Scientists are still exploring which patients should be eligible for PRP injections. While no definitive conclusions can be made, experts recommend that patients have already tried appropriate traditional non-surgical treatments such as rest and physical therapy.
Suggested Indications for Treating Tendons with PRP
Experts have not developed definitive criteria for deciding when and to whom to recommend PRP injections, but some suggestions are below:
- Tendon pain affects daily activities
- Physical therapy has not adequately improved function and reduced pain
- Other non-surgical treatments have failed or been eliminated
- The patient is sensitive to anti-inflammatory medications (NSAIDs) such as ibuprofen; finds medications do not provide adequate pain relief; or wants to avoid long-term use of medications.
- Surgical treatment is not optional or not desired.
Platelet-rich plasma injections may not be recommended for the most severe cases of tendinosis or tendinopathy. In these cases a doctor may advise the patient to consider surgery to repair the damaged tendon.
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Contraindications for PRP Therapy
Platelet-rich plasma injections may not be appropriate for a patient who:
- Has a medical condition that could worsen or spread with injections, such as an active infection, a metastatic disease, or certain skin diseases
- Has certain blood and bleeding disorders
- Is undergoing anticoagulation therapy (and cannot temporarily suspend treatment)
- Is anemic
- Is pregnant
Additionally, patients who have an allergy to cow products should tell their doctor. These patients could experience an allergic reaction if the platelet-rich plasma is combined with an additive called bovine thrombin, which is derived from cows.