How does PRP injection work for knee pain?

Doctor's Answers 2

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Dr Henry Chan

Orthopaedic Surgeon

PRP stands for platelet rich plasma injection. This technique is developed based on the fact that platelets cells in our own blood contains a vast amount of our bodies’ natural growth factors and healing power.

The process of PRP injection is incredibly simple. First, we take some blood from the patient and process the blood in a strict sterile and clean environment. This process takes approximately 15 mins.

The processed plasma (the “liquid” portion of the blood, comprised of around 10-15% of the volume) now contains a high concentration of the platelets cells (hence the word platelet rich plasma), which carries with them all the “goodies” required to heal the injured body parts.

We will then inject this portion (approximately 3 to 4 mls in volume) directly into the injured parts of your body. It is just a small injection and it can be done at outpatient setting.

You'll have virtually 0% risk of developing any allergic reaction to the injection because it comes from your own body. I’d say it’s probably 100% safe, if done properly by a trained Orthopaedic Surgeon in a strictly sterile manner.

PRP injection works differently from all the other injections given by Orthopaedic Surgeons.

H&L injection contains steroids and its main mode of action is to reduce the swelling and inflammation of the affected area. On it's own, it does not possess any healing potential or growth properties.

Hyaluronic Acid Injection is simply a lubricant for the joint. Again it does not possess any healing potential or growth properties. In this aspect, PRP injection is unique as it harvests the healing potential of the body and kick starts the healing process of the injured body parts.

PRP injections are readily available in most established orthopaedic clinics. It has been proven to work well (and approved by Singapore Ministry of Health) for soft tissue conditions such as:

  1. Tennis elbow (lateral epicondylitis)
  2. Achilles’ tendon tendinitis
  3. Muscles tear/ ligament partial tear

So if your knee pain is due to soft tissue injuries such as ligament partial tear, tendinitis or muscle tears, you can safely give PRP injections a try.

However, it your knee pain is due to osteoarthritis, the efficacy of PRP injection is still being investigated by various research trials. The hypothesis is that it will probably work, although we need more large scale and rigorous research trials to prove the efficacy. The bottom line is that it will not cause more harm to the knees.

At this moment, PRP injections are still considered experimental as a treatment of knee osteoarthritis in Singapore, although it’s been a very established treatment option for other soft tissue conditions.

Please seek the opinion of an Orthopaedic Surgeon, we need to find out what is the exact cause of your pain from a detailed clinical history, thorough physical examination and advanced imaging. Then we can advice you further whether PRP injection is a suitable treatment option for you.

Dr Henry has given you a thorough synopsis of the options in terms of injection treatments, but I thought that I would give some anecdotes from clinical practice.

Situations where my patients have tried PRP for knees include

1. OA

2. Chondromalacia Patella

3. Osteochondral defects

4. Patella tendinoapthy/tears

For some, it works well. For others - not so.

Personally, I think it’s worth trying as there should be minimal side effects and if done under ultrasound guidance, you can be sure that the PRP is placed correctly.

The main caveat is that it is not cheap - even in subsidised institutions. The equipment usually costs $200-300 on top of the procedure. Privately will be considerably more.

After the procedure, you will need to rest for a few days and rehab is a MUST!

Hope this helps.

Bw

Dr Dinesh

Similar Questions

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Age is just a number, if your mom has been taking care of herself well. The average life span for a Singaporean woman is now 86 years old, according to the Singapore Census 2010. I’ve known patients who are not even 40 years old, and have lost 3 limbs (both legs and right hand) due to poorly controlled diabetes. There are also many patients who are barely 40+ years old, but failed to take care of themselves. Consequently, they suffered from kidney failures, strokes and heart attacks. This is the concept of physiological age, when your body is being kept at a optimal condition.

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Answered By

Dr Henry Chan

Orthopaedic Surgeon

How can a frequent runner with knee pain heal his knee?

I’m in awe of your dad! Kudos to him for his commitment to keeping fit and healthy. If only the rest of our population could do that – we would certainly have much fewer people in hospital. In the absence of any other information leading up to his knee injury (ie did he suffer any knee trauma, suffer a fall while running, hear a pop and twist his knee etc), his injury sound like it’s training volume-related, or an overuse injury – he’s clocked up quite a lot of miles, and it seems like even with his injury, he hasn’t actually held off with his training.

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