What should you know about blood prepared for PRP?

What details about the PRP shot matter to you?

Ask how much PRP will be in the shot and how many platelets it holds. The amount matters because clinics don't all prepare the same shot.

You can also ask whether staff tested the finished PRP or used an estimate. A test describes your prepared blood; an estimate only describes what the machine often makes.

Some mixes keep white blood cells, which may cause more soreness afterward. More platelets still don't mean that you'll get more relief.

What's enough to know? You need the shot amount, its platelet count, and whether white cells remain. Machine names won't answer those questions.

What will QC Kinetix discuss at the visit?

At QC Kinetix, regenerative treatments are non-surgical choices drawn from your blood and given there. The words medical providers mean staff checking your joint, giving care, and reviewing your health.

They can explain PRP, recovery, the full cost, and later visits. They'll also tell you why another kind of care may fit better.

You can take time after the visit to weigh the possible help. The price and the chance of no relief both matter.

How can you leave with a clear next step?

Take your X-ray report and the names of your medicines. Tell the provider which movements hurt and what has eased the ache.

Ask for plain written directions before you schedule the shot. You'll want to know what happens that day and when to call later.

Sometimes PRP isn't a good fit for the cause. That answer can spare you cost, worry, and extra soreness.

Sources

1. A systematic review of 105 clinical PRP studies in orthopaedics published 2006-2016 found that only 11 (10%) described the preparation protocol clearly enough for another investigator to repeat it, and only 17 (16%) reported any quantitative metric of the final PRP composition. The authors concluded that the current reporting of PRP preparation and composition does not allow the PRP products actually delivered to patients to be compared between studies.

   Chahla J, Cinque ME, Piuzzi NS, et al. — A Call for Standardization in Platelet-Rich Plasma Preparation Protocols and Composition Reporting: A Systematic Review of the Clinical Orthopaedic Literature. Journal of Bone and Joint Surgery (American), 2017. DOI: 10.2106/JBJS.16.01374.

2. 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. DOI: 10.1136/rapm-2018-100356.

3. 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. DOI: 10.1016/j.arthro.2012.04.148.

4. The DEPA classification was built because platelet and leukocyte counts alone do not describe an injection. Applied retrospectively to 20 published PRP preparations, the dose of injected platelets ranged from 0.21 billion to 5.43 billion - a 25-fold spread. No device recovered more than 90% of the platelets in the blood drawn, and most preparations were contaminated with red blood cells: only three of the devices reached a purity score corresponding to more than 90% platelets relative to red cells and leukocytes.

   Magalon J, Chateau AL, Bertrand B, et al. — DEPA classification: a proposal for standardising PRP use and a retrospective application of available devices. BMJ Open Sport & Exercise Medicine, 2016. DOI: 10.1136/bmjsem-2015-000060.

5. A technical and biological review screened 1379 studies and identified 50 commercial PRP preparation systems in three technical categories (tubes, syringes, bags). Sufficient biological characterisation was available for only 14 of those 50 systems. Comparing the 36 characterised preparations across the seven existing PRP classifications revealed 'a large heterogeneity among the available current PRP commercial systems' and showed the classifications themselves differ in how well they discriminate between preparations.

   Magalon J, Brandin T, Francois P, et al. — Technical and biological review of authorized medical devices for platelets-rich plasma preparation in the field of regenerative medicine. Platelets, 2021. DOI: 10.1080/09537104.2020.1832653.

6. 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. DOI: 10.1177/0363546510387517.

7. Three healthy adults each donated 181 mL of blood which was processed through four commercial PRP kits (GPS III, Smart-Prep2, Magellan, ACP). The three kits that draw from the buffy-coat layer produced platelet concentrations 3-6 times baseline and white-cell concentrations 3-6 times baseline; the one kit drawing from plasma produced platelet concentrations only 1.5 times baseline. The authors concluded that the lack of standardisation of PRP preparation has contributed, at least in part, to the varying clinical efficacy reported for PRP.

   Fitzpatrick J, Bulsara MK, McCrory PR, et al. — Analysis of Platelet-Rich Plasma Extraction: Variations in Platelet and Blood Components Between 4 Common Commercial Kits. Orthopaedic Journal of Sports Medicine, 2017. DOI: 10.1177/2325967116675272.

8. A Delphi consensus of 24 invited experts produced the Minimum Information for Studies Evaluating Biologics in Orthopaedics (MIBO) checklists: 58 items reached consensus for PRP and were compiled into a 23-statement reporting checklist, with a parallel 25-statement checklist for mesenchymal stem cells. The need for it was identified because clinical studies of PRP and MSCs are 'limited by inadequate reporting of scientific details critical to outcome'.

   Murray IR, Geeslin AG, Goudie EB, et al. — Minimum Information for Studies Evaluating Biologics in Orthopaedics (MIBO): Platelet-Rich Plasma and Mesenchymal Stem Cells. Journal of Bone and Joint Surgery (American), 2017. DOI: 10.2106/JBJS.16.00793.

9. 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. DOI: 10.1302/2058-5241.6.200017.