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PRP / Ultrasound

What is prp?

Platelet-rich plasma (PRP) is a cutting-edge treatment for tendinosis, tendon tears, osteoarthritis, and more. We take your blood, spin it in a centrifuge, and inject the platelets under ultrasound guidance. Platelets have growth factors that can provide significant pain relief and even regenerate some tissue without surgery. PRP is a fantastic method to get you back to living your life with less down time and pain than surgery.

What is Ultrasound?

Ultrasound technology has been around for many years as a way to look at specific structures inside a person’s body. Ultrasound machines use sound waves to make a live, two-dimensional picture. It is different from X-rays and CT scans since it uses no radiation, and it is different from MRI since it uses no magnets. Obstetricians use ultrasound technology to look at a pregnant person’s baby. At SOBH Sports, we use ultrasound to see the health of your tendons, muscles, ligaments, and other structures. We look for causes of discomfort, like degeneration and tears, and we even use ultrasound to help guide injections, providing quality and service to our patients. Ultrasound is a fast, cost-effective, and safe way to help get you on your way to living a better life!

Does PRP actually work?

Everyone is different, but PRP can definitely work if it’s done right.

Three things that PRP needs to be successful:

Platelet Concentration

Too much or too little can be ineffective.

Ultrasound Guidance

Tendons are small. Imagine trying to poke around the tendon, hoping you inject into the tear. It’s like trying to shoot an arrow in the dark! This is why using the ultrasound to guide the needle is very important. Best part? You can watch (if you’re up for it)!

Physical Therapy

Proper physical therapy is necessary to maximize tendon regrowth and strengthen supporting muscles.

What do you treat with PRP?

Osteoarthritis of most any joint (shoulder, hip, knee, ankle, etc.)

Tendon degeneration (tendinosis)/tendon tears: tennis elbow, golfer’s elbow, patellar tendinosis, Achilles tendinosis, peroneal tendinosis, rotator cuff tendinosis, gluteal tendinosis 

Meniscus/cartilage tears: knee, TFCC (wrist)

Labral tears: hip, shoulder

Hair loss and facial rejuvenation (microneedling with PRP)

Orthopedics

Tendon
We use ultrasound-guidance to that we know exactly where we are putting the PRP. Most of the time, only one treatment is needed. An ultrasound exam will be done at 8 and 12 weeks to compare progress. An overwhelming majority of patients have seen significant improvement in pain and quality of life after 12 weeks! 1, 2

 

Osteoarthritis
PRP has been shown to significantly improve pain from osteoarthritis when compared to placebo and viscosupplementation (gel shots). The studies show that patients experience the most improvement with three treatments. 3, 4, 5

PRP can also be used to treat meniscus and labral tears!

Before After

(Left/Before) Ultrasound image of the patellar tendon before PRP. The dark area with the white dotted line is degeneration (tendinosis). (Right/After) Ultrasound image of the same patellar tendon eight weeks after PRP. Notice the dark area has filled in with new tendon fibers.

COSMETIC

PRP works very well for androgenic alopecia (male and female pattern baldness). The studies show that you need one treatment a month for four months, then every 2-6 months for maintenance.6 Most patients will start to see results after a few treatments. Package deals and referral discounts are available.

Hair_Before_1 Hair_After_1

All images were used with permission.

Facial rejuvenation

The recommendation is four to six monthly sessions with a once yearly maintenance treatment. Studies show that there is a 400% increase in collagen and elastin 6 months after the last treatment.7, 8

SOBH Sports can help you get back to enjoying the life you love and living the life you deserve.

PRP results are not guaranteed and indications may not be approved by the FDA.

1. Salamanna F, et al. New and Emerging Strategies in Platelet-Rich Plasma Application in Musculoskeletal Regenerative Procedures: General Overview on Still Open Questions and Outlook. Biomed Res Int. 2015; 2015: 846045.

Different platelet concentrations are required for treatments of bone, tendon, cartilage, and ligaments.

2. Yuan T, et al. Augmenting tendon and ligament repair with platelet-rich plasma (PRP). Muscles Ligaments Tendons J. 2013 Jul-Sep; 3(3): 139–149.

3. Xie X.,  Zhang C., and Tuan R. Biology of platelet-rich plasma and its clinical application in cartilage repair. Arthritis Res Ther. 2014; 16(1): 204.

