PRP Has Changed, and We’ve Changed with It

7 Sept

Written By Clarke Holmes

PRP: What’s New—and What’s Not?

Platelet-rich plasma (PRP) continues to evolve—and so does our understanding of how to use it effectively.

At Impact Sports Medicine & Orthopedics, we have been performing and studying PRP for years. One of the most exciting things about regenerative medicine is that it is not static. The technology continues to improve, our understanding of the biology continues to grow, and we continue to learn how to better match the treatment to the individual patient.

So, what’s new with PRP—and what hasn’t changed?

What’s New?

More precise PRP preparation

The technology used to prepare PRP has become increasingly sophisticated.

With the advanced systems we use, we can more precisely control important characteristics of the final PRP product—including:

The volume of PRP
Platelet concentration and number
White blood cell concentration
The type of white blood cells present
The overall composition of the preparation

Why does this matter?

PRP is not simply one standardized product. Different orthopedic problems may benefit from different biologic preparations. Being able to more precisely control what we are injecting allows us to customize treatment to the specific tissue and problem we are trying to address.

We’re learning more about the value of plasma

PRP isn’t only about platelets.

The plasma portion of your blood contains numerous biologically active proteins and other components, including extracellular vesicles, that may contribute to tissue signaling and healing.

Advances in processing technology are allowing us to better understand—and potentially utilize—these components as part of a regenerative treatment strategy.

The goal isn’t simply to create “more powerful” PRP. The goal is to create the right biologic preparation for the problem we are treating.

More patients are asking about PRP

The word is out.

Patients are increasingly interested in PRP as a nonsurgical option for managing pain, reducing inflammation, treating certain tendon and ligament problems, and managing arthritis.

Importantly, PRP isn’t a cure-all. But for appropriately selected patients, it can be a valuable tool in our orthopedic treatment toolbox.

We now pay much more attention to what happens before and after the injection

One of the biggest lessons we have learned is that the injection itself is only part of the treatment.

What you do before and after PRP can influence your recovery and potentially your outcome.

That’s why we provide specific recommendations regarding:

Exercise and activity
Hydration
Nutrition
Medications
Supplements
Rest
Protection or temporary immobilization when appropriate
Gradual return to activity

Our philosophy is simple: if we’re going to invest the time and resources to perform a biologic treatment, we want to put your body in the best possible environment to respond to it.

What Hasn’t Changed?

We continue to study PRP

PRP is not something we learned about years ago and then stopped thinking about.

We continue to devote significant time outside of normal office hours to reviewing medical literature, studying new research, participating in educational webinars, evaluating new technology, and refining our techniques.

Why?

Because our responsibility doesn’t end when we become comfortable with a procedure.

We want to continually ask:

Is there a better way to do this?

What does the newest evidence tell us?

How can we improve the experience and outcome for our patients?

Ultrasound guidance remains essential

A sophisticated biologic treatment is only useful if it is delivered to the right location.

That’s why we use ultrasound guidance for our PRP procedures.

Traditional landmark-based, or “blind,” injections rely on external anatomy to estimate where the needle should go. While this can sometimes work, there is greater potential for the injection to miss the intended target.

Ultrasound allows us to visualize the anatomy in real time and place the needle precisely where the treatment is intended to be delivered.

In our view, this is an important part of providing a high-quality PRP procedure.

Fair pricing matters—but the cheapest PRP isn’t necessarily the best PRP

PRP is generally not covered by insurance, which can make cost an important consideration for patients.

We believe patients deserve fair and transparent pricing. At the same time, we encourage you not to make your decision based solely on price.

The cost of a PRP procedure can reflect many things:

The quality and sophistication of the preparation system
The equipment used
Physician experience
Ultrasound guidance
Time spent evaluating and preparing the patient
The level of customization
Post-procedure care and follow-up

PRP is not a commodity where every injection is necessarily equivalent to every other injection.

Don’t automatically choose the cheapest PRP procedure.

Instead, ask what you’re actually receiving.

Honesty and integrity are perhaps the most important parts of the process

Most importantly, PRP isn’t right for everyone.

There are patients for whom PRP may provide little benefit. In some situations, it may simply be a waste of time and money.

Our job is not to sell you a procedure.

Our job is to determine whether the procedure makes sense for you.

If you have a condition that is better treated with physical therapy, medication, another minimally invasive procedure, or even surgery, we will tell you.

For example, a patient with a major structural tear, significant joint instability, or advanced arthritis requiring joint replacement may not be an appropriate PRP candidate.

We believe in treating our patients the way we would want to be treated ourselves.

The Bottom Line

PRP has come a long way—and it continues to evolve.

The technology is better. Our ability to customize the biologic preparation is better. Our understanding of the biology continues to improve. And our approach to preparing patients and managing them after the injection has become increasingly sophisticated.

But some principles haven’t changed:

Use good science.

Use good technology.

Place the treatment precisely.

