PRP-San Diego
San Diego Center for Integrative Medicine
Dr. Joseph  Aiello


Q. and A. for PRP

What is PRP?

PRP stands for Platelet Rich Plasma.  It is an advanced therapy that applies a patient’s own natural healing mechanisms in the platelets to heal injured tendons and ligaments supporting the joints.  Joints become painful and non-healing when the body’s natural healing mechanism gets short circuited, whether with repetitive injury, poor nutrition, or use of anti-inflammatories.  PRP can accelerate the ongoing but slowed healing in acute injuries or restart stalled healing in chronic injuries.

How does it work?

When a joint is injured, the ligaments and tendons are stretched.  The first cells to start the healing process are the platelets.  They move into the damaged tissue and start to plug the bleeding at the tears.  They then release growth factors which start the healing cascade.  These growth factors call in new cells and cause new blood vessels to form in the tendons and ligaments.  Eventually, stem cells remodel the tissues and lay down new collagen and fibroblasts.  When patients have chronic injuries, somewhere this healing process got short circuited. 

We inject the PRP into the injured ligaments and tendons which restarts the healing process at the sites that need it. 

How long does it take?

The PRP process takes about 30 minutes in the office.  It starts with drawing some blood from the patient.  It is then placed in a special separator cup which goes into a tabletop centrifuge and is spun for 15 minutes.  During that 15 minutes, the ligaments and tendons of the joint are anesthetized with local anesthetic.  After 15 minutes, the PRP has been separated and concentrated by the centrifuge.  It is then injected into the joint to be treated.

Which joints can be treated?

Any injured joint can be treated.  I have treated ankles, knees, hips, lower backs, shoulders, elbows and wrists.  The injury can be acute or chronic. 

How does this compare to cortisone?

I don’t use cortisone any more.  It does the opposite of PRP.  It causes the tissues to thin and become weaker.  PRP, on the other hand, causes the tendons and ligaments to thicken and strengthen.

What kind of result can I expect?

In a study of my patients, 80% of the patients achieved at least 60% improvement in symptoms.  They had the injuries for a couple months to a several decades.  The patients typically felt better in a week.   The patients required an average of 1-2 shots per joint.  Some of the symptoms that improved were more joint stability, less joint pain, more mobility, less use of pain medicines, and better sleeping.  Over 85% of patients were satisfied to very satisfied with the treatment. 

Recently, I completed a one year follow-up.  The pain level decreased from an average of 3.4/10 to 2.6/10.  52% had increased activity level one year after the last injection.

Down Time/When can I return to training?

I ask patients to do light activity for a couple days and they can resume heavier activity in one week.

Is it covered by insurance?

Yes, PPO insurances typically cover the PRP.  

Who is using PRP?

This is the therapy that professional athletes are using to get back in the game quicker without surgery.  They avoid lengthy downtime and lengthy physical therapy commitments.  Those athletes have been Tiger Woods, Hines Ward and various professional football and baseball players.


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