PRP Therapies (Tendons, Joints, Spine)

  • Ajax Yang
  • Corey W. Hunter
  • Tory L. McJunkin


The natural healing passage of tendon, ligament, and connective tissue is often slow and incomplete. This is particularly true when the mechanism of injury is a result of repetitive microtrauma, aging, and vascular compromise. The basis of platelet-rich plasma (PRP) therapy is rooted in the powerful bioactive proteins and potent growth factors released by the platelets into plasma to expedite tissues healing and regeneration. As such, PRP holds a promising potential to promote an effective recovery. PRP therapy is especially appealing to individuals that prefer or are unable to undergo more invasive procedures. The scientific principles of PRP are discussed elsewhere in this book. This chapter will mainly focus on the application of PRP in the treatments of joint, tendinous, and spinal pathologies.


Platelet-rich plasma PRP Regenerative medicine Osteoarthritis Tendinopathy Degenerative disc disease DDD OA 

Recommended Reading

  1. 1.
    Anitua E. Plasma rich in growth factors: preliminary results of use in the preparation of future sites for implants. Int J Oral Maxillofac Implants. 1999;14(4):529–35.PubMedGoogle Scholar
  2. 2.
    Anitua E. The use of plasma-rich growth factors (PRGF) in oral surgery. Pract Proced Aesthet Dent. 2001;13(6):487–93.. quiz 487–93PubMedGoogle Scholar
  3. 3.
    Brooks PM. The burden of musculoskeletal disease—a global perspective. Clin Rheumatol. 2006;25(6):778–81.CrossRefGoogle Scholar
  4. 4.
    Cavallo C, Filardo G, Mariani E, et al. Comparison of platelet-rich plasma formulations for cartilage healing. J Bone Joint Surg Am. 2014;96(5):423–9.CrossRefGoogle Scholar
  5. 5.
    Cavallo C, Roffi A, Grigolo B, et al. Platelet-rich plasma: the choice of activation method affects the release of bioactive molecules. Biomed Res Int. 2016;2016:6591717.CrossRefGoogle Scholar
  6. 6.
    Creaney L, Wallace A, Curtis M, Connell D. Growth factor-based therapies provide additional benefit beyond physical therapy in resistant elbow tendinopathy: a prospective, single-blind, randomised trial of autologous blood injections versus platelet-rich plasma injections. Br J Sports Med. 2011;45:966; bjsports82503CrossRefGoogle Scholar
  7. 7.
    de Vos RJ, Weir A, van Schie HTM, et al. Platelet-rich plasma injection for chronic Achilles tendinopathy: a randomized controlled trial. JAMA. 2010;303(2):144–9.CrossRefGoogle Scholar
  8. 8.
    Eby BW. Platelet-rich plasma: harvesting with a single-spin centrifuge. J Oral Implantol. 2002;28(6):297–301.CrossRefGoogle Scholar
  9. 9.
    Finnoff JT, Fowler SP, Lai JK, et al. Treatment of chronic tendinopathy with ultrasound-guided needle tenotomy and platelet-rich plasma injection. PM R. 2011;3(10):900–11.CrossRefGoogle Scholar
  10. 10.
    Fullerton BD, Reeves KD. Ultrasonography in regenerative injection (prolotherapy) using dextrose, platelet-rich plasma, and other injectants. Phys Med Rehabil Clin N Am. 2010;21(3):585–605.CrossRefGoogle Scholar
  11. 11.
    Jang S-J, Kim J-D, Cha S-S. Platelet-rich plasma (PRP) injections as an effective treatment for early osteoarthritis. Eur J Orthop Surg Traumatol. 2013;23(5):573–80.CrossRefGoogle Scholar
  12. 12.
    Kumar V, Fausto N, Abbas A. Pathologic basis of disease. 7th ed: WB Saunders; 2005.Google Scholar
  13. 13.
    Landesberg R, Roy M, Glickman RS. Quantification of growth factor levels using a simplified method of platelet-rich plasma gel preparation. J Oral Maxillofac Surg. 2000;58(3):297–300; discussion 300–1.CrossRefGoogle Scholar
  14. 14.
    Marx RE. Platelet-rich plasma: evidence to support its use. J Oral Maxillofac Surg. 2004;62(4):489–96.CrossRefGoogle Scholar
  15. 15.
    McShane JM, Shah VN, Nazarian LN. Sonographically guided percutaneous needle tenotomy for treatment of common extensor tendinosis in the elbow. J Ultrasound Med. 2008;27(8):1137–44.CrossRefGoogle Scholar
  16. 16.
    Mishra A, Pavelko T. Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. Am J Sports Med. 2006;34(11):1774–8.CrossRefGoogle Scholar
  17. 17.
    Mody GM, Brooks PM. Improving musculoskeletal health: global issues. Best Pract Res Clin Rheumatol. 2012;26(2):237–49.CrossRefGoogle Scholar
  18. 18.
    Narouze SN. Atlas of ultrasound-guided procedures in interventional pain management: Springer; 2010.Google Scholar
  19. 19.
    Peerbooms JC, Sluimer J, Bruijn DJ, Gosens T. Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial. Am J Sports Med. 2010;38(2):255–62.CrossRefGoogle Scholar
  20. 20.
    Rabago D, Best TM, Zgierska AE, Zeisig E, Ryan M, Crane D. A systematic review of four injection therapies for lateral epicondylosis: prolotherapy, polidocanol, whole blood and platelet-rich plasma. Br J Sports Med. 2009;43(7):471–81.CrossRefGoogle Scholar
  21. 21.
    Schilephake H. Bone growth factors in maxillofacial skeletal reconstruction. Int J Oral Maxillofac Surg. 2002;31(5):469–84.CrossRefGoogle Scholar
  22. 22.
    Storheim K, Zwart J-A. Musculoskeletal disorders and the Global Burden of Disease study. Ann Rheum Dis. 2014;73(6):949–50.CrossRefGoogle Scholar
  23. 23.
    Vora A, Borg-Stein J, Nguyen RT. Regenerative injection therapy for osteoarthritis: fundamental concepts and evidence-based review. PM R. 2012;4(5 Suppl):S104–9.CrossRefGoogle Scholar
  24. 24.
    WHO Scientific Group on the Burden of Musculoskeletal Conditions at the Start of the New Millennium. The burden of musculoskeletal conditions at the start of the new millennium. World Health Organ Tech Rep Ser. 2003;919:i – x, 1–218, back cover.Google Scholar
  25. 25.
    Wu J, Du Z, Lv Y, et al. A new technique for the treatment of lumbar facet joint syndrome using intra-articular injection with autologous platelet rich plasma. Pain Physician. 2016;19(8):617–25.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Ajax Yang
    • 1
  • Corey W. Hunter
    • 1
    • 2
  • Tory L. McJunkin
    • 3
  1. 1.Department of Rehabilitation Medicine, Icahn School of Medicine at Mount SinaiNew YorkUSA
  2. 2.Ainsworth Institute of Pain ManagementNew YorkUSA
  3. 3.Arizona Pain SpecialistsScottsdaleUSA

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