Role of PRP Injections in Orthopaedics

Platelet-rich plasma (PRP) therapy has revolutionised non-surgical orthopaedic care in the past decade. From elite athletes to elderly individuals suffering from chronic joint pain, PRP is being widely used as a safe and natural treatment option to heal the damaged tissues and reduce pain by using the body’s own healing mechanism. PRP helps accelerate recovery from injuries and even delays disease progression in degenerative conditions. Let’s try to understand this innovative treatment in detail.

What is PRP?

Human blood is composed of 3 types of cells suspended in plasma:

• Red blood cells: carry oxygen

• White blood cells: form the main part of the body’s immune system

• Platelets: essential for clotting of blood and healing of tissues

• Plasma: liquid portion containing nutrients

Platelets are rich in various growth factors, i.e. biological proteins that promote cell repair, new tissue formation and reduce inflammation. These are Platelet Derived Growth Factor (PDGF), Transforming Growth Factor Beta (TGF-B), Vascular Endothelial Growth Factor (VEGF), etc.

They act like the body’s ‘repair crew’.

How does PRP work inside the body?

Once injected into the affected area, PRP gradually releases growth factors over several days. These help in:

• Pain reduction: by decreasing inflammation

• Cell regeneration: stimulating new cell growth in damaged tissues

• Improved blood supply: enhancing natural healing

• Stronger tissue repair: beneficial for degenerative joint or tendon conditions

This makes PRP an excellent choice for patients who have persistent pain despite prolonged treatment with medications, physiotherapy and lifestyle changes.

In which orthopaedic conditions is PRP effective?

PRP has shown promising results in both acute injuries and long-standing degenerative conditions:

A) Joint Disorders

• Knee osteoarthritis (early stages)

• Hip, shoulder arthritis

It reduces inflammation during an acute flare-up inside the joint, thereby reducing pain, swelling, and stiffness, and thereby improving joint mobility.

B) Tendon Problems

• Tennis Elbow, Golfer’s Elbow

• Plantar Fasciitis

• Achilles Tendinopathy

• Rotator Cuff Tendinitis

• Jumper’s Knee (Patellar Tendinitis)

In chronic tendon problems, the local blood supply is reduced. PRP enhances healing in these ‘difficult to heal’ areas by delivering growth factors directly to the site.

C) Sports injuries

• Muscle strains (hamstring, calf, thigh)

• Overuse injuries in runners and athletes

PRP promotes rapid healing and a faster return to sports.

When is PRP recommended?

An orthopaedic surgeon recommends PRP when:

• Persistent pain despite medications and supervised physiotherapy

• For temporary relief to slow down the disease progression, e.g. early knee arthritis

• When you prefer natural, regenerative treatment options in the form of injections over steroids

What is the step-by-step procedure?

The entire procedure usually takes about 30 minutes:

1. Blood collection
30-40ml of blood taken from your arm (similar to a routine blood test).

2. Centrifugation: Blood is spun in a specialised device to isolate platelet-rich plasma.

3. Injection: PRP is injected into the targeted area.

4. Post-procedure recovery
Mild soreness, warmth may be experienced for 1-2 days.
Rest and icepack application are advised.

You can start walking immediately and resume daily activities.

Single Spin Vs Double Spin PRP

Single Spin PRP

1. Centrifugation Process: Single-spin PRP uses one round of centrifugation to separate blood components. The process typically yields platelet concentrations approximately 3 to 5 times greater than those of whole blood.

2. Applications: Often preferred for cosmetic and dermatological treatments such as facial rejuvenation, hair restoration, and scar reduction.

Double Spin PRP

1. Centrifugation Process: Double spin PRP involves two centrifuge cycles, resulting in higher platelet concentrations, typically exceeding 5 to 7 times that of whole blood.

2. Applications: Used in orthopaedic and sports medicine applications such as arthritis, tendonitis, and ligament injuries.

How many injections are usually required?

This depends on the condition:

Condition	Typical Number of Sessions
Tendon Injuries	1–2 sessions
Knee Osteoarthritis	2–3 sessions (4 weeks apart)
Muscle injuries	1-2 sessions

Symptomatic improvement usually starts within 2 weeks and continues over several months as the tissue heals.

What are the benefits of PRP therapy?

        Uses the natural healing process of the body

        Minimal side effects & downtime

        Longer-lasting improvement compared to steroids

        Allows earlier return to activities & sports

        Can be combined with physiotherapy for better results

Who should avoid PRP?

Though safe, PRP is not advisable in:

• Severe end-stage arthritis

• Patients with blood-clotting disorders

• Individuals on blood thinner medications like Ecosprin, Clopidogrel

• Active infections in the body or at the injection site

Frequently Asked Questions About PRP

Q. Is the injection painful?

Local anaesthesia is given before injecting the PRP. So the actual process becomes painless.

Q. Are there any side effects?

Mild swelling, warmth and soreness can be felt for the initial 24 to 48 hours, which resolves on its own.

Q. Can PRP treatment avoid surgery altogether?

No! PRP can only help in delaying the process of arthritis and relieving the pain for some duration, but it can not completely prevent or reverse the arthritis.

Q. Do I need physiotherapy after PRP?

Yes. Physiotherapy enhances healing and maintains strength and mobility. Results are better when both are combined.

Comparison of PRP vs Steroid injection

Feature	PRP	Steroids
Type	Natural, regenerative	Synthetic, anti-inflammatory
Duration of relief	Long-term	Short-term
Tissue effect	Strengthening	Can weaken tissues with repeated use
Safety	Very safe	Higher side-effect risk

Thus, PRP is a better choice for a long-lasting benefit.

What does the research say?

Osteoarthritis: PRP injections are superior to hyaluronic acid in relieving knee osteoarthritis symptoms. [PMC10333515]

Tendinopathies: PRP improves functional recovery and reduces pain in lateral epicondylitis. [BMJ Open SEM]

Spinal Pain: Emerging evidence suggests intra-discal PRP improves chronic discogenic low back pain. [PMID: 28470129]

So what did we learn?

PRP therapy is a significant advancement in regenerative orthopaedics. By utilising the body's own healing ability, PRP offers a natural, safe and effective solution for chronic pain, sports injuries and early arthritis. For many patients, it helps restore mobility, delay surgery and return to an active lifestyle.

If you are suffering from persistent joint pain, arthritis, tendinopathy or have sustained a sport injury which is not responding to other treatment modalities, consult Dr. Ajinkya Achalare at ArthroSports Speciality Orthopaedic Clinic at Shivaji Park, Dadar, Mumbai. As a part of sports medicine, along with other treatment options, Dr. Achalare can guide you regarding the PRP injections and help you recover faster!