PRP injections Gilbert: help for soreness and stiff joints

When soreness appears helps explain the cause

Notice the motion that starts the soreness and how long the ache remains. Stiffness after rest differs from a sharp pull during one movement. Swelling, weakness, or a knee that buckles also matters.

Tell the clinician which tasks have become hard for you. Stairs, sleep, walking, reaching, and standing from a chair are useful examples. These ordinary tasks give the exam a clear focus.

Your daily limits are useful facts.

Gentle movement and simple care may ease soreness

Reduce the activity that hurts, then add it back slowly as you feel better. Exercise can strengthen nearby muscles and help the joint with daily work. A brace may also support a sore knee.

Ibuprofen and naproxen are anti-inflammatory medicines, meaning they lower swelling and soreness. They aren’t safe for everyone, so ask your clinician before using them and don’t stop prescribed medicine on your own.

Keep every movement comfortable for now.

Soreness that stays is worth an exam

Arrange a visit when soreness keeps waking you or limiting normal tasks. Bring any earlier X-ray and a complete list of medicines. The clinician will examine the joint and review what you’ve already tried.

When simple care hasn’t helped enough, QC Kinetix offers consultations about regenerative treatments. That clinic term means non-surgical care that may use blood taken from your arm and prepared there. A medical provider, the clinician who examines you, discusses whether such care fits.

The letters PRP stand for platelet rich plasma: your blood is spun to keep clear liquid with extra clot-forming platelets. The aim is less soreness and easier movement, but improvement isn’t certain at the nearest clinic in Chandler.

Sources

1. In a controlled laboratory study, blood from five healthy donors was processed through three commercial PRP systems (MTF Cascade, Arteriocyte Magellan, Biomet GPS III). Platelet, red-cell and TGF-beta1 concentrations did not differ significantly between systems, but white-cell counts and PDGF-alpha-beta, PDGF-beta-beta and VEGF concentrations differed significantly across all three. Cascade produced leukocyte-poor PRP while GPS III and Magellan produced leukocyte-rich PRP with correspondingly higher white cells and growth factors.

   Castillo TN, Pouliot MA, Kim HJ, et al. — Comparison of growth factor and platelet concentration from commercial platelet-rich plasma separation systems. American Journal of Sports Medicine, 2011. DOI: 10.1177/0363546510387517.

2. A systematic review that screened 876 studies and extracted standardised data from 33 commercially available PRP systems and protocols found that final product concentrations of platelets, white cells and growth factors varied widely between systems, as did the preparation protocols themselves. Platelet concentration correlated directly with the volume of blood drawn and with the centrifugal force of the device. The authors called the heterogeneity between separation systems something that 'must be resolved for proper study of this promising treatment'.

   Fadadu PP, Mazzola AJ, Hunter CW, et al. — Review of concentration yields in commercially available platelet-rich plasma (PRP) systems: a call for PRP standardization. Regional Anesthesia and Pain Medicine, 2019. DOI: 10.1136/rapm-2018-100356.

3. In the RESTORE trial - the largest placebo-controlled PRP trial in knee osteoarthritis - 288 adults aged 50+ with symptomatic Kellgren-Lawrence grade 2-3 medial knee OA received three weekly intra-articular injections of leukocyte-poor PRP from a commercial system or saline placebo. At 12 months the mean change in knee pain was -2.1 points with PRP versus -1.8 with saline (difference -0.4; 95% CI -0.9 to 0.2; P=.17) against a minimum clinically important difference of 1.8, and the change in medial tibial cartilage volume was -1.4% versus -1.2% (difference -0.2%; 95% CI -1.9% to 1.5%; P=.81). Twenty-nine of 31 prespecified secondary outcomes showed no significant between-group difference. The authors concluded the findings do not support use of PRP for knee OA.

   Bennell KL, Paterson KL, Metcalf BR, et al. — Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial. JAMA, 2021. DOI: 10.1001/jama.2021.19415.

4. The devices used to spin PRP at the point of care are cleared by FDA as clinical centrifuges, product code JQC, a Class I device under 21 CFR 862.2050 - for example the Biomet GPS Platelet Separation Kit (K030555, cleared 2003) and the Harvest SmartPrep2 / SmartPrep Platelet Concentration System (K103340, cleared 2010). That clearance covers the equipment that separates blood. It is not an FDA approval of platelet-rich plasma as a treatment for osteoarthritis, tendinopathy or any other orthopedic condition, and copy must never blur the two.

   U.S. Food and Drug Administration (Center for Devices and Radiological Health) — 510(k) Premarket Notification database and Product Classification: JQC, Centrifuges (Micro, Ultra, Refrigerated) For Clinical Use, 21 CFR 862.2050. FDA accessdata (CDRH device databases), 2003.