Multiple studies show that PRP is a promising treatment for osteoarthritis. PRP has some growth effects on cartilage, stem cells, and lubricant-making cells. PRP can also act as a scaffold to help fill some defects in cartilage. Last, PRP can inhibit inflammation and help treat osteoarthritis symptoms safely.

4. Kavadar G, et al. Effectiveness of platelet-rich plasma in the treatment of moderate knee osteoarthritis: a randomized prospective study. J Phys Ther Sci. 2015 Dec; 27(12): 3863–3867.

PRP can be effective and reliable in treating pain and function for Grade 3 osteoarthritis, with a minimum of two injections showing the best outcomes.

5. Shen, L., Yuan, T., Chen, S. et al. The temporal effect of platelet-rich plasma on pain and physical function in the treatment of knee osteoarthritis: systematic review and meta-analysis of randomized controlled trials. J Orthop Surg Res 12, 16 (2017).

PRP injections improve the pain and function of knee osteoarthritis at 3, 6, and 12 months follow up when comparing injections of saline placebo, hyaluronic acid (gel shots), ozone, and corticosteroids.

6. Gentile P,  Garcovich S, et al. The Effect of Platelet-Rich Plasma in Hair Regrowth: A Randomized Placebo-Controlled Trial Stem Cells Transl Med. 2015 Nov; 4(11): 1317–1323.

After three monthly treatments, the average number of hairs and the thickness of hair increased. The data clearly illustrates the positive effects of PRP injections for pattern hair loss.

7. Fabbrocini G, Fardella N, Monfrecola A, Proietti I, Innocenzi D (2009) Acne scarring treatment using skin needling. Clin Exp Dermatol 34: 874-879.

8. Fabbrocini G, Annunziata MC, D’Arco V, De Vita V, Lodi G, Mauriello MC, Pastore F, Monfrecola G (2010) Acne scars: Pathogenesis, classification, and treatment. Dermatol Res Pract 2010: 893080.

BOOK YOUR APPOINTMENT

(213) 297-4395

Pre-Procedure Instructions

what to do/not do before the procedure

  1. Stop all anti-inflammatory medications (NSAIDs) two weeks prior to the procedure: ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), Celebrex, meloxicam (Mobic), etc.
  2. Stop taking blood thinners two weeks prior to the procedure: Aspirin, Plavix, Coumadin (warfarin) etc. Please speak to your cardiologist or primary care before stopping your medications.
  3. Stop taking the following vitamins/supplements 1 week before the procedure: vitamin E, vitamin A, Ginko, Garlic, Flax, Fish oils, and Essential Fatty Acids. You can start these one week after your procedure
  4. Arrange for someone to take you home after the procedure, as you may have some pain that may interfere with your ability to drive.

IMPORTANT: unless you are medically unable, please drink a half a gallon of water (about 8 cups) throughout the day before your procedure (don’t drink too much before bed). Please drink about 2 cups the morning of your procedure (one bottle of water).

POST-Procedure Instructions

what to expect afterwards

  1. Please have someone take you home after the procedure
  2. Blood thinners (Aspirin, Plavix, Coumadin (warfarin) etc) can be started 24 hours after the procedure
  3. Avoid anti-inflammatory medications (ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), Celebrex, meloxicam (Mobic), etc.) for six weeks after the procedure
  4. You may have some irritation around the injection site for several days after the injection. This is normal. AVOID ice and anti-inflammatory medications. Take Tylenol or the prescribed pain medication as needed.
  5. Signs of infection include fevers, persistent redness/swelling, significant pain, and pus. If you notice any of these, please come in immediately for evaluation.
  6. It is very important to follow all instructions given. Limit movement of the treated area for the first three days after the procedure. Avoid lifting and strenuous activity for the first seven days. Please use the splint (if one was provided) as instructed. Please take post-PRP rehabilitation program with you to your physical therapy appointments. On average, sports-related drills begin at 8 weeks from the procedure and return to play usually occurs at 12 weeks from the procedure.

IMPORTANT: unless you are medically unable, please drink a half a gallon of water (about 8 cups) throughout the day before your procedure (don’t drink too much before bed). Please drink about 2 cups the morning of your procedure (one bottle of water).

