One shot to rule them all?

Whether it be Mac Jones high ankle sprain or Russel Wilson’s undisclosed shoulder injury, orthopedic medicine often has a solution. The course by which to get to a solution could vary patient to patient and in severity, but orthopedic medicine offers a variety of methods to help its patients. In particular, the administration of injections can alleviate painful symptoms associated with sports related injuries or arthritis. In my experience working at an orthopedic clinic, the three most administered injections were corticosteroid, hyaluronic acid, and Platelet Rich Plasma injections (PRP). The overarching goal is symptomatic relief, but PRP injections aim to provide that by means of promoting the healing process of the affected area. Now there is a difference between a patient’s perceived outcome and the actual outcome. The table below has a comprehensive list of PRP components and their associated effects, but the idea is to create highly concentrated plasma with these factors and inject it into the site of injury/damage (O’Connell et al., 2019). In doing so, this concentrated plasma can promote the healing process so one may increase recovery time, alleviate symptoms, or avoid surgery completely. While the effects of these growth factors have been shown to promote healing, you’ll find most research on PRP injections have to do with meta-analysis of perceived outcomes or pain scores. So what do we know PRP injections do? We think that the factors in PRP could induce a healing response, but have not been able to provide strong in vitro or animal model evidence that translate to a clinical setting (Everts et al., 2020). We know that in clinical practice, PRP injections can decrease the inflammatory response, which would correlate with one’s level of pain (O’Connell et al., 2019). We know that it can increase perceived outcomes associated with arthritis for some patients (O’Connell et al., 2019). What PRP research lacks is hard data on the extent to which it promotes healing and physical tissue growth. Additionally, PRP can be administered to the shoulder, the knee, an ankle, or even the plantar fascia of your foot. It would seem there are likely differences in each of these areas which further questions research and application associated with PRP injections, especially if procedures for administration don't change based off the site of injury (Everts et al., 2020). Furthermore, PRP injections are often not covered by insurance placing the financial buren directly on the patient. It seems that PRP injections could be beneficial for some patients, but research lacks evidence to suggest this method of injection can actually promote the healing process across the board for every patient.

From: The use of PRP injections in the management of knee osteoarthritis

Table 1.

 

O’Connell, B., Wragg, N.M. & Wilson, S.L. The use of PRP injections in the management of knee osteoarthritis. Cell Tissue Res 376, 143–152 (2019). https://doi-org.dml.regis.edu/10.1007/s00441-019-02996-x

Everts, P., Onishi, K., Jayaram, P., Lana, J. F., & Mautner, K. (2020). Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020. International journal of molecular sciences, 21(20), 7794. https://doi.org/10.3390/ijms21207794