PRP - Plasma Rich Platelet Therapy
PRP (Platelet Rich Plasma) was developed about 20 years ago with the goal of healing wounds and reducing blood loss. The use of PRP in orthopedics has a long history.
Various orthopedic diseases that were treated with other treatments are now being treated successfully using platelet-rich plasma (Platelet Rich Plasma-PRP). The PRP is an injectable treatment in which the blood of the patient himself is used, which with special treatment and enrichment is injected locally in the area of the lesion.
The double centrifugation procedure has been shown to increase platelet counts by 8-10 times the usual.
PRP is a plasma with much more platelets than is present in the blood, ie the platelet concentration is 8-10 times higher than usual. During the procedure a small amount of blood is taken from the patient (10-30ml), which is placed in a centrifugal machine that rotates at fast speeds.
Rotation causes the blood to split into 3 parts:
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The red blood cells
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The white blood cells
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And the platelets (plasma) where their concentration increases during the special treatment called centrifugation
This procedure (treatment) can be performed in the orthopedic clinic with peripheral venous blood sampling. It lasts about 15-30 minutes and anti-inflammatory drugs should not be taken one week before and one week after the procedure. Because it is created by the patient's own blood, it does not cause allergic reactions or complications.
PRP helps heal injured tendons, muscles and articular cartilage. Studies have shown that the increased concentration of growth factors potentially achieves the healing process.
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Indications:
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Backache - Chronic pain in the lower back
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Tendonitis
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Tennis elbow epicondylitis
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Knee tendonitis
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Tendonitis and partial rupture of the rotator cuff of the shoulder
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Achilles tendonitis
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Plantar fasciitis
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Adductors tendonitis
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Gluteal tendonitis
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Onset of osteoarthritis (knee - hip)
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Stenotic tendonitis of the hand
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Hip trochanteritis
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Contusion of the adductor, quadriceps, iliac, posterior femoral muscles
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Chondropathies of the knee, hip and ankle
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Knee cup cartilage softening
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Partial ligament rupture
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Tibial band syndrome
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Sprained ankle
Hyaluronic Acid
An alternative treatment that belongs to the conservative treatments for the treatment of osteoarthritis, is hyaluronic acid and in particular, its infusion in aching joint. Hyaluronic acid is a substance that is normally present in synovial fluid and articular cartilage. It acts as a "lubricant" for the joints and also helps to absorb their vibrations.
Patients with osteoarthritis have less hyaluronic acid in their joints than normal and by injecting it, we aim to replenish it, thus facilitating the sliding of the joints and reducing the pain. Scientific studies have shown that injecting hyaluronic acid inhibits prostaglandins and cytokines, substances that cause an inflammatory reaction and joint pain.
The joint is examined clinically by the doctor and the necessary imaging test is performed, either with a plain X-ray or with an MRI scan if this is deemed necessary. The joint (usually of the knee) is prepared and under aseptic conditions the doctor proceeds to puncture it, removing any excess fluid that may be present. and then pours hyaluronic acid. The procedure is performed in the doctor's office under aseptic conditions as mentioned above and may or may not precede it local anesthesia.
There are various treatment regimens that depend on the concentration and density of the spilled hyaluronic acid and are individualized accordingly. The most common are either regimens with an average of 3-5 injections over a period of a few weeks to complete a treatment, or 1 high-density injection. The latter is usually preferable as the patient does not suffer from frequent visits, and the risk of inflammation from repeated punctures is reduced. It usually takes a few weeks for the improvement to show. The beneficial effects of hyaluronic acid infusion can last for months or even years. After this period, the administration can be repeated if the arthritis is still in the early stages. It has been found that the effects of hyaluronic acid infusion are superior in patients with milder, early (early) form of osteoarthritis usually of the knee, while in advanced osteoarthritis it does not seem to help much.
Complications although extremely rare include:
Inflammation
Allergic reaction
Pain
A slight reaction of the joint to hyaluronic acid may sometimes occur the day after the infusion. There is no particular cause for concern and almost always, it gradually recedes. Laying ice can help. It is generally recommended to limit intense joint activity for 24-48 hours.
