PLATELET RICH PLASMA INJECTIONS

PATIENT INFORMATION

BACKGROUND: Platelet rich plasma (PRP) injections are an alternative treatment option for chronic plantar fasciitis and Achilles tendonitis at Still Foot and Ankle Care. This therapy is also utilized frequently for elbow tendonitis. It has gained more widespread use in the last 1-2 years. It is not prolotherapy, which is different. This is often referred to as the field of “orthobiologics”. It originally had use in the dental field 20 years ago. Physicians and Scientists have learned that platelets, a component of our blood release “growth factors” to help accelerate healing to an area. In high concentrations they can be beneficial to the healing of injured tissue especially tendons and fascia which is similar to tendon. However, currently insurance companies are not covering this treatment option b/c they consider it experimental/investigational in the foot and ankle. However, there is little risk b/c this treatment option involves the use of the patient’s own blood. The injection involves spinning down a patient’s own blood in a special machine so that what is obtained is “platelet rich” blood. This blood is then injected into the area usually with 3-6 injection sites each getting 1.25-2.0 cc of this platelet rich blood. It attempts to have your own body respond to the area with an inflammatory reaction to try and heal it. Often with chronic tendonitis or fasciitis your body is not responding to the chronic inflammation b/c it is so chronic and your condition lingers. This treatment is being widely used in athletes, especially professional and Olympic athletes as an alternative to surgery or steroids (cortisone). This treatment option has shown good results but is not a guarantee that you will obtain a successful outcome.

BEFORE YOUR INJECTION: It is important to be off all oral anti-inflammatory medications such as aspirin, ibuprofen, Aleve, Motrin or any prescription anti-inflammatories. If you take an aspirin or even a “baby” aspirin for your heart or other medical problems you will need to get clearance from your regular doctor to be off this medication for 7 days prior and at least 7 days post-injection. It is preferable to be off anti-inflammatories for 14 days post-injection.

AFTER YOUR INJECTION: After your injection as stated above you will need to be off all anti-inflammatories for 7-14 days, preferably 14. You will also need to immobilize the area to get the best effect and this will be done by Dr. Still dispensing a Velcro boot for you to wear for 14 days.

After the injection patients often experience a moderate to severe amount of pain for 2-3 days then it subsides. It is important to not take ibuprofen type products or anti-inflammatories. Dr. Still may prescribe you pain medication to help with the pain. It is also important not to ice the area at all in this time period. You want your body to actually create an inflammatory response and icing will decrease this. At 7-8 days post-injection you will begin some isometric and stretching exercises that Dr. Still or his medical assistant will verbally give you to do. Do these daily.

TECHNIQUE: A representative from a company that makes the machine to “spin down” the blood will come in the day of your scheduled time to have this done. Dr. Stills’ assistant or a phlebotomist will obtain 50-60cc of blood from your arm and then this blood will be put into the machine and spun down. From that 50-60cc of blood Dr. Still will inject approx. 8cc of your own platelet rich blood into the area through 3-6 separate injection sites. Dr. Still will numb the area to be injected with lidocaine prior so that pain is reduced. The company that we currently use is Arteriocyte for the machine to spin the blood.

COST: The cost for this treatment is $400.00 and ¾ of the cost goes to pay for fees the office has for having the representative from Arteriocyte come to your appointment and use the machine. This is due the day of the treatment in full. At this time we will not bill your insurance since this alternative treatment option although widely used is not currently accepted by insurance. Hopefully that will change in time.