Pre-Procedure Instructions

what to do/not do before the procedure

  1. Stop all anti-inflammatory medications (NSAIDs) and Aspirin 1 week prior to the procedure: ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), Celebrex, meloxicam (Mobic), etc.
  2. Avoid systemic corticosteroids (1-2 weeks) and corticosteroid injections (4 weeks) prior to your injection (inhaled corticosteroids are fine)
  3. Avoid alcohol and all smoking for one week prior to and one week after your procedure
  4. Stop taking the following vitamins/supplements 1 week before the procedure: vitamin E, vitamin A, Ginko, Garlic, Flax, Fish oils, and Essential Fatty Acids. You can start these one week after your procedure
  5. You can color your hair up to 3 days before the procedure and 3 days after the procedure
  6. You can shampoo your hair the morning of the procedure and 24 hours after the procedure

IMPORTANT: unless you are medically unable, please drink a half a gallon of water (about 8 cups) throughout the day before your procedure (don’t drink too much before bed). Please drink about 2 cups the morning of your procedure (one bottle of water).

POST-Procedure Instructions

what to expect afterwards

  1. Avoid anti-inflammatory medications (ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), Celebrex, meloxicam (Mobic), etc.) and Aspirin for one week after the procedure
  2. Avoid systemic corticosteroids for 1 weeks after the procedure (inhaled corticosteroids are fine)
  3. Avoid alcohol and all smoking for one week after your procedure
  4. You may have some irritation around the injection site for several days after the injection. This is normal. AVOID anti-inflammatory medications and ice. Take Tylenol if you need it.
  5. Stop taking the following vitamins/supplements 1 week before the procedure: vitamin E, vitamin A, Ginko, Garlic, Flax, Fish oils, and Essential Fatty Acids. You can start these one week after your procedure.
  6. Avoid sun exposure to your head for 2-3 days after the procedure. You can also wear a hat.
  7. Signs of infection include fevers, persistent redness/swelling, significant pain, and pus. If you notice any of these, please come in for evaluation.

IMPORTANT: unless you are medically unable, please drink a half a gallon of water (about 8 cups) throughout the day before your procedure (don’t drink too much before bed). Please drink about 2 cups the morning of your procedure (one bottle of water).

Pre-Procedure Instructions

what to do/not do before the procedure

  1. Stop all anti-inflammatory medications (NSAIDs) and Aspirin 1 week prior to the procedure: ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), Celebrex, meloxicam (Mobic), etc.
  2. Avoid systemic corticosteroids (1-2 weeks) and corticosteroid injections (4 weeks) prior to your injection (inhaled corticosteroids are fine)
  3. Avoid alcohol and all smoking for one week prior to and one week after your procedure
  4. Stop taking the following vitamins/supplements 1 week before the procedure: vitamin E, vitamin A, Ginko, Garlic, Flax, Fish oils, and Essential Fatty Acids. You can start these one week after your procedure
  5. Please do not wear make-up on the day of the procedure.

IMPORTANT: unless you are medically unable, please drink a half a gallon of water (about 8 cups) throughout the day before your procedure (don’t drink too much before bed). Please drink about 2 cups the morning of your procedure (one bottle of water).

POST-Procedure Instructions

what to expect afterwards

  1. Your recovery time will be influenced by how aggressive your treatment was, along withyour individual skin’s response. Your doctor will have discussed with you the individual time frame but you should expect between 1-4 days.
  2. Sun Exposure: Avoid direct sun for 3-5 days.
  3. Sun Block is mandatory if outside and should be reapplied every 2 hours.
  4. Waxing/Laser treatments: Avoid for 2 weeks.
  5. Facial Treatments: Avoid for 2 weeks.
  6. Exercise or swimming: Avoid for 24 hours (You do not want to sweat).
  7. No Exfoliating Products, Vitamin C, Retin-A, Astringents, Acids, or products containing alcohol/fragrance for 3 days unless instructed by your doctor.
  8. NO Make-up for 24 hours. It is recommended to use mineral makeup after that time.
  9. Increase water intake to include at least 8 glasses.
  10. Wash treated area with gentle cleanser 3 days post treatment. Do NOT use washcloths as they can irritate your skin.
  11. DO NOT PICK AT SKIN!

IMPORTANT: unless you are medically unable, please drink a half a gallon of water (about 8 cups) throughout the day before your procedure (don’t drink too much before bed). Please drink about 2 cups the morning of your procedure (one bottle of water).