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Platelet Rich Plasma Injection: Difference between revisions
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*3 x injections for maximal effect | *3 x injections for maximal effect | ||
*Stop NSAIDs and potentially anti-platelet prior to and just after (as long as not contraindicated to stop). | *Stop NSAIDs and potentially anti-platelet prior to and just after (as long as not contraindicated to stop). | ||
==References== | |||
Thank you to Dr Holtzhause and | |||
[[Category:General Procedure Concepts]] | [[Category:General Procedure Concepts]] | ||
[[Category:Partially complete articles]] | [[Category:Partially complete articles]] |
Revision as of 20:40, 5 August 2020
This article is still missing information.
Indications
Tendinopathy, mild osteoarthritis, cartilage tears etc
Risks
infection, bleed, nerve damage all rare
Pre-procedure Instructions
Stop NSAIDs and potentially anti-platelet prior to and just after (as long as not contraindicated to stop).
Equipment
Procedure described for doing one leukocyte rich and one leukocyte poor injection.
- Syringes
- 60mL syringe for the blood
- 10mL syringe for the local anaesthetic
- 10mL syringe for the leukocyte poor PRP
- 10mL syringe for the leukocyte rich PRP
- Needles
- butterfly set for taking blood
- drawing up needle
- 25g needle for the local anaesthetic
- Needle for the PRP injection e.g. 22g 70mm spinal needle for the hip joint.
- 3 x ACDA tubes for the anticoagulant
- PRP kit
- One cartridge for the blood (e.g. omni PRP which is ~6x concentration, or regen which is ~2x concentration)
- Another cartridge as a counterbalance, measured to weigh the same, filled with water.
- Centrifuge
- Sterile ultrasound jelly
- Ultrasound machine
- PRP benchtop processing station.
Preparation
- Leukocyte rich PRP extraction.jpg
Extraction of leukocyte rich PRP
- Extract ~2.5mL of ACDA into the 60mL syringe
- Draw up 55mL of blood into the 60mL syringe
- Place the drawing up syringe onto the syringe, open the top of the cartridge, and then transfer the mixed blood/ACDA solution. Close the top
- Place the cartridge into the centrifuge, along with an equal counterweight cartridge.
- Spin at 3350rpm for 7 minutes
- Remove the cartridge, it should be separated into red cells at the bottom, leukocytes in the middle, and plasma at the top
- Place the cartridge into the PRP benchtop processing station, facing up
- Use the dial on the station to control the plunger
- Remove and discard the top half of the plasma which is called platelet poor plasma.
- The remaining plasma is leukocyte poor at the top, and leukocyte rich at the bottom. The very bottom of the plasma has the leukocytes which is called the buffy coat.
- Transfer the top remaining half (leukocyte poor) into a 10mL syringe
- Transfer the bottom remaining half, including some of the leukocytes into another 10mL syringe.
Procedure
- Joint
- Infiltrate the skin and capsule with local anaesthetic but not the joint space
- Inject into the joint space or joint structure with the leukocyte poor solution
- Tendon
- Inject around the tendon with the leukocyte rich solution
Aftercare
- Leukocyte rich PRP can cause a pain flare for a few days.
- Advise to wait for minimum 4 weeks before assessing efficacy.
- Use joint gently after procedure (e.g. low resistance cycling).
- 3 x injections for maximal effect
- Stop NSAIDs and potentially anti-platelet prior to and just after (as long as not contraindicated to stop).
References
Thank you to Dr Holtzhause and