Are there any safety issues with blood injection plasma for tendon tears?

Q: Are there any safety issues with blood injection plasma for tendon tears? I'm planning to have this treatment but thought I'd do a little checking on the Internet before actually going through with it.

A: Platelet-rich plasma (PRP) (also known as blood injection therapy) is a medical treatment being used for a wide range of musculoskeletal problems. Platelet-rich plasma refers to a sample of serum (blood) plasma that has as much as nine times more than the normal amount of platelets. This treatment enhances the body’s natural ability to heal itself and is used to improve healing and shorten recovery time from acute and chronic soft tissue injuries.

It has been used for years after plastic surgery and surgery on the mouth, jaw, and neck. It seems to promote bone graft healing. Researchers have found a way to combine this substance with other chemicals to make it into a putty or gel that can be painted on a surgical site to speed up healing.

Blood injection therapy of this type has been used for knee osteoarthritis, degenerative cartilage, spinal fusion, bone fractures that don’t heal, and poor wound healing. This treatment technique is fairly new in the sports medicine treatment of musculoskeletal problems, but gaining popularity quickly.

The injectable substance is created by first drawing the patient's own blood and putting it in a special machine called a centrifuge. The centrifuge spins around at a fast rate and separates the various component parts of blood based on density and weight. The heavier red blood cells sink to the bottom faster than the lighter white blood cells and platelets.

There are at least 16 different collection kits available on the market for platelet-rich plasma (PRP). They are not all the same and the differences may make affect results of studies trying to determine the effectiveness and long-lasting benefit of this treatment.

Depending on how the blood sample is processed, the final amount of platelets and platelet-rich plasma can vary considerably. Large, prospective, and randomized trials are needed to compare results using different PRP kits for each individual problem treated.

Safety is an area of concern and potential study. Since the product comes from the patient's own blood, there is little risk involved. Rejection is not an issue. Local skin reactions, inflammation, and pain have been reported.

The positive benefits of speeding up healing are actually only part of the effectiveness of PRP. At least one study has shown that PRP increases the body's ability to fight off staph infections and E. coli. The antimicrobial action of PRP is an added bonus to the patient.

Reference: James Saucedo, MD, MBA, et al. Platelet-Rich Plasma. In The Journal of Hand Surgery. March 2012. Vol. 37A. No. 3. Pp.587-589.