Frequently Asked Questions

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Patients should consider PRP treatments if they are experiencing osteoarthritis in the hip, knee or shoulder or chronic tendonitis in the elbow, ankle and shoulders. PRP is an alternative treatment for patients who prefer to explore other options besides surgery. Initial evaluation will determine if PRP is a viable treatment option for you. 

PRP therapy is generally safe and complications are rare. Although uncommon, the risks include:
 

· Pain and mild swelling for few days

· Infection

· No relief of symptoms

· Allergic reaction

PRP has healing properties, known as essential growth factors, that cortisone injections lack. Cortisone injections may provide a quick fix for temporary relief and lessening of inflammation but can potentially produce a weakening effect in the tissue. Consequently, they generally do not provide long term healing benefits. The effect of the cortisone injection is weaker with multiple injections. 

This treatment is not a quick fix and is designed to promote long-term healing of the tendon. Time and rehabilitation are required to allow the injured tendon to heal. 

Individuals who are affected from bleeding disorders, active infections, cancer, and pregnancy, or who are taking blood thinners (Coumadin), are not candidates for PRP. 

We recommend that you contact our office and talk with a specialist to determine if you are a candidate.   

Because PRP is a relatively new treatment, OHIP will not cover the cost of  treatment. 

PRP works by enhancing the body’s natural ability to heal. It generally takes a few weeks to begin feeling the difference.

The procedure usually takes 20 to 30 minutes. The process includes taking a vial of blood from your vein, spinning the blood in the centrifuge to separate the blood components, and injecting the plasma and platelets into the affected joint or tendon using ultrasound guidance.

When treating Tendonitis, one treatment is generally enough to cure the affliction.   When treating Arthritis, there is evidence that two injections 7 to 10 days apart will produce the best results. 

If the treatment is focused on arthritis, which is a degenerative disease, it’s unlikely that PRP will have permanent effects. In my clinical experience, for mild arthritis, it may provide 1-2 years of relief  In contrast, for partial tendon or ligament injuries, there may be permanent relief as the prevailing thought is that PRP may heal the tear.

The use of ultrasound technology allows doctors to produce pictures of the inside of their patient’s body via sound waves.  

Ultrasound technology uses a small probe and gel placed directly onto the skin. High-frequency sound waves are transmitted into the body and allow the probe to collect the sounds that bounce back. The probe sends this information to a computer that then uses those waves to create an image. Ultrasound lacks ionizing radiation and thus no radiation is exposed to the patient. The images are captured in real time, which display the structure and movement of one's soft-tissue. 

The use of ultrasound technology allows doctors to produce pictures of the inside of their patient’s body via sound waves.  

Ultrasound technology uses a small probe and gel placed directly onto the skin. High-frequency sound waves are transmitted into the body and allow the probe to collect the sounds that bounce back. The probe sends this information to a computer that then uses those waves to create an image. Ultrasound lacks ionizing radiation and thus no radiation is exposed to the patient. The images are captured in real time, which display the structure and movement of one's soft-tissue. 

The primary objective behind using ultrasound guided technology for musculoskeletal injections is to ensure the utmost accuracy during the treatment. The areas being treated are only a few millimetres in size, meaning the imaging can help the doctor to accurately locate and target these structures.  

Traditionally, musculoskeletal injections have been performed based on anatomical landmarks, also known as “blind” technique. The doctor feels for specific bones, muscles, or tendons and injects into the desired area. There is no definitive way of knowing where the tip of the needle is entering. Musculoskeletal ultrasound has become popular for guiding needles during musculoskeletal injections, especially for injecting joints and tendons. 

• Precision: The needle tip can be seen on the ultrasound screen, and the exact location of the injection is optimized.
• Less pain: Ultrasound imaging provides real-time needle placement to the target area, providing a reduction in pain during the procedure as compared to blind injections.
• Less risk of complication: A visual path helps the doctor to avoid hitting nerves and blood vessels, thereby reducing the chance of complications (i.e. nerve damage, excessive bleeding).
• More effective: Injection accuracy allows the treatment to be more effective.
• The ultrasound increases diagnostic feedback to the treatment provider. If the doctor is sure the injection has been placed in the target area, and does not work, then the doctor will know that they must look for another cause of the patient’s symptoms.

Several studies have examined the accuracy of ultrasound-guided injections compared to blind injections. The American Medical Society for Sports Medicine (AMSSM) published a position statement on interventional musculoskeletal ultrasounds. 

The conclusions are based on a systematic review of the literature, including 124 studies, demonstrating high-quality evidence that ultrasound-guided injections are more accurate than landmark-guided injections.