Ask what PRP means when reading Arizona PRP clinic reviews

What to know about PRP first

Your blood contains small cells called platelets. They bunch together to stop bleeding after a cut.

A machine spins a small blood sample and separates its layers. The clinic keeps the liquid layer that contains many platelets.

Concentrated PRP means that kept liquid has more platelets than blood usually has. The name alone doesn't tell you how many.

Platelets also release proteins that start the body's repair work. That explains the idea behind PRP, but it doesn't promise relief.

Clinics can prepare the blood in different ways. Ask exactly which blood layer will be used for your treatment.

What to ask during the visit

Ask whether the kept liquid contains many white blood cells. These cells fight germs and can also bring more soreness after treatment.

Then ask what the doctor or nurse sees while examining you. The answer should name the movement, swelling, or sore spot that matters.

Ask why PRP is worth considering for your joint. Don't accept an answer based only on what the clinic usually does.

Home care, physical therapy, medicine, a brace, or surgery may also come up. Ask why any one of these choices comes before another.

Ask how sore you could feel after the PRP treatment. Find out how long that soreness may last and who handles your call.

Choose something you hope to do with less trouble. Ask when the clinic will check that activity with you again.

What to do before leaving home

Make a full medicine list, including aspirin. Keep taking prescribed medicine until your own doctor or nurse says otherwise.

Take earlier reports and brief notes about your soreness. Include what starts the ache and what settles it.

Wear loose clothes that give access to the joint. Keep your questions with your keys so you won't forget them.

When PRP is planned, ask how to prepare for treatment. You may want an easier day after the visit.

Evidence sources

1. A systematic review that screened 876 studies and extracted standardised data from 33 commercially available PRP systems and protocols found that final product concentrations of platelets, white cells and growth factors varied widely between systems, as did the preparation protocols themselves. Platelet concentration correlated directly with the volume of blood drawn and with the centrifugal force of the device. The authors called the heterogeneity between separation systems something that 'must be resolved for proper study of this promising treatment'.

   Fadadu PP, Mazzola AJ, Hunter CW, et al. — Review of concentration yields in commercially available platelet-rich plasma (PRP) systems: a call for PRP standardization. Regional Anesthesia and Pain Medicine, 2019.

2. The PAW classification was proposed because PRP preparation protocols 'vary widely between authors and are often not well documented in the literature, making results difficult to compare or replicate'. It sorts preparations by three variables: the absolute number of Platelets, the manner of Activation, and the presence or absence of White cells - the three levers that make two injections both called 'PRP' materially different products.

   DeLong JM, Russell RP, Mazzocca AD — Platelet-rich plasma: the PAW classification system. Arthroscopy, 2012.

3. In a controlled laboratory study, blood from five healthy donors was processed through three commercial PRP systems (MTF Cascade, Arteriocyte Magellan, Biomet GPS III). Platelet, red-cell and TGF-beta1 concentrations did not differ significantly between systems, but white-cell counts and PDGF-alpha-beta, PDGF-beta-beta and VEGF concentrations differed significantly across all three. Cascade produced leukocyte-poor PRP while GPS III and Magellan produced leukocyte-rich PRP with correspondingly higher white cells and growth factors.

   Castillo TN, Pouliot MA, Kim HJ, et al. — Comparison of growth factor and platelet concentration from commercial platelet-rich plasma separation systems. American Journal of Sports Medicine, 2011.

4. A narrative review of PRP concluded that the literature suggests leukocyte-rich PRP is more beneficial in tendinopathies while pure (leukocyte-poor) PRP is more beneficial in cartilage pathology - but stated plainly that different PRP preparations have not been directly compared head-to-head in ANY pathology, and that the PRP type used is frequently not even stated in published research.

   Collins T, Alexander D, Barkatali B — Platelet-rich plasma: a narrative review. EFORT Open Reviews, 2021.

5. A prospective fixed-sequence controlled laboratory study in healthy men found that daily low-dose aspirin significantly reduced release of VEGF, PDGF-AB and TGF-beta1 from freshly isolated leukocyte-rich PRP when activated with arachidonic acid. This is the mechanistic basis for the routine instruction to review antiplatelet and NSAID use before a PRP draw - and the authors noted clinical studies are still needed to establish how much this matters in vivo.

   Jayaram P, Yeh P, Patel SJ, et al. — Effects of Aspirin on Growth Factor Release From Freshly Isolated Leukocyte-Rich Platelet-Rich Plasma in Healthy Men: A Prospective Fixed-Sequence Controlled Laboratory Study. American Journal of Sports Medicine, 2019.