PRP therapy Peoria: a shot prepared from your blood

Wear, strain, and old injuries often leave a joint sore

A knee can ache after walking and stiffen while you sit. Reaching high or lying on one side can bother a shoulder. A hip may feel tight as you stand. Arthritis can make these joints stiff and tender. A strain affects the rope-like tissue that fastens muscle to bone. An old injury may also flare after extra work. The feeling alone can’t sort out these causes.

With my own joint, I’d notice whether the ache changes the whole day.

Ease back from whatever starts the ache. Unless told otherwise, use the joint with care. A short walk, easy bending, or a brace might help you. Don’t try a medicine that hasn’t been safe for you before. Heat can loosen stiffness. Cold may settle soreness after activity. When none of this is helping, an exam may give you an answer.

An exam comes before choosing a treatment

Tell the clinician which motions bring on the ache and how it started. Mention a fall, a pop, swelling, weakness, or trouble standing on that leg. The clinician may move the joint and check an X-ray you have. That exam can separate joint wear from a strain or a fresh injury.

Here’s what I wouldn’t skip: learn the likely cause before you pay.

At QC Kinetix, regenerative care means non-surgical treatments handled in the office by medical providers who examine the sore area, prepare the blood-based shot, and give it to you there. One choice is PRP. To make it, the provider spins the blood they draw and chooses the needed layer. A provider places that layer in the sore joint or the rope-like tissue beside it. Concentrated PRP is the same blood-based shot with more platelets, tiny parts of blood that form a plug over a cut. The exact mix isn’t always alike. Neither choice is certain to help, so you’ll want to ask what the clinician expects for your joint.

Sources

1. The devices used to spin PRP at the point of care are cleared by FDA as clinical centrifuges, product code JQC, a Class I device under 21 CFR 862.2050 - for example the Biomet GPS Platelet Separation Kit (K030555, cleared 2003) and the Harvest SmartPrep2 / SmartPrep Platelet Concentration System (K103340, cleared 2010). That clearance covers the equipment that separates blood. It is not an FDA approval of platelet-rich plasma as a treatment for osteoarthritis, tendinopathy or any other orthopedic condition, and copy must never blur the two.

   U.S. Food and Drug Administration (Center for Devices and Radiological Health) — 510(k) Premarket Notification database and Product Classification: JQC, Centrifuges (Micro, Ultra, Refrigerated) For Clinical Use, 21 CFR 862.2050. FDA accessdata (CDRH device databases), 2003.

2. In the RESTORE trial - the largest placebo-controlled PRP trial in knee osteoarthritis - 288 adults aged 50+ with symptomatic Kellgren-Lawrence grade 2-3 medial knee OA received three weekly intra-articular injections of leukocyte-poor PRP from a commercial system or saline placebo. At 12 months the mean change in knee pain was -2.1 points with PRP versus -1.8 with saline (difference -0.4; 95% CI -0.9 to 0.2; P=.17) against a minimum clinically important difference of 1.8, and the change in medial tibial cartilage volume was -1.4% versus -1.2% (difference -0.2%; 95% CI -1.9% to 1.5%; P=.81). Twenty-nine of 31 prespecified secondary outcomes showed no significant between-group difference. The authors concluded the findings do not support use of PRP for knee OA.

   Bennell KL, Paterson KL, Metcalf BR, et al. — Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial. JAMA, 2021. DOI: 10.1001/jama.2021.19415.

3. A systematic review of 105 clinical PRP studies in orthopaedics published 2006-2016 found that only 11 (10%) described the preparation protocol clearly enough for another investigator to repeat it, and only 17 (16%) reported any quantitative metric of the final PRP composition. The authors concluded that the current reporting of PRP preparation and composition does not allow the PRP products actually delivered to patients to be compared between studies.

   Chahla J, Cinque ME, Piuzzi NS, et al. — A Call for Standardization in Platelet-Rich Plasma Preparation Protocols and Composition Reporting: A Systematic Review of the Clinical Orthopaedic Literature. Journal of Bone and Joint Surgery (American), 2017. DOI: 10.2106/JBJS.16.01374.

4. A systematic review of 132 Level I/II PRP studies across all medical specialties, covering 28 different conditions, found inconsistent reporting of PRP composition in every field of medicine. Musculoskeletal indications - knee osteoarthritis and tendinopathy above all - accounted for the majority of high-level studies. Sixty-one percent of the studies reported PRP as favourable over the control treatment, with no difference in that proportion between musculoskeletal and non-musculoskeletal specialties.

   Nazaroff J, Oyadomari S, Brown N, et al. — Reporting in clinical studies on platelet-rich plasma therapy among all medical specialties: A systematic review of Level I and II studies. PLOS ONE, 2021. DOI: 10.1371/journal.pone.0250007.