Regenerative Medicine: PRP - Platelet Rich Plasma/Prolotherapy
Regenerative medicine is a rapidly expanding field of medicine (especially in musculoskeletal medicine) that relies on using the body’s innate healing mechanisms to resolve injuries. Currently this is done by injecting either Prolotherapy, PRP, or Stem Cells* into the area of concern.
Why Does PRP Work?
Platelets are a specialized type of blood cell. Blood is made up of 93% red cells (RBCs), 6% Platelets, 1% white blood cells (WBCs), and plasma.
Most people associate platelets with clot formation. While that certainly is an important function of platelets, they are also very much involved in injury healing. Human platelets are naturally extremely rich in connective tissue growth factors.
Injecting these growth factors into damaged ligaments, tendons, and joints stimulates a natural repair process. But in order to benefit from these natural healing proteins, the platelets must first be concentrated. In other words, PRP recreates and stimulates the body’s natural healing process.
In the case of Prolotherapy a hypertonic solution of Dextrose is given in order to cause an inflammatory response and induce the body to produce the natural healing response at the area of injection.
Corticosteroid or “cortisone” injections, as they are commonly referred to, cannot be injected into weight bearing tendons such as the patellar tendon of the knee and Achilles tendon of the ankle because then can weaken the tendon and cause it to rupture. PRP can safely be used in these tendons without the risk of rupture.
How is PRP Done?
In the office, blood is drawn from the patient (just like getting a blood test) and placed in a special centrifuge. The centrifuge separates the RBCs, and the remaining platelets and plasma are then highly concentrated. (The WBCs, which comprise only a fraction of the total cells, go along for the ride with the platelets and plasma.) The red blood cells are discarded, and the resulting platelet concentrate is used for treatment.
In most cases the injections are given under direct ultrasound guidance to insure accurate placement of the platelet concentrate in the damaged area. The entire treatment, from blood draw, to solution preparation, to injection, takes 45 minutes.
If you are having Prolotherapy there is no blood draw necessary, the injection is given the same as PRP.
How often are Injections Given?
After the initial treatment, a follow up visit is scheduled 2-4 weeks later to evaluate healing progress. Some patients respond very well to just one treatment. However, 2-3 treatments may be necessary in some injuries and 3-6 for Prolotherapy. If multiple injections are given, injections are typically given every 2-4 weeks.
What Conditions Benefit From PRP/ Prolotherapy?
PRP treatment works for acute and chronic ligament and tendon sprains/strains that have failed other conservative treatment, including:
- Rotator cuff injuries
- Shoulder pain and instability
- Tennis & golfer’s elbow
- Hamstring and hip strains
- Knee sprains and instability
- Patellofemoral syndrome and patellar tendinosis
- Ankle sprains
- Achilles tendinosis & plantar fasciitis
- Knee, hip, and other joint osteoarthritis
- Sports hernias & athletic pubalgia
- Loose or subluxing joints
- Plantar Fasciitis
- Soft tissue pain around joints
- Shin Splints
- Arthritic Pain
- Other chronic tendon and ligament problems
- In addition, PRP can be very helpful for many cases of osteoarthritis (the "wear & tear" kind).
- PRP can help stimulate a "smoothing over" of the roughened and arthritic cartilage, reducing the pain and disability of arthritis. This includes:
- Knee arthritis
- Hip joint arthritis
- And other joint arthritis
Is it Covered by Insurance?
Insurance plans, including Medicare, do NOT pay for regenerative injections.
Do PRP Injections Hurt?
Because lidocaine interferes with the platelet function, it is not used during the PRP injection. Unlike a steroid injection, there may be pain for the next few days after an injection. For the days preceding the injection and for the first week after the injections it is critical to avoid anti-inflammatory medications, including Advil, Motrin, ibuprofen, Aleve, Celebrex and aspirin (unless prescribed by your heart doctor). These will interfere with the healing response. Tylenol is OK. Your doctor may prescribe pain medication also.
Lidocaine is used for Prolotherapy and it is generally considered a somewhat less painful injection.
Are there risks with these Injections?
Anytime a needle is placed anywhere in the body, even getting blood drawn, there is a risk of infection, bleeding, and nerve damage. However, these are very rare. Other complications, though rare, vary depending on the area being treated, and will be discussed by your doctor before starting treatment. Because PRP uses your own blood adverse reactions are rare.
What is the Success Rate?
Studies suggest an improvement of 80-85%. Some patients experience complete relief of their pain. The results are generally permanent.
Curr Rev Musculoskelet Med (2008) 1:165–174
*At this time we are not providing Stem Cell therapy secondary to the extremely high cost and lack of evidence that it is of any greater benefit than Prolotherapy or PRP.
