Platelets are known for their role in clotting. Platelets also release substances that promote tissue repair and influence the reactivity of vascular and other blood cells in the formation of new vessels and in inflammation. Once activated, the platelets release their storage pool of powerful growth factors.
Platelet Rich Plasma (PRP) injections were first used in human medicine for tennis elbow and plantar fasciitis. 93% of patients treated reported a reduction in pain without undergoing surgery. It has also been used in human dental patients to reduce healing times and minimize dental visits.
PRP can be used to jump-start the healing cascade and accelerate tissue regeneration in skin, soft tissue, and bone. PRP has been used in horses to treat ligament and tendon injuries, eye ulcers, and skin wounds. It is particularly beneficial in treating injuries in areas of limited vascularization, or blood flow. These growth factors have been shown to stimulate tendon and ligament healing. The enhanced healing response on a cellular and molecular level may ultimately improve the quality of repair, improve the prognosis for return to performance, and decrease the incidence of re-injury.
Platelet-derived Growth Factors:
- Mediate inflammation
- Affect tissue growth
- Stimulate cell regeneration
- Reduce scar tissue formation
- Have an analgesic (pain relief) effect
- Available – PRP is made patient-side with simple centrifugation
- Autologous – Will not be rejected by the patient’s immune system since it is made from the patient’s own blood
Typical PRP Scenario
- The injury is diagnosed with an ultrasound exam.
- Wait for the majority of inflammation to subside (7-10 days), using icing and anti-inflammatories to help reduce the swelling. (*** This step may not be necessary if the lesion is already chronic***)
- 60 cc of blood pulled from the jugular vein in a specially prepared syringe, placed in a disposable container and spun in a proprietary centrifuge for 14 minutes.
- The majority of the platelet poor plasma fluid is removed, leaving 4 – 8 mls of PRP = the autologous platelet concentrate enriched with growth factors.
- The leg is scrubbed and a regional nerve block is performed above the area to be injected.
- The lesion is injected with ultrasound guidance. Multiple needles OR “splitting” of the lesion often performed. 2-4 mls of PRP is injected. A second portion is frozen for potential use in 30 days.
- The leg is bandaged for 24 hours. The horse is stall rested for 2 weeks with hand walking, followed by 2 weeks of stall rest with walking under tack. No turnout during this period.
- Recheck ultrasound exam at 30 days to assess healing. If not completely healed, the second fraction may be thawed and injected at this time. If the lesion is healed, a slow return to work over the next 60 days is begun.
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