Soft Tissue Injury and the Use of Platelet Rich Plasma In Athletes
Acute and chronic musculoskeletal injuries in sports are common and problematic for both athletes and clinicians. A significant proportion of these injuries remain difficult to treat, and many athletes suffer from decreased performance and longstanding pain and discomfort. The real cost of these injuries to an athlete and a Club is not only money spent on healthcare but also the loss of time on the field and depending on the player and the competition this time off can have a devastating effect to the Club and athlete. Thus, for professional athletes or sports patients the impact of these injuries is great and the rapid recovery and return to full efficiency and to competition, is of primary importance. The optimal treatment for these injuries should therefore aim to restore athletes to their pre-injury status in a safe, cost effective way, as quickly as possible.
A new frontier in the treatment of sports injuries is the growing science of “Orthobiologics”, or the science of injectables to promote healing through the use of the athlete’s own biological tissue. Platelet Rich Plasma (PRP) is such a treatment and although used for decades in fields such as dentistry, neurosurgery, urology, wound healing, cardiothoracic and maxillofacial surgery, it is an expanding and exciting treatment for soft tissue injuries in sports.
Without going into too much science, the scientific rational for the use of PRP is to stimulate the body’s own natural healing process, to aid tissue repair and regeneration by a “supraphysiologic” release of Growth Factors (GFs) directly administered to the site of injury. Platelets are complex cells found in blood, containing a variety of GFs and these GFs mediate the biological process necessary for repair of soft tissue following acute traumatic or overuse injury.
The use and clinical validation of PRP for the treatment of sports injuries is a rapidly expanding field. PRP therapy, previously controversial and with its critics, due in part because of the lack of large numbers of randomised control studies, there is now a growing body of evidence providing clinical safety and clinical efficacy data indicating promising results. Human and Animal studies have demonstrated clear benefits in terms of acceleration healing and anti-inflammatory action of PRP and there is interesting clinical and scientific work exploring [clinical]condition specific PRP therapy, using specific concentrations of platelets for different clinical therapeutic needs. .
A 2009 systematic review of the scientific literature concluded that although there are few controlled clinical trials; PRP is "a promising, treatment option for joint, tendon, ligament, and muscle injuries".
One of the greatest benefits to this treatment is that the injured athlete uses his/her own blood for the procedure. The procedure involves the doctor drawing blood from the athlete (between 10- 35 mls), the blood is processed at point of care, in a specialised blood processing system (5-15 minutes) which concentrates and separates the PRP enriched plasma, from the whole blood. This concentrated PRP, which contains large amounts of the highly specialised tissue growth and repair factors, [referred to as cytokines and chemokines], is then injected into the site of the injury, with the use of sophisticated image guidance technology, such as dynamic ultrasound.
The World Anti Doping Association (WADA) allows athletes to have PRP treatment to heal ligament, tendons and joint injuries.
If you'd like more information on the London Sports Injury Clinic click here
Dr Ralph Rogers MD PhD MBA
Medical Director The London Sports Injury Clinic 108 Harley Street