COVID-19 News & Announcements
New! June 23: Going Home after Birth during the COVID-19 Pandemic
New! June 23: Volver a casa después de dar a luz durante la pandemia de COVID-19
To minimize the risk of spreading COVID-19, Virginia Mason Memorial (VMM) would like to remind all patients and visitors that masks are REQUIRED at all VMM facilities, including our clinics.
To conserve supplies, we request that all patients and visitors bring masks to their appointments. A limited number of reusable cloth masks, made by community members, will be available if you need one.
We also strongly encourage all community members to wear masks when in public - this is one of our best tools to prevent the spread of COVID-19.
UPDATED! May 26: New Visitation Policy
As a response to the current community situation with COVID-19, we are suspending most in-person visits to our hospitalized patients. The decision to suspend hospital visits was difficult and made only after careful consideration.
Read More »
Prescription Home Delivery
We now offer home delivery for your prescription medications.
Visitors to Generations OB/GYN
As part of our continuing efforts to focus on patient safety during the COVID-19 pandemic, Generations has changed its visitor policy.
No visitors will be allowed for clinic visits, with the only exceptions being:
1 Visitor will be allowed for the first OB appointment
1 visitor will be allowed at the 20 week anatomy ultrasound
Visitors to the Family Birthplace
Women in the Family Birthplace may have one visitor.
Telehealth: Your questions answered
COVID-19 Evaluation Clinic
Our Creekside HealthyNow location is now a COVID-19 evaluation clinic. If you have cough and fever, please schedule your visit at our Creekside Location. Please list your symptoms in the reason for visit so our team is better prepared to assist you.
This location completes an evaluation to determine if you're a candidate for COVID testing. Learn more »
We have reduced the number of Physician and Provider positions we are recruiting for in the wake of the COVID-19 pandemic. Should you be interested in possible employment with Virginia Mason Memorial, please contact us at firstname.lastname@example.org. We are actively reviewing our staffing needs and new positions are being approved for posting. We appreciate your interest in us and hope to have the opportunity to consider you for a role with VMM.
Additional Spiritual Resources During COVID-19
Chaplains at Virginia Mason Memorial Hospital provide care for every patient regardless of their personal beliefs or non-beliefs. For support, assistance, prayers, and all other spiritual care requests, please email email@example.com or call the spiritual care office: (509) 575-8035
There are times when a direct face to face spiritual care conversation is not the best option (due to distance, a pandemic, patient preference). That's where Tele-Chaplaincy provides another possibility. You can request chaplain support using your personal, or hospital room, phone. Calls are confidential. Chaplains will listen, provide encouragement, offer help and resources, and if desired, offer prayer. If you are part of a faith community a chaplain can help you connect with them.
Without regular visits from family and friends a stay in the hospital can be even more challenging. One of our newest offerings, Virtual Chaplaincy using Zoom, helps make connections. By contacting the Spiritual Care team at the email or phone number above you can request a Zoom meeting. Family and friends throughout the Yakima Valley, from the four corners of the state, from across the country and even internationally, are meeting with patients via Zoom to offer their love and support. Due to the popularity of this option scheduling and frequency may, at times, be limited.
Hospital Lab Services
All out-patient lab services - including newborn screens and bilirubin collections - will now be provided at Memorial Cornerstone Medicine, 4003 Creekside Loop. Hours are 7 a.m. to 6 p.m. Monday through Friday; 8 a.m. to noon, Saturday and Sunday.
Beginning Thursday, March 19, the hospital pharmacy is closed to the public for the duration of the pandemic. The public may choose to have those prescriptions transferred to VMM's Pharmacy at Creekside or the pharmacy of their choice.
The Pharmacy at Creekside, 4003 Creekside Loop, is open 8:30 a.m. to 6 p.m. Monday through Friday; and Saturday and Sunday 8 a.m. to 4:30 p.m. and offers walk-in or drive-through options for pickup.
Farmacia Del Hospital
A partir del jueves 19 de marzo, la farmacia del hospital estará cerrada al público mientras dure la pandemia. El público puede escoger si quiere que sus recetas sean transferidas a la otra farmacia de Virginia Mason Memorial, localizada en la clínica Cornerstone o también puede elegir cualquier otra farmacia de su preferencia. La clínica de Cornerstone, está localizada en el 4003 Creekside Loop. En esta farmacia se puede recoger la medicina por la ventana y/o adentro de la clínica.
Horario: Lunes a Viernes de 8:30 a.m. a 6:00 p.m. y sábado y domingo de las 8:00 a.m. a las 4:30 pm