Nguyen Sports Medicine
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    • Home
    • About Dr. Nguyen
    • Clinical Assistants
    • SportsMed MiniFellowship
    • ACL Surgery
    • SportsFractureClinic
    • ACL Rehab
    • PRP Injections
    • PRP Injections 2
    • Hyaluronic gel Injections
    • Sports Medicine Symposium
    • Pediatric ACL Surgery
    • Meniscus Surgery
    • Meniscus Surgery 2
    • Medical Education
    • Health Law
    • MPFL reconstruction
    • Osteochondral OCD repair
    • Sports Trauma
    • OATS Cartilage Transfer

  • Home
  • About Dr. Nguyen
  • Clinical Assistants
  • SportsMed MiniFellowship
  • ACL Surgery
  • SportsFractureClinic
  • ACL Rehab
  • PRP Injections
  • PRP Injections 2
  • Hyaluronic gel Injections
  • Sports Medicine Symposium
  • Pediatric ACL Surgery
  • Meniscus Surgery
  • Meniscus Surgery 2
  • Medical Education
  • Health Law
  • MPFL reconstruction
  • Osteochondral OCD repair
  • Sports Trauma
  • OATS Cartilage Transfer

Platelet Rich Plasma Injections

What exactly are PRP (platelet rich plasma) Injections?

Platelet Rich Plasma (PRP) injections for muscle, ligament tendon, cartilage injuries

Platelet Rich Plasma (PRP) injections for muscle, ligament tendon, cartilage injuries

Platelet Rich Plasma (PRP) injections for muscle, ligament tendon, cartilage injuries

  

http://orthoinfo.aaos.org/topic.cfm?topic=A00648
 

http://www.aaos.org/news/aaosnow/sep10/clinical1.asp


http://www.aaos.org/news/aaosnow/jun10/clinical9.asp

Blood draw

Platelet Rich Plasma (PRP) injections for muscle, ligament tendon, cartilage injuries

Platelet Rich Plasma (PRP) injections for muscle, ligament tendon, cartilage injuries

Performed under sterile technique 

Blood delivery into Centrifuge system

Platelet Rich Plasma (PRP) injections for muscle, ligament tendon, cartilage injuries

Blood delivery into Centrifuge system

Centrifuge system will separate the platelet rich plasma from red blood cells and white blood cells

(Flow Cytometry)

Programming the centrifuge

Separation of blood components by light

Blood delivery into Centrifuge system

Can generate white blood cells rich or poor plasma depending on the clinical indication (articular vs. soft tissue injections)

Separation of blood components by light

Separation of blood components by light

Separation of blood components by light

Final PRP product

Separation of blood components by light

Separation of blood components by light

PRP automatically withdrawn into sterile syringe by the centrifuge. 

Closed loop system to minimize contamination

Sterile blood draw

15 cc whole blood required (ACP) / 60 cc (Angel)

Knee PRP injection technique

Autologous Conditoned Plasma (ACP) PRP Injections


Technique

Prime double syringe

21G Butterfly needle - draw 15 cc blood. No need for citrate if injected w/in 30 mins

Place syringe red cap into centrifuge w/ counterbalance (saline filled syringe)

Spin @ 1500 rpm x 5 mins

Place index fingers under clear wings of outer syringe & use thumbs to depress red wings of inner syringe to draw the plasma into inner syringe. 

Insert 22g needle & inject

Select literature Study

Intra-articular Autologous Conditioned Plasma Injections Provide Safe and Efficacious Treatment for Knee Osteoarthritis: An FDA-Sanctioned, Randomized, Double-blind, Placebo-controlled Clinical Trial

Patrick A Smith. Am J Sports Med. 2016 April


Conclusion: ACP is safe & provides quantifiable benefits for pain relief & functional improvement w/ regard to knee OA. No adverse events were reported for ACP administration. After 1 year, WOMAC scores for ACP subjects had improved by 78% from baseline score compared to only 7% for placebo control group had improved.







Autologous Conditoned Plasma (ACP) Injections : Platelets + Growth Factors

Elbow PRP injection Technique

(ACP) Platelet Rich Plasma #PRP Injections #dryneedling for #tennis elbow / #lateralepicondylitis

Effects of trigger point dry needling on lateral epicondylalgia of musculoskeletal origin: a systematic review & meta-analysis

Marcos J Navarro-Santana et al. Clin Rehabil. 2020 Nov.

