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Recent evidence suggests that leucocyte-poor is better for arthritis, but leucocyte-rich is better for tendonitis. For example, a recent study found that leukocyte-poor PRP has fewer side effects, but it is as effective as leucocyte-rich PRP. Conversely, leucocyte-rich PRP is more effective in hip tendonitis or greater trochanteric syndrome.

How do PRP injections reduce pain?

Many studies analyze the effects of PRP on cells and tissue in a lab. Platelets are essential cells that control clotting. They contain a high concentration of growth factors. These growth factors influence inflammation and healing. Injecting plasma therapy into a joint or tendon leads to the release of growth factors improving the local environment. Ultimately, this leads to a lower level of pain and tissue healing.

According to NICE – a body in the UK that assesses treatments – PRP reduces pain and potentially delays the need for a knee replacement.

Platelet-rich Plasma injections for arthritis and tendonitis

Platelet-rich Plasma or PRP injections for joints and tendons are becoming more popular. They form part of the new field of regenerative medicine for use in joints and tendons to reduce pain and encourage healing. But is there evidence that a Platelet-rich Plasma injection works for conditions such as arthritis

What is Platelet-rich Plasma?   

In summary, platelet-rich plasma, also called plasma therapy, is a blood sample with a concentration of platelets greater than whole blood.

Platelet-rich plasma or PRP comes from whole blood. We obtain blood from a vein in the patient’s arm. The spinning of the blood forms different layers: red cells, white cells, and plasma. The plasma component contains high platelets and is separated and injected into joints or tendons. First, red and white cells are removed. Next, we remove the red cells as we know that these red cells break down cartilage and stimulate inflammation – an effect we don’t want.

Why do we want a higher concentration of platelets?

In general, different PRP or plasma systems produce different concentrations of platelets. For example, some PRP systems have platelet concentrations of just above 1.5X whole blood. However, other systems can have greater than 5X whole blood platelet concentrations. We don’t know whether a higher concentration of platelets has a more significant effect.

What is the difference between leucocyte-poor vs. leucocyte-rich PRP?

Some PRP systems are a little more complicated and increase the concentration of platelets and white cells (also known as leukocytes). Generally, these systems need more blood (50mls) and repeated spins.  Some of these systems include N-stride PRP.