OCSS Health PRP Update: Advancements in Platelet-Rich Plasma for Physiatry

Understanding PRP in Physiatry:

• PRP has been a focal point in regenerative medicine since its high-profile use in 2009.
• A recent survey shows that 67% of patients research regenerative options like PRP before consulting an orthopedic specialist, with 73% considering these therapies before surgery.

Recent Research Highlights:

• Current studies emphasize PRP's effectiveness in treating tendinopathies and knee osteoarthritis (KOA).
• The Bansal et al. study (2021) suggests a minimum of 10 billion platelets for efficacy in KOA, though this is debated, with other studies showing success with fewer platelets.

Challenges in PRP Preparation:

• Over 25 different PRP protocols exist, varying in platelet count, leukocyte types, and preparation techniques.
• This variability complicates standardization and consistent clinical application, as highlighted by Dr. Don Buford's comprehensive characterization framework.

Clinical Implications:

• Variability in PRP preparation leads to inconsistent outcomes, challenging the development of clear evidence-based guidelines.
• Despite promising results, major orthopedic societies often label PRP findings as "inconclusive."

Efficacy in Recent Studies:

• Tendinopathies:

  • PRP injections have shown to reduce pain in chronic tendinopathy at 6, 12, and 24 months.
  • Meta-analyses indicate short-term pain relief and functional gains in rotator cuff tendinopathy.
  • Higher platelet levels may be beneficial for lateral epicondylitis, though the role of WBCs is still unclear.

• Knee Osteoarthritis (KOA):

  • PRP outperforms hyaluronic acid (HA) in pain relief and functional improvement, particularly in mild to moderate KOA.
  • Leukocyte-poor PRP (LP-PRP) offers superior outcomes compared to HA and corticosteroids.
  • Tailoring PRP protocols to the osteoarthritis stage yields optimal results.

Future Directions:

• Combining PRP with HA shows potential in reducing knee pain and improving functional scores.
• The orthobiologic therapy market remains active, with patients often paying out of pocket due to lack of insurance coverage.
• Continued research and collaboration are essential to refine PRP applications and enhance patient outcomes.

Conclusion: PRP has made significant strides over the past 15 years, yet there is still much to learn. Ongoing research and dialogue within the medical community will help refine PRP applications and improve patient outcomes.

Contact Information:

• Dr. Vivek Babaria, DO
• OCSS Health
• 3501 Jamboree Road, Ste 1250, Newport Beach, CA, 92660
• Phone: 949-216-5277

Author

Dr. Vivek Babaria, DO Dr. Vivek Babaria, DO, FAAPMR is a double board-certified specialist in Interventional Spine, Sports, and Regenerative Medicine. Known for his precision diagnostics and minimally invasive approach, Dr. Babaria integrates cutting-edge technologies like musculoskeletal ultrasound, biologic therapies, and image-guided interventions to restore function and relieve pain. He trained at top institutions and brings a high-touch, patient-first philosophy to every consultation. Whether you're a high-performance athlete, weekend warrior, or navigating chronic pain, Dr. Babaria is committed to personalized, evidence-based care that helps you move, feel, and live better. His practice blends modern medicine with a holistic understanding of the body, making him a leader in the future of non-surgical musculoskeletal care.