I Had PrP Injections Last Week

An update.

Since a couple of you asked, a quick update on my PrP injections. It’s been One Week (insert link to Bare-Naked Ladies song here). First, a review. PrP stands for PLATELET-Rich PLASMA.

“Platelet-rich plasma therapy is a form of regenerative medicine that harnesses and amplifies the natural growth factors found in our blood cells to help heal damaged tissue. Plasma is the liquid portion of whole blood. It is composed largely of water and proteins, and it provides a medium for red blood cells, white blood cells and platelets to circulate through the body. Platelets, also called thrombocytes, are blood cells that cause blood clots, as well as other necessary growth and healing functions.

“Platelet-rich plasma (PRP) is produced from a person's own blood. It is a concentration of one type of blood cell (platelets), which is critical for blood clotting. The platelets are collected and concentrated to anywhere from 2 to 8 times their normal number. This concentration is injected to an injured or diseased part of a person’s body to accelerate the healing of damaged tendons, ligaments, muscles, bones and joints.

“The activation of the concentrated platelets in platelet-rich plasma releases growth factors that stimulate and increase the number of reparative cells your body produces. This significantly enhances the body's natural healing process.

Recent data suggests that PRP treatment is superior to than hyaluronic acid injections (also known as viscosupplementation or “gel shots”) for knee osteoarthritis, especially in regard to the duration of its positive effect.” – New York Hospital for Special Surgery.

I have old tears in my right lateral meniscus and relatively new tears in my left medial meniscus. In both knees, the torn sides were either bone-on-bone or relatively close. While I still did pretty much everything I did prior to the tears, some simple tasks (going down stairs, e.g.) were less than pleasant. Skiing ranged from okay to no effing way today. On the bike, when I’d get out of the saddle to sprint, I never knew whether my (L) knee would be stable under me. In the weight room, I could squat 285 but that required heavy-duty compression sleeves, hinged stability braces, and over that, powerlifting knee wraps. Since there is very little torque, squats didn’t really hurt. It’s all about the torque. When I would ruck, I’d use 35 lbs in the backpack, and the hinged braces. Again, not a lot of torque when you walk.

Prior to the injections, I did a crap-ton of prehab work. I train 6 days a week. Every week, one day was dedicated to work on my knees. It helped a lot. But not enough for my 66 year old knees.

The doc pulled out about 50 mL of blood (I had both knees injected) and spun it in a centrifuge for about 15 minutes to separate the platelets from the rest of the blood solids. Under ultrasound, he injected it into the joint capsule. He used a relatively small gauge needle. No local anesthesia needed. Painless.

While some patients show some regrowth of cartilage over the long term, my orthopod cautioned me that this was not likely in my case. I was told to ride the bike, Zone 1, with high rpms and very low pressure for two days following. After that, I was to let any discomfort be my guide. I was also told that max results might not be reached until 1-3 months out from my injection date.

As of today, I can go up stairs pain-free and in a normal gait. No handrail required. Downstairs, I am relatively pain free, and once again able to use a normal, bilateral gait, but I still keep my hand close to the rail. Just in case. I did an hour on the bike, Zone 2, two days ago. Yesterday, I did tempo intervals, 53x18, 100 RPM for 4 minutes x 4 and it felt great to be around 75-80% of max heart rate. I’m not going to squat for another 3 weeks as I let the PrP do its thing. Today, I will do leg extensions and leg curls, just as regularly do on leg days.

Clearly, 7 days later, the arthritic inflammation in my knees, which was also accelerated by my bout with Covid 18 months ago, has lessened greatly. They haven’t felt this good since I tore the medial meniscus in the left knee getting up and out of my rollie desk chair at school 7 years ago. So far, 10/10 -highly recommend. More bulletins are events warrant. News on the 8’s. Film at Eleven.