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Author Topic: Right way to do PRP  (Read 3897 times)

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Offline razuzin

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Right way to do PRP
« on: November 19, 2015, 03:15:26 AM »
I just had my first PRP to the knee done. Would like to know if the procedure done had all standard steps.

My knee has two problem areas, trochlear groove under patella and medial meniscus. However, the doc said that he'll just make one injection right above the patella and the PRP particles would find their way to the damaged area. I thought the injection should be done directly to the problem areas. Plus he injected it more on a lateral side, pretty far from my medial meniscus.

In addition he used quite a liberal amount of lidocaine to numb the knee, let it work in for about 10 minutes, and then did the injection. Obviously, I felt nothing, is it normal to use lidocaine with the injection?
I thought it's an anti-inflammatory on its own which aren't recommended with PRP.

Now few hours after the injection the knee feels swollen as expected but mainly around the injection spot, don't feel much around the meniscus.
He injected around 6 cc of PRP, spun twice on the centrifuge.

Wondering how this compares with the experience others here had.

Offline Vickster

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Re: Right way to do PRP
« Reply #1 on: November 19, 2015, 05:59:20 AM »
I've not had PRP in a knee but I've had it into a tendon for tennis elbow. Ultrasound guided, no local anaesthetic was used as the surgeon told me it actually kills the cells. It was very painful therefore and I wouldn't rush to have it again! This was in the UK

I've had steroid into the knee with local and HA without, not as painful as the PRP (around 3-4 cc if I recall into a rather smaller area than a knee joint)
Came off bike onto concrete 9/9/09
LK arthroscopy 8/2/10
2nd scope on 16/12/10
RK arthroscopy on 5/2/15
Lateral meniscus trim, excision of hoffa's fat pad, chondral stabilisation
LK scope 10.1.19 medial menisectomy, trochlea microfracture, general tidy up

Offline razuzin

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Re: Right way to do PRP
« Reply #2 on: November 19, 2015, 02:40:44 PM »
Vicster,
thank you for your response. Yeah, it looks like there is quite a bit of a research online indicating that anaesthetics typically reduce the potency of PRP, although some small superficial amounts seem to be the norm.

I'll discuss it with the doctor as I scheduled my next injection with him, and ask him to use no anaesthetic.

Offline dal_knee

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Re: Right way to do PRP
« Reply #3 on: November 19, 2015, 04:07:40 PM »
Razuzin,

I've had about 6 or 7 PRP's.  Ask the doctor to go with a no-anesthetic approach, and eliminate the concern.  The pain is rather minimal, not a big deal.   If you've had HA and steroid injections, I'd say the order of pain from least to greatest would be:  PRP, HA, then steroid. 

As for injection location, can't really comment much here but I understand the concern.  Sounds like he went with superolateral approach which is very standard and will adequately target the meniscus but I wonder about getting it into the patellofemoral space.     Just ask the doc or his PA.  They really like these types of questions.   

2007 - partial medial meniscectomy
2010 - full thickness chondral defect & adjacent subchondral edema MFC.   Direct result of stupid partial mensicectomy from 2007.
2014 - Subchondroplasty, chondroplasty, unauthorized 2nd partial medial meniscectomy.
2015 - partial failure of subchondroplasty.

Offline razuzin

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Re: Right way to do PRP
« Reply #4 on: November 19, 2015, 05:48:08 PM »
Thanks dal_knee,
actually I already asked the doc via email and he responded saying that he just put the lidocaine under the skin and injected the PRP deeper, he has no problem giving me the next injection with no lidocaine.

I felt no pain during injection and for 15 mins after whatsoever, and then the inflammation gradually started but very tolerable.

Yes, I had HA and cortisone, I'd say HA was the least painful, just a little pinch and no burning from the liquid at all. The cortisone was quite painful but probably because of the condition of my knee, it was very swollen.

Offline ouassini1979

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Re: Right way to do PRP
« Reply #5 on: November 16, 2016, 01:46:26 PM »
Hello Razurin ,

the right way to do PRP should be using a good centrifuge to extract max and good quality Plasma , else it will not provide a vry good results , please check more here prp-injection dot com .