Ligament and Tendon Healing with Platelet Rich Plasma
Ligament and tendon injuries like total or partial Achilles tendon tears are commonly seen among active individuals and athletes, which can cause severe pain and loss of function. This can affect a patient’s ability to do simple daily activities.
Achilles tendon injuries can be treated with reconstructive surgery, but unfortunately, this does not effectively heal the affected ligament or tendon due to the formation of scar tissue. Scar tissue is hard and dense and do not actually have the same elasticity as ligament and tendons. This area or scar formation is actually prone to re-injury. Also, as with any surgery, there is a risk of infection in reconstructive surgery and may also cause a dehiscence of the sutures. This will need further wound cleaning and reconstruction of the affected ligament or tendon.
An alternative treatment for such injuries, which is actually very popular in sports medicine, is Platelet Rich Plasma or PRP.
via Wikimedia Commons
What are Platelets?
Platelets are blood cells that play a very important role in our body’s homeostasis. Platelets cover any injury to prevent us from bleeding out. Like red blood cells, platelets are formed in the bone marrow and do not have a nucleus. In a healthy adult, the ratio of red blood cells and platelets is 1:10 to 1:20.
Generally, platelets roam freely in the circulatory system and remain inactive, once an interrupted endothelium or injury occurs, the platelets gather at the site and plug the damaged tissue. Three steps occur during this event.
1. Adhesion – platelets attaches to the injury.
2. Activation – the platelets secret chemical messengers and transform into receptors.
3. Aggregation – the platelets bind together, creating the wall or plug to stop the bleeding.
What is the role of Platelet Rich Plasma in Ligament and Tendon Injuries?
PRP or platelet rich plasma is basically blood plasma that has high concentrations of platelets and growth factors. Certain growth factors are very effective in healing various injuries. High concentration of these growth factors is theoretically the basis PRP is being used for tissue repair. By adding thrombin and calcium chloride to collected PRP, this triggers platelet activation and induces the release of the mentioned growth factors. These growth factors promote cell proliferation and the formation of a mesh-like structure, which enhances cell migration and incorporation, hence, regenerating new tissue repair.
Collection and Application
PRP is analogous and is completely safe. No allergic reaction or rejection will occur since the PRP is collected from the patient. The amount of blood drawn depends on the type of treatment/injury.
WHAT IS PRP?
Platelet-rich plasma or PRP is blood plasma that has been enriched with platelets. It helps stimulate healing of bone and soft tissue.