Several months ago, Dr. Val Jones wrote about a growing fad in the treatment of musculoskeletal disorders. The therapy, called platelet rich plasma (PRP) injection, involves taking a small amount of blood from a patient, spinning it down in a centrifuge, and then injecting the plasma component into…somewhere. This treatment is becoming increasingly popular, and can be very lucrative for doctors. But does it work?
Blood platelets are very biologically active particles and plasma is not a bland fluid. Platelets and plasma contain many biologically active molecules, some of which may be implicated in “healing”. This gives PRP at least a veneer of plausibility, but like any other treatment, plausibility is only the first step.
There have been a few human studies of PRP. A recent article in the Journal of the American Medical Association (JAMA) showed no difference between PRP and saline injections for chronic Achilles tendon problems.
A small pilot study looked at PRP for the treatment of a particular periodontal disease, and found some possible benefit.
Another interesting study looked at PRPs affect on the healing of anterior cruciate ligament (ACL) grafts in the knee. This study included long term (two year) follow up, and found no benefit.
And that’s really about it. There is little evidence to support platelet rich plasma for the treatment of anything. And yet it is being hyped and sold everywhere as a miracle cure for musculoskeletal injuries. Perhaps more studies will enlighten the issue further, but at this point, PRP is nothing but expensive snake oil, and those who promote and use it should re-examine the data and their ethics.
de Vos RJ, Weir A, van Schie HT, Bierma-Zeinstra SM, Verhaar JA, Weinans H, & Tol JL (2010). Platelet-rich plasma injection for chronic Achilles tendinopathy: a randomized controlled trial. JAMA : the journal of the American Medical Association, 303 (2), 144-9 PMID: 20068208
Markou N, Pepelassi E, Vavouraki H, Stamatakis HC, Nikolopoulos G, Vrotsos I, & Tsiklakis K (2009). Treatment of periodontal endosseous defects with platelet-rich plasma alone or in combination with demineralized freeze-dried bone allograft: a comparative clinical trial. Journal of periodontology, 80 (12), 1911-9 PMID: 19961374
Nin JR, Gasque GM, Azcárate AV, Beola JD, & Gonzalez MH (2009). Has platelet-rich plasma any role in anterior cruciate ligament allograft healing? Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 25 (11), 1206-13 PMID: 19896041