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Platelet-Rich Plasma

synonyms: PRP

Platelet-Rich Plasma CPT

  • PRP is considered experimental and not currently reimbursed by third party payers.

Platelet-Rich Plasma

  • Defined as autologous blood with concentrations of platelets above baseline values
  • Autologous anti-coagulated blood is centrifuged into platelet rich and platelet poor portions. PRP can be given with or without activation. Combing PRP with calcium chloride or thrombin immediately before injection "activitates" it by inititiating platelet activation, clot formation, and growth factor release.
  • Growth factors in PRP: platelet-derived growth factor, vascular endothelial growth factor, TGF-B1, fibroblast growth factor, epidermal growth factor, hepatocyte growth factor, insulin-like growth factor-1

Platelet-Rich Plasma Indications

  • Lateral Epicondylitis (Mishra A, AJSM 2006; 34:1774), (Mishra A, Clin Sports Med 2009; 28:113)
  • Chronic Patellar Tendinitis (Kon E, Injury 2009; 40:598)
  • Plantar Fasciitis (Barrett S, Podiatry Today 2004; 17:37)
  • Muscle Injury
  • Knee Osteoarthritis(Sánchez M, Clin Exp Rheumatol 2008; 26:910).
  • Achilles Tendon Repair (Sánchez M, AJSM 2007; 35:245)
  • Rotator Cuff Repair (Randelli PS, Disabil Rehabil 2008; 30:1584)

Platelet-Rich Plasma Contraindications

  • Thrombocytopenia
  • Concurrent anticoagulant use
  • Active infection
  • Tumor / Metatastic disease
  • Pregnancy

Platelet-Rich Plasma Available Preparations

  • Cost averages $150/syringe
  • Autologous Conditioned Plasma - Arthrex
  • Cascade - MTF
  • GPS III - Biomet
  • SmartPRep - Harvest Technologies

Platelet-Rich Plasma References

  • Sanchez M, Sports Med 2009;39:345
  • Hall MP, JAAOS 2009;17:602