Optimize the patient before and after the procedure.

And, most importantly, be honest about who is—and isn’t—a good candidate.

At Impact Sports Medicine & Orthopedics, our goal isn’t simply to offer PRP.

Our goal is to offer PRP the right way, to the right patient, for the right problem.

F. Clarke Holmes, M.D.

Clarke Holmes

PRP Has Changed, and We’ve Changed with It

PRP: What’s New—and What’s Not?

Platelet-rich plasma (PRP) continues to evolve—and so does our understanding of how to use it effectively.

So, what’s new with PRP—and what hasn’t changed?

What’s New?

More precise PRP preparation

The technology used to prepare PRP has become increasingly sophisticated.

With the advanced systems we use, we can more precisely control important characteristics of the final PRP product—including:

The volume of PRP

Platelet concentration and number

White blood cell concentration

The type of white blood cells present

The overall composition of the preparation

Why does this matter?

PRP is not simply one standardized product. Different orthopedic problems may benefit from different biologic preparations. Being able to more precisely control what we are injecting allows us to customize treatment to the specific tissue and problem we are trying to address.

We’re learning more about the value of plasma

PRP isn’t only about platelets.

The plasma portion of your blood contains numerous biologically active proteins and other components, including extracellular vesicles, that may contribute to tissue signaling and healing.

Advances in processing technology are allowing us to better understand—and potentially utilize—these components as part of a regenerative treatment strategy.

The goal isn’t simply to create “more powerful” PRP. The goal is to create the right biologic preparation for the problem we are treating.

More patients are asking about PRP

The word is out.

Patients are increasingly interested in PRP as a nonsurgical option for managing pain, reducing inflammation, treating certain tendon and ligament problems, and managing arthritis.

Importantly, PRP isn’t a cure-all. But for appropriately selected patients, it can be a valuable tool in our orthopedic treatment toolbox.

We now pay much more attention to what happens before and after the injection

One of the biggest lessons we have learned is that the injection itself is only part of the treatment.

What you do before and after PRP can influence your recovery and potentially your outcome.

That’s why we provide specific recommendations regarding:

Exercise and activity

Hydration

Nutrition

Medications

Supplements

Rest

Protection or temporary immobilization when appropriate

Gradual return to activity

Our philosophy is simple: if we’re going to invest the time and resources to perform a biologic treatment, we want to put your body in the best possible environment to respond to it.

What Hasn’t Changed?

We continue to study PRP

PRP is not something we learned about years ago and then stopped thinking about.

We continue to devote significant time outside of normal office hours to reviewing medical literature, studying new research, participating in educational webinars, evaluating new technology, and refining our techniques.

Why?

Because our responsibility doesn’t end when we become comfortable with a procedure.

We want to continually ask:

Is there a better way to do this?

What does the newest evidence tell us?

How can we improve the experience and outcome for our patients?

Ultrasound guidance remains essential

A sophisticated biologic treatment is only useful if it is delivered to the right location.

That’s why we use ultrasound guidance for our PRP procedures.

Traditional landmark-based, or “blind,” injections rely on external anatomy to estimate where the needle should go. While this can sometimes work, there is greater potential for the injection to miss the intended target.

Ultrasound allows us to visualize the anatomy in real time and place the needle precisely where the treatment is intended to be delivered.

In our view, this is an important part of providing a high-quality PRP procedure.

Fair pricing matters—but the cheapest PRP isn’t necessarily the best PRP

PRP is generally not covered by insurance, which can make cost an important consideration for patients.

We believe patients deserve fair and transparent pricing. At the same time, we encourage you not to make your decision based solely on price.

The cost of a PRP procedure can reflect many things:

The quality and sophistication of the preparation system

The equipment used

Physician experience

Ultrasound guidance

Time spent evaluating and preparing the patient

The level of customization

Post-procedure care and follow-up

PRP is not a commodity where every injection is necessarily equivalent to every other injection.

Don’t automatically choose the cheapest PRP procedure.

Instead, ask what you’re actually receiving.

Honesty and integrity are perhaps the most important parts of the process

Most importantly, PRP isn’t right for everyone.

There are patients for whom PRP may provide little benefit. In some situations, it may simply be a waste of time and money.

Our job is not to sell you a procedure.

Our job is to determine whether the procedure makes sense for you.

If you have a condition that is better treated with physical therapy, medication, another minimally invasive procedure, or even surgery, we will tell you.

For example, a patient with a major structural tear, significant joint instability, or advanced arthritis requiring joint replacement may not be an appropriate PRP candidate.

We believe in treating our patients the way we would want to be treated ourselves.

The Bottom Line

PRP has come a long way—and it continues to evolve.

The technology is better. Our ability to customize the biologic preparation is better. Our understanding of the biology continues to improve. And our approach to preparing patients and managing them after the injection has become increasingly sophisticated.

But some principles haven’t changed:

Use good science.