7studies (320 pts)

Conclusion: Low to moderate evidence suggests a positive effect of dry needling for pain, pain-related disability, pressure pain sensitivity & strength at short-term in patients w/ lateral epicondylalgia

literature review - prp injections for muscle tears PRP may decrease swelling & speed up healing which in turn may decrease time for return to play

Ultrasound guidance - A dynamic diagnostic visualization

Ultrasound guided PRP (platelet rich plasma) injections

Correlation of the site of pathology on MRI

Ultrasound guided PRP Injection

Elbow lateral epicondylitis (tennis elbow)

Meta-analysis of 18 studies

Primary outcome = change in pain intensity. Leukocyte rich prp better than leukocyte poor prp

Indications: tennis elbow, patella tendonitis, rotator cuff tendinopathy, achilles tendinopathy. 

Recommendations: ultrasound guided single prp injection into tendon with 2 mm local anesthetic superficial to tendon using 6 pass peppering dry needling

Shoulder PRP Injection - partial thickness rotator cuff tear

Select article 

Randomized Controlled Trial

Platelet rich plasma (PRP) in patients with partial thickness rotator cuff tears or tendinopathy leads to significantly improved short term pain relief & function compared with corticosteroid injection: a double blind randomized controlled trial. 

Cory A Kwong et al. Arthroscopy. 2021 Feb.
 Conclusions: Patients with PTRCTs or tendinopathy experienced clinical improvement in pain & patient-reported outcome scores after both ultrasound-guided cortisone & PRP injections. Patients who received PRP obtained superior improvement in pain & function at short-term follow-up (3 months). There was no sustained benefit of PRP over cortisone at longer-term follow-up (12 months).

PRP injection for shoulder rotator cuff tendinopathy

PRP injection for shoulder rotator cuff tendinopathy

Evidence based sports medicine

Subacromial Platelet-Rich Plasma Injections Decrease Pain and Improve Functional Outcomes in Patients With Refractory Rotator Cuff Tendinopathy

Luciano A Rossi et al. Arthroscopy. 2021 Sep.

Methods: Between March & October 2019, 50 patients w/ #rotatorcufftendinopathy refractory to conservative treatment were treated w/ one subacromial PRP injection. 

MRI was performed in all patients to confirm diagnosis. Visual analog scale (VAS) used to evaluate pain. 

#Rangeofmotion, the #AmericanShoulderandElbowSurgeons #ASESscore, & the #Constantscore were used to assess functional outcomes

80% of patients (40 of 50 patients) & 86% the patients (43 of 50 patients) achieved a clinically significant improvement that exceeded the substantial clinical benefit for the ASES & Constant scores, respectively. Mean (SD) age was 37.3 (9.3) years.

Results: All mobility parameters evaluated improved significantly after treatment. The VAS, ASES, & Constant scores showed statistical improvement after the injection (P < .001). Sleep disturbances (Pittsburgh Sleep Quality Index) were resolved in 86% of patients. 

Of the 32 patients who practiced #sports before the injury, 84% returned to sports &  78% returned to the same level.

There were no complications associated with the procedure.

Conclusions: In most patients with refractory rotator cuff tendinopathy, subacromial injections of leukocyte-rich PRP significantly decreased pain, improved functional outcomes, and resolved sleep disturbances. Moreover, most of the athletes returned to sports at the same level they had before the injury.

Combined PRP + Hyaluronic Gel Injection for Knee Arthritis

PRP (Platelet Rich Plasma) Infused Hyaluronic Acid Gel Injection for shoulder rotator cuff tear

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  • About Dr. Nguyen
  • Clinical Assistants
  • SportsMed MiniFellowship
  • ACL Surgery
  • SportsFractureClinic
  • ACL Rehab
  • PRP Injections
  • PRP Injections 2
  • Hyaluronic gel Injections
  • Sports Medicine Symposium
  • Pediatric ACL Surgery
  • Meniscus Surgery
  • Meniscus Surgery 2
  • Medical Education
  • Health Law
  • MPFL reconstruction
  • Osteochondral OCD repair
  • Sports Trauma
  • OATS Cartilage Transfer