Ultrasound Guided Platelet Rich Plasma (PRP) Injection For Tendinosis

PRP is most commonly used for tendon attachments at the elbow (tennis elbow and golfer’s elbow), hamstring origin, patella (jumper’s knee), Achilles tendon or the plantar fascia (heel spur). To be successful, it is essential that any image-guided injection forms part of a complete rehabilitation program guided by your surgeon, sports doctor, GP or physiotherapist.

Ultrasound Guided PRP Imaging Preparation

Anti-inflammatory medication such as Nurofen, Voltaren, Mobic and Celebrex should be stopped 10 days before the procedure, and not used for ten days after as it may reduce the effectiveness of the procedure.

Please tell us at time of booking if you are on medication to thin your blood (e.g. Warfarin, Aspirin or Clopidogrel). You may need to stop taking these before the procedure, however, it is essential that you discuss it with your doctor first.

If possible, wear clothing that allows easy access to the area that is being imaged.

Procedure

Before treatment, an accurate diagnosis is essential, which will usually require a diagnostic ultrasound or MRI scan.

PRP is currently available at St Andrew’s and Calvary Adelaide Hospitals.

A vial of blood is taken from a vein like a normal blood test. The blood is then placed in a centrifuge to remove the red blood cells and obtain plasma that has ten times the concentration of platelets and growth factors.

Your skin at the area of concern is then cleaned with antiseptic, and a fine needle is positioned into the abnormal area using ultrasound guidance to ensure precise placement. A local anaesthetic may also be used.

Duration

This procedure usually takes 40 – 60 minutes.

Post-Procedure Care

Some swelling or discomfort is common in the first few days because this injection works by activating “good” inflammation to promote the healing process. You may benefit from an ice-pack or paracetamol (Panadol) but avoid anti-inflammatory medication, such as Nurofen, Voltaren, Mobic and Celebrex as it may reduce the effectiveness.

A rehabilitation programme will need to be guided by your referring clinician but would typically involve:

• Week 1: No deliberate exercise.
• Weeks 2-4: A 3 week graduated program of stretching and specific exercises.
• End of week 4: Re-assess.

Risks / Side effects

As we are re-injecting your own blood, there is no risk of allergic reaction and no adverse effect on the tendon structure. Any injection carries a small risk of introducing infection, about 1 in 30,000, and we take precautions to minimise this. If you experience increased swelling or redness, please call your doctor.