he had found it in his practice. So, that is my only input. It is being used a lot by some (one I know of) of the sports med MDs.

[Justin Bittner]

Funny, I said I had not had any patients inquire about PRP and today two different patients ask me. This certainly seems like a question we are going to be receiving more often over the next year or two.

[Erik Lineberry]

I have had 2 patients receive them. Both had lateral epicondylalgia. One saw a large change and was back to PLOF within 2 weeks following injection with PT. The other aw no change with injections are was in PT for a significant amount of time following injection.

This is obviously a small sample size and there are a number of pnt-specific factors that may contribute to these outcomes, but it would be interesting to know the specific procedure each of these patients received as Eric alluded to in his post. I am also curious to see the long-term outcomes of these procedures.

[Kristin Kelley]

Thanks for posting Erik. I’ve had more patients inquiring about outcomes w/PRP injections lately and have one pt who is undergoing a series of 1-3 injections for lateral elbow pain (she’s currently on injection #2). I do not know the type of injection or application method but plan to inquire. After injection 1 (in adjunct to PT post injection), she has improved w/her pain and function by ~ 80%. She just had the 2nd one hoping to gain the last 20% for return to painfree (and NSAID free) sleeping and golf playing.
It appears PRP, like many other new options out there for tendinopathy pain control, truly has not had enough RCT’s and/or does not have enough set standards to recommend its effectiveness to the masses….or does the pt truly have tendinopathy??

[Scott Resetar]

Similar to Erik, I’ve had two patients who have received PRP injections. One was for patellar tendinopathy and the patient had a very poor outcome, probably made her worse. However, she had a significant history of 5 different surgeries for her knee, lots of arthritis, lateral meniscus tear, in pain for many years, and had concurrent stem cell injections as well. So that was a very mixed bag.

The other patient had low grade rib pain due to instability and it really helped him with a serious of injections.

Take it for what its worth!

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