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This website is under development - The information contained on this site is for guidance only and is not intended for self diagnosis or self treatment. This will not replace professional medical advice or consultation. Always seek the professional advice of a qualified health care provider like your doctor or specialist before embarking on  any treatment. If you have a problem please consult your doctor or specialist.
Arthroscopic stabilisation    Reverse Replacement    P R P injection
WHAT IS PRP?

PRP stands for Platelet Rich Plasma preparation. It is prepared from a sample of your blood.

Your blood contains red blood cells (which carry oxygen), white blood cells (which fight infections), platelets (the store house for growth factors) and plasma (the yellowish protein filled fluid). PRP is harvested by using special equipment (centrifuge) and is used for treating chronic inflammation in tendons, thus using your own healing potential.


CHRONIC TENDONITIS

Chronic tendonitis is a condition where there is ineffective healing of micro-tears within the tendons near their attachments. This may be so as the tendon in question is under constant tension during its natural movements. Non-healing of these micro-tears lead to ongoing inflammation with pain.

Typical examples for these conditions are “Tennis Elbow” or “Golfer’s Elbow”. Similar pathology may exist in other places like knee and ankle tendons and some ligaments which take significant load like the plan-tar fascia in the foot (heel pain).
Steroid injections decrease inflammation and may help in healing. Surgery allows one to remove unhealthy tissues and suture the tendons to promote healing.

However, by using PRP, we deposit a high concentration of “agitated” platelet cells in the area where it releases large quantities of healing factors. This is thought to promote healing.


PROCEDURE

You would have received information regarding this before you visit the clinic. On the day of the proposed injection, the surgeon will re-examine you and perform an ultrasound scan to locate the inflamed scar tissue. Consent will be obtained and you will be requested to complete a questionnaire to monitor your response (Quick DASH questionnaire) using web based calculator.  

Approximately 28 ml of blood is taken. It will take about 40 minutes to separate the components of the blood. Then using specialised equipment approximately 2 to 3 ml of PRP containing high concentration of activated platelet is separated.

Once the preparation is ready you will be invited back to the room. The injection will then be carried out. Some-times this will be under
ultrasound guidance. Local anaesthetic may be used in some situations. The total time for the procedure is likely to be up to 2 hours.

SIDE EFFECTS


Pain during or just after the injection.

Bruising lasting for a few weeks.

Pins & Needle sensation in the forearm/hand.

On-going pain taking up to 3 to 4 weeks to settle.

Some weakness, especially in power grip.

FIRST FEW DAYS


Do not drive for 24 to 48 hours after the injection. Bring someone to take you back home on the day of the injection.

Use ice compression to decrease pain.

Take adequate pain killers; BUT avoid anti-inflammatory tablets (common ones are ibuprofen, diclofenac, naproxen etc)

On-going pain can take up to 3 to 4 weeks to settle.


WHO IS ELIGIBLE?


The condition should be present for a minimum 6 months.

Failed to resolve with all simple measures like activity modification, stretching & eccentric loading exercises, anti-inflammatory tablets, use of splints etc

Should have received one or two steroid and local anaesthetic injection and yet no better.

Ready to opt for surgical solution but cannot do so due to risk aversion or inability to participate in lengthy reha-bilitation.


EXPECTED COURSE

In the first 6 weeks after the injection you may think that this has not worked as well as a steroid injection or may even feel worse.
At 3 months, on balance, it is likely to have worked better than a steroid injection. At 6 months, it is expected that about two thirds of the patients would be symptom free.

The best of the available evidence suggests that up to 70% of the patients who receive PRP will avoid surgery. Unlike steroid injections this can be repeated if needed.
Leaflet - NHS Leaflet - Mount Stuart