For the past 20 years in animals and for approximately 10 years in humans, Platelet Rich Plasma (PRP) injections have been done. To help you understand this very exciting part of medicine, called regenerative medicine, some questions need to be asked, followed by some answers from what current research tell us.
Exactly what is Platelet Rich Plasma also known as PRP?
PRP is a volume of plasma having a platelet concentration above normative baseline values. It is taken from the patient’s own blood and concentrated in a centrifuge.
What types of conditions are treated with PRP ?
Tendinosis and tears of tendons
Osteoarthritis of shoulders, hips and knees as well as other peripheral joints
Lumbar degenerative discs and anular tears of the disc cartilage
Will my insurance pay for these treatments?
Currently in NYS only Worker’s Compensation Carriers with prior approval routinely pay for PRP but not stem cells. No-fault insurances carriers may cover PRP but no prior approval process is in place and payment can be retroactively denied and then you are responsible for the payment. Private insurance companies do not currently cover Stem Cells nor PRP injections.
What can you expect to pay for the PRP procedure in Western New York?
With the older systems a series of 3 injections each costing $400 is not uncommon. With the newer systems a single injection costing between $795 -$1000 is typical. The majority of the patients will receive one injection with the centrifuge system that Dr. Geraci uses, however if the tear is large, a second injection may be indicated.
Is PRP allowed for athletes?
YES! Annual review of the list of banned substances put out by WADA (World Anti-Doping Agency) includes substances that:
Poses a danger to athletes health
Are against spirit of sport
PRP was taken off the WADA banned list in 2011 once further studies confirmed that PRP does none of the above. The FDA also does not regulate PRP since the platelets are not altered.
Professional sports teams in the US and around the world have been using PRP successfully in treating their injured athletes.
Are these injections safe?
Yes, they are safe and effective. Adverse reactions are similar to other injections.
Are these injections well tolerated?
Post-Injection pain is common for a 2-3 days. Local anesthetic used in the skin, but not into the injured tissues as local anesthetics decrease the function of platelets. Relative rest for 3 weeks post-injection is recommended.
Is there evidence for benefits?
Double blinded randomized study showed PRP is better than steroid at 26 and 52 weeks.Others studies have shown PRP at the 2 year follow up, works better to control pain and increase function when compared to steroids and viscosupplements. PRP given for anular tears in lumbar discs can heal these types of tears. A few studies have demonstrated that Stem Cells and PRP in the lumbar discs have increased disc height.
Are there any cautions for a patient to be aware of when considering PRP?
Ultrasound or fluoroscopic (x-ray) guidance with contrast should be used for accurate placement. Discuss with the physician performing the procedure whether any medications you are currently taking need to be stopped before you have your PRP injection. Be aware that currently in Buffalo, a number of university as well as private physicians are providing PRP injections. Generally, one PRP injection is needed but in a MINORITY of cases where a tear is large, then 2 PRP injections may be required. If a series of injections is recommended and the payment is expected for all injections up front, this practice is not routine and is strongly discouraged by international experts from this year’s world conference on regenerative medicine.