PRP (platelete rich plasma – strong plasma from platelet) procedure is the use of the patient’s own blood for treatment by concentrating the thrombocyte cells. PRP is used especially in knee calcification, hip and all joint calcification, shoulder tendon tears, local cartilage injuries in ankle and other joints, ligament and tendon injuries, tendinitis, bursitis, medial and lateral epicondylitis (golfer’s elbow, tennis elbow) soft tissue rheumatism. is used. It is also frequently used in aesthetic clinics for facial rejuvenation and hair loss.
Despite the heavy use of PRP, some issues are not properly addressed. In my own clinical practice, I often hear the phrase “sir, I had PRP done on my knees, but it didn’t work at all”. There could be many reasons for this situation. The first is PRP preparation kits. The preparation of PRP, that is, the presence of platelet cells in the desired ratio in the PRP liquid, depends on the kit used and the optimal centrifuge device specific to this kit. The kit used may be insufficient. Indeed, the Ministry of Health has been inspected for the last year and many PRP kits on the market have not been approved by the Ministry of Health. Unfortunately, I can say that what was done was not PRP. Another important point that is not subject to inspection is the use of a kit-specific centrifuge device. If the centrifuge device is not specific to the kit used, the prepared PRP will not have sufficient treatment activity.
Another factor that directly affects the effectiveness of PRP treatment is the method of application of PRP. No matter how ideally PRP is prepared, it will be ineffective unless it is done correctly. Until 5-10 years ago, local injections were done without the use of any auxiliary device. But now we definitely use ultrasound imaging even for the easiest injections. Ultrasound-guided injection can be made to the real point at rates approaching 90-95%. Otherwise, this rate remains at 50%.
Another important issue is the selection of patients to whom PRP will be applied. PRP is an ideal treatment for mild to moderate calcification events. It can be considered in severe cases, but if there is no other treatment option. In my clinical practice, I come across patients who think that they can improve with PRP treatment even though they have very severe calcification. Unfortunately, there is no option other than surgery for these patients. Sometimes, cortisone injection can be tried in cases where surgery cannot be performed.
It is not possible for a PRP injection prepared with an ideal kit to be made to the right point with the help of ultrasound to be ineffective for a suitable patient, unless there are some special conditions caused by the patient or the disease. PRP treatment should definitely be supported with protective-assist measures such as training. In this way, long-term smoothness can be achieved with PRP treatment.