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Specialist Advice — 16 minutes

Platelet-rich plasma, or how to accelerate healing of complex injuries

Dr Roxanne Labranche
Radiologist

Running long distances, practicing your forehand in tennis, doing repetitive tasks at work or getting into an accident can lead to painful joint injuries that take ages to heal. Now, platelet-rich plasma (PRP) injections are offering a new solution where conventional treatments have failed. Especially popular in the world of sports, PRP in most cases enables a return to play much sooner than anticipated.

A 100% natural treatment

Plasma is a natural component of blood that is especially rich in proteins (immunoglobulins, albumin, fibrinogen, etc.). In this liquid gold we find red blood cells, white blood cells and platelets, which are all essential for healing injuries.[1]

Dr. Étienne Cardinal, Vice President Operations and Medical Director, Medical Imaging, Imagix, a partner of Biron, explains that the platelets found in plasma are especially active in healing an injury. “They cluster at the site of bleeding and attract fibroblasts. These specialized cells in turn generate scar tissue, which accelerates healing,” he says.

Nature usually does its job well, but some tendon injuries take longer to heal, or become recurrent or even chronic. In these situations, PRP injections offer an additional treatment tool to help achieve a full recovery without the need for surgery.

Platelet-rich plasma (PRP) infiltration involves injecting a concentrate of platelets into a joint or tendon, in order to repair the tissue and relieve pain.

Video available in french only

A therapy that can avoid the need for surgery

Conservative treatments are often effective in helping achieve a full recovery. Physiotherapy and cortisone injections are therefore at the forefront of the chain of care to assist with healing and pain relief. However, because cortisone is a powerful corticosteroid, the risk of weakening the tissue over the long term makes prolonged use of this remedy impossible.

Sometimes, in cases involving tendon or muscle tears, or joint pain such as osteoarthritis, conventional medicine no longer works. In these situations, PRP injections offer an additional option before considering surgery.

PRP treatment, Dr. Cardinal explains, uses the body’s natural ability to regenerate itself and involves three steps: Reinjection, performed under ultrasound guidance, makes it possible to confirm and precisely locate the injury. The procedure lasts a total of only 30 minutes, including about 10 minutes for the centrifugation process alone.

An effective treatment in nearly 70% of cases

The PRP process generates a concentration of platelets that is five to six times greater than the body’s normal production. Combined with the precision of medical imaging, this concentration increases the chance of recovery by about 70%.

“Improvement in pain is in the range of 50% and higher. Some people will achieve 100% relief, while for others it doesn’t work. For those in between, we may consider repeating the procedure to improve the outcome.”

Dr Étienne Cardinal
Dr Étienne Cardinal
Vice President, Medical Direction – Medical Imaging, Imagix and Medvue

PRP is very safe for patients

Dr. Cardinal says that no complication specific to PRP has been reported to date with this method (although there are always minor risks related to passing a needle through the skin). As a result it is a safe procedure, although there is still some pain for a time afterwards. “The first few days will be a little painful,” the radiologist says, “It’s like a minor operation but not too invasive, and it takes two to three weeks with reduced activity to recover.”

After that, physiotherapy treatments and a gradual return to physical activity, especially sports, will likely be necessary.

What are the situations where injection is recommended?

In many cases of injury, the body’s natural regeneration process allows the patient to return to normal activity after a few days or weeks of convalescence. On the other hand, when the situation persists or causes great suffering, conventional treatments should be encouraged (prescription painkillers, anti-inflammatory drugs and physiotherapy).

After that, if all these methods have failed, it is usually time to consider PRP. Injections can prove necessary and effective in a number of situations:

  • Tendonitis of the elbow, knee or shoulder
  • Injuries to the plantar fascia or Achilles tendon
  • Joint problems
  • Relief of pain related to osteoarthritis
  • Damaged meniscus, etc.

Some studies also suggest a potential benefit in PRP treatment of ligament injuries, the medical imaging specialist adds.

In fact, ligaments and especially tendons are made up of white cords that are poorly vascularized, unlike muscles, for example. Lesions in these locations therefore bleed little and the components of blood cannot do their job as well. As a result, PRP often proves effective, especially long after the injury, when the healing process has run its course. In these conditions, PRP provides far more platelets than during the initial response to the injury.

In addition, PRP locally restores the conditions of a recent injury. Stem cells then start multiplying in order to repair the tissue. This highly reactivated repair process frequently leads to healing after one to three injections.

PRP is suitable for athletes

Practicing a sport, especially if it is intensive, increases the risk of musculoskeletal injury.[2]

In the world of professional sports, an operation is often synonymous with being out of commission for several weeks or months. This is also the case for amateur athletes, who risk being away from their favourite sport for a long time.

In this case, PRP treatment may be the solution to consider in order to shorten the length of unavailability, as it significantly improves the speed of healing while also avoiding all the potential complications associated with surgery.

Moreover, thanks to its high concentration of platelets, PRP improves healing and enables tissues, ligaments and tendons to regain better elasticity. Athletes can therefore hope to recover their full range of movement without being slowed down by poor healing.[3]

How to benefit from this type of treatment

To assess the potential for PRP treatment, you need a medical prescription. You can then meet with a team that specializes in musculoskeletal medicine and is qualified to use ultrasound to ensure an accurate diagnosis.

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Do you have a medical prescription for one of these tests? Book an appointment online or contact Biron Health Group’s customer service at 1 833 590-2712.

Sources3
  1. Héma-Québec. “What is plasma?” undated, https://www.hema-quebec.qc.ca/plasma/donneur-de-plasma/definition-du-plasma.en.html.
  2. J. Pelletier. “Blessures sportives fréquentes: de A à C,” August 16, 2016, https://axophysio.com/blessures-sportives-frequentes-de-a-a-c/.
  3. S. Cascua. “Plasma riche en plaquettes: une colle biologique pour vos blessures,” December 15, 2020, https://www.docdusport.com/plasma-riche-en-plaquettes-une-colle-biologique-pour-vos-blessures/.
Dr Roxanne Labranche
Radiologist
Holding a doctorate in medicine and a residency in radiology from the Université de Montréal, Dr. Roxane Labranche joined the Imagix and Medvue network of radiology clinics in 2019. Since then, she has developed and implemented the platelet-rich plasma (PRP) injection treatment program for musculoskeletal pathologies at Medvue. She currently holds the position of medical director at the Medvue clinic in Boisbriand.