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|New Jersey Platelet Rich Plasma Therapy
|Dr. Silberman specializes in regenerative injections, PRP or Platelet Rich
Plasma Therapy for joint, tendon, muscle, nerve, cartilage and ligament injuries
and disease. Dr. Silberman trained under one of the pioneers in the field of
regenerative medicine, Dr. Brian Shiple, while a fellow at the Crozer Chester
Medical Center Sports Medicine Institute.
What is platelet rich plasma (PRP) therapy?
Platelet rich plasma therapy or PRP is a treatment where your own blood
(autologous blood therapy) in a concentrated form of platelets (rich in growth
factors and cytokines) is injected into an injured muscle, tendon, ligament, or
arthritic joint to treat pain, improve function, and stimulate your own body to
heal damaged tissue.
The normal number of platelets in blood is 150,000 to 400,000 platelets per
mcL. PRP would contain any number greater than baseline. Some authors have
reported an ideal platelet concentration of 1 to 1.5 million / mcL. More does not
always mean better, as concentrations of 2 to 3 million / mcL have been found to
potentially inhibit healing.
High cellular PRP (red color) would contain a higher amount of WBCs and RBCs
than low cellular PRP (yellow color). To date no clear conclusion exists at to
what type of PRP is the most efficacious for individual musculoskeletal
conditions, in regards to the actual platelet concentration, volume of PRP,
presence or absence of WBCs or RBCs, or exogenous activation.
Some Conditions Dr. Silberman may treat with Platelet Rich Plasma (PRP):
Arthritis of the knee, hip, shoulder, any joint arthritis
Rhuematoid Arthritis (NEW 2017 PRP Study on RA)
Frozen Shoulder (adhesive capsulitis)
Tennis Elbow (lateral epicondylitis), Tears and Tendonosis
Rotator Cuff Tendonosis and Rotator Cuff Tears
Patella or Quadriceps Tendonosis and Tears (jumpers knee or runners knee)
Achilles Tendonosis, Achilles Tears
Plantar Fasciitis or Fasciosis (heel pain)
Hamstring and Quadriceps and Gastrocnemius Calf Muscle Tears
Chronic and Acute ligament sprains
Osteochondral defect and cartilage joint injuries
Carpal Tunnel Syndrome
Hair Loss (as requested by his patients, Dr. Silberman can inject your scalp,
What to expect?
Prior to your platelet rich plasma therapy (PRP) a baseline platelet count will be
measured via a finger stick to determine the correct amount of blood to be
removed for your PRP. If you have a low baseline platelet count and a provider
processes your platelets without checking a baseline, you may end up with lower
concentrated platelet plasma and a poorer result.
A small amount of blood is drawn from a vein in your arm as in a simple
venipuncture. Your blood is then spun in a centrifuge to concentrate and
separate the platelets from the other blood components. The platelet rich plasma
(PRP) is then injected under ultrasound guidance into your site of injury.
Soreness is expected after the procedure that may last for a few to several days.
Two to three treatments may be needed in some cases up to six for cartilage
joint injuries, performed in 2-4 week intervals. Most see improvement in as
little as two weeks.
A hematology analyzer is used to measure the concentration of platelets in your
What is the cost?
Cost for one PRP Platelet Rich Plasma joint, ligament, or tendon injection is
$600. Multiple injections may be discounted. It is not covered by insurance.
Platelet Concentration that may be achieved:
Blood Volume 40 - 60 mL
PRP Volume 4 - 6 mL
Platelet Concentration enrichment greater than five-fold increase
Platelet Count/µl 1,000,000 to 2,000,00 (average 1.5 million)
Is PRP (platelet rich plasma) for everyone?
No. I have seen many athletes and patients come from other locations treated
with prolotherapy, ozone, stem cells, and/or PRP when they should not have been
treated with these out of pocket treatments.
A 2017 article demonstrates how Platelet Rich Plasma (PRP) protects against
cartilage degradation in arthritis by 1. increasing the proliferation of
chondrocytes, the only cells located in cartilage, whose job it is to produce and
maintain your cartilage, 2. reversing senescence (deterioration with age) and
increasing quiescent cells (non-aging cells that can withstand stress and
preserve key functional features ), and by 3. significantly decreasing
chondrocyte apoptosis (cell death).
A 2017 meta-analysis of randomized clinical trials on platelet rich plasma (PRP)
versus steroid cortisone injection for lateral epicondylitis or tennis elbow
concludes PRP is more effective in relieving pain and improving function in the
long term than cortisone and is now the recommended preferred first line
treatment by these authors.
A new study in 2017 on PRP in rheumatoid arthritis (RA) one of the most
devastating kinds of arthritis, found platelet rich plasma inhibits inflammatory
factors and represses rheumatoid fibroblast-like synoviocytes in rheumatoid
arthritis. Another 2017 article demonstrating PRP anti-inflammatory effect in
A new study in 2017 supports platelet rich plasma (PRP) over cortisone injection
for tennis elbow as PRP had a longer duration of effect of improved function and
decrease in pain and caused greater healing as demonstrated by ultrasound, with
cortisone effect wearing off after 3 months.
A new randomized prospective double blinded study in 2017 found evidence
platelet rich plasma (PRP) is even effective for advanced late stage knee
Platelet rich plasma PRP injections were found to be superior than gel injections
for arthritis. In a 2017 meta-analysis of ten Level I randomized control trials,
PRP was found to provide superior pain relief and greater functional outcomes
than viscosupplementation or gel injections (hyaluronic acid) in patients with
symptomatic knee osteoarthritis one year after injection.
PRP superior to cortisone for tennis elbow in a double blind placebo controlled
A single ultrasound guided, injection of PRP in rotator cuff tears resulted in safe,
significant, sustained improvement of pain, function, and MRI outcomes
refractory to physical therapy and cortisone injection.
A single PRP injection for hamstring injuries combined with a rehabilitation
program was significantly more effective than a rehabilitation program alone.
PRP injection of achilles and patella tendinopathy resulted in significant and
lasting improvement of clinical symptoms.
Other injection therapies that Dr. Silberman may discuss with you:
Cortisone - covered by insurance
Viscosupplementation (Synvisc) - covered by insurance
Bone Marrow Aspirate Stem Cells - not covered by insurance
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