TENDON INJURIES AND PRP

Tendons are the thick, collagen-filled connective tissues that connect muscle to bone.  Tendons are flexible and strong, but they do not stretch, so they are vulnerable to injury through trauma, or over time and with repetitive use.

Platelet Rich Plasma (PRP) therapy has gained popularity in the field of orthopedics as a potential treatment for tendon injuries and other musculoskeletal conditions. PRP is a form of regenerative medicine that involves using a patient’s own blood components, predominantly plasma and growth factors, to promote healing. It is thought to accelerate the body’s natural healing processes and reduce inflammation, making it a promising option for tendon injuries.

WHAT’S PRP?

PRP is derived from the patient’s own blood and contains a concentrated mixture of platelets, growth factors, and other bioactive substances. Platelets play a crucial role in tissue repair and regeneration, making PRP a potentially effective treatment for injuries like tendonitis and tendinosis.

PRP for Tendon Injuries 

PRP is commonly used to treat tendon injuries, including:

• Tendonitis: Inflammation of the tendon.
• Tendinosis: Chronic degeneration of the tendon.
• Tear or Strain: Partial or complete tears of the tendon.

Mechanism of Action

PRP is believed to work by releasing growth factors and cytokines, which stimulate the body’s natural healing response. This can lead to improved blood flow, reduced inflammation and the promotion of tissue repair.

1. Considerations:
   • The success of PRP treatment can vary depending on factors such as the type and location of the tendon injury, the patient’s overall health, and the specific PRP preparation method used.
   • Patients should be informed about the potential benefits and risks of PRP therapy, including the possibility of transient pain or swelling at the injection site.

The response to PRP (Platelet Rich Plasma) treatment can vary from one individual to another, and it can depend on several factors, including the specific tendon injury, the patient’s overall health, and other individual characteristics. While PRP therapy has shown promise in treating various tendon injuries, some tendons may be more likely to respond positively to treatment based on their location, blood supply, and the nature of the injury. Here are some general considerations:

1. Tendons with Good Blood Supply: Tendons with a robust blood supply may respond better to PRP treatment. Adequate blood flow can facilitate the delivery of growth factors and other healing components present in PRP to the injured area. Tendons with relatively better blood supply include those in the extremities like the Achilles tendon and patellar tendon.
2. Superficial Tendons: Tendons that are closer to the surface of the body may be more accessible for PRP injections, potentially making the treatment more effective. For example, tendons in the elbow (e.g., tennis elbow) or the rotator cuff tendons in the shoulder might be more amenable to PRP treatment.
3. Chronic Tendinopathies: PRP has often been used for chronic tendon injuries or tendinopathies where there’s persistent pain and inflammation. These conditions are often associated with degeneration of the tendon and may benefit from the regenerative properties of PRP.
4. Partial Tears or Tendinosis: PRP may be considered for tendons with partial tears or tendinosis (chronic degeneration) as opposed to complete ruptures. PRP could potentially help stimulate tissue repair and reduce pain and inflammation in these cases.
5. Patient Factors: Individual patient factors, such as age, overall health, and activity level, can also influence the response to PRP treatment. Younger patients with fewer comorbidities may respond more favorably.
6. Proper Diagnosis: Accurate diagnosis of the tendon injury is crucial. PRP may not be appropriate for all types of tendon problems. A thorough evaluation by a healthcare professional is necessary to determine if PRP is a suitable treatment option.

It’s important to note that while PRP has shown promise in many clinical studies and has been used successfully in treating various tendon injuries, it is not a guaranteed cure for all cases. Response to PRP therapy can be variable, some individuals may experience significant improvement, while others may have more modest results.

Ultimately, the decision to use PRP for a specific tendon injury should be made after a thorough assessment by a medical professional who can consider the individual patient’s condition and needs.  The healthcare provider can then determine whether PRP therapy is an appropriate and recommended treatment option for that particular case.

Tenotomy and the Tenex Procedure

Tendon injuries can vary in severity, and different treatments may be considered based on the specific condition. Two treatment options that are sometimes utilized are tenotomy and the Tenex procedure.

Tenotomy: Tenotomy is a surgical procedure that involves the complete or partial cutting of a tendon. It is typically performed to release tension in the tendon, address severe tendon injuries, or improve range of motion in cases of conditions like tendinopathy. Tenotomy may be considered when other conservative treatments have not yielded the desired results.

The Tenex Procedure: The Tenex procedure is a minimally invasive orthopedic technique designed to treat chronic tendon pain and injuries. It uses ultrasound imaging to precisely identify and remove damaged tissue within the tendon. The procedure is less invasive than traditional surgery, leading to quicker recovery times and less post-operative discomfort. 

For detailed information on tenotomy, the Tenex procedure, and other orthopedic treatments for tendon injuries, please visit our website at goldenstateortho.com.

1. Supporting Studies: Several studies have investigated the effectiveness of PRP for tendon injuries. It’s important to note that results can vary, and research is ongoing. Here are some key studies:
   • A systematic review and meta-analysis published in the American Journal of Sports Medicine in 2017 found that PRP therapy had a positive effect on pain reduction and function improvement in patients with chronic tendinopathy (https://pubmed.ncbi.nlm.nih.gov/27881367/).
   • A study published in the Journal of Orthopaedic Research in 2014 reported that PRP injections improved the structural and mechanical properties of tendons in a rabbit model, suggesting potential benefits for tendon healing (https://pubmed.ncbi.nlm.nih.gov/24965168/).
   • A randomized controlled trial published in the American Journal of Sports Medicine in 2018 compared PRP injections with a saline placebo in patients with chronic Achilles tendinopathy. The study found that PRP resulted in greater improvements in pain and function compared to the placebo group (https://pubmed.ncbi.nlm.nih.gov/30043697/).

These studies suggest that PRP therapy may be a promising option for certain tendon injuries, but more research is needed to establish standardized protocols and confirm its long-term effectiveness.