PRP: The Power of Platelets
Could self-donated plasma help soothe arthritic joints?
When standard treatments for osteoarthritis fail, a growing number of physicians are turning to a relatively untested alternative: platelet-rich plasma, or PRP, therapy, in which patients are injected with an altered version of their own blood.
In theory, PRP therapy uses the healing power of blood platelets: a rich source of substances known as growth factors, which promote tissue repair and may help rebuild cartilage, reduce inflammation and lubricate joints, says physician Steven Sampson, director of the Orthohealing Center in Los Angeles. Despite limited and conflicting evidence that it works, golfer Tiger Woods has said he used PRP to speed recovery from injuries, and football player Hines Ward of the Pittsburgh Steelers is said to have used it.
In a typical PRP treatment, 30 to 60 milliliters of blood is drawn and spun in a special centrifuge to concentrate the platelet level in plasma—the fluid that carries blood components, including red and white blood cells and platelets—to four to six times the normal level. That plasma is then injected into and around the joint.
PRP treatments cost $1,000 or more, and the therapy has yet to be proved effective in randomized trials. But many physicians, including Joanne Borg-Stein, medical director of Spaulding Rehabilitation Hospital’s Wellesley, Mass., location, have tried PRP on the basis of observational evidence showing the treatment helps heal joint tissue. Borg-Stein has treated roughly 100 OA patients, typically as a last resort before knee replacement, and says her patients have had significantly less pain and improved function.
Others see mixed results. Elizaveta Kon of the Rizzoli Orthopaedic Institute in Bologna recently completed a study showing PRP to be more effective than another OA treatment, hyaluronic acid. But Kon, who has found that PRP primarily benefits patients younger than 50 with mild arthritis, says, “It’s not holy water.”