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New Jersey Platelet Rich Fibrin Therapy
What is platelet rich plasma (PRP) and platelet rich fibrin (PRF)?
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.

Platelet rich fibrin (PRF) is a second generation platelet concentrate referred to
as Injectable Platelet Rich Fibrin Smart Blood with Stem Cells (Shukla 2019).  
Platelet Rich Fibrin is an advancement of PRP that requires no additive to
prepare, selectively enriching leukocytes, platelets, and growth factors with
significantly higher numbers compared to traditional PRP (Choukron 2017).

Injectable Platelet Rich Fibrin (i-PRF) refers to the injectable form of platelet
rich fibrin obtained by low speed centrifuge without any anticoagulants
(Choukroun 2017).

Injectable Platelet Rich Fibrin (i-PRF) in addition to platelets and growth factors,
contains B- and T-lymphocytes, monocytes, neutrophilic granulocytes, and stem
cells required for neovascularization and angiogenesis used in healing
(Choukron 2017).

More data is needed demonstrating how many leukocytes, growth factors, or
platelets within PRF are sufficient for the best possible physiological condition
for tissue and bone healing and regeneration.

Some Conditions Dr. Silberman may treat with Platelet Rich Plasma (PRP) or
Platelet Rich Fibrin (PRF):
Arthritis of the knee, hip, shoulder, any joint arthritis
Rhuematoid Arthritis (
NEW 2017 PRP Study on RA)
Chondromalacia Patella
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,
PTT Posterior Tibial Tendon Tear
Plantar Fasciitis or Fasciosis (heel pain)
High Hamstring Tendonitis / Tendonopathy
Hamstring and Quadriceps and Gastrocnemius Calf Muscle Tears
Chronic and Acute ligament sprains
Osteochondral defect and cartilage joint injuries
Carpal Tunnel Syndrome
Low back pain, sacroiliac joint pain (SI joint pain), buttock pain
Sports Hernia or Athletic Pubalgia (Adductor Tendon Tear)

What to expect with a PRP or PRF injection?
Blood is withdrawn from a vein in your arm with a simple venipuncture.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) or platelet rich fibrin
(PRF) is then injected under ultrasound guidance into your site of  injury.  Local
anesthetic is used to numb the injection entry site.  You may experience some
pain or pressure during a tendon injection.  Soreness is expected after the
procedure that may last for a few to several days. A small percentage can get
severe pain for a few days requiring pain medication.  Two to three treatments
may be needed and in some cases up to six for cartilage joint injuries, performed
in 3-4 week intervals.  Most patients in my practice have required one injection.  
You may see improvement in as little as two weeks but it can take up to 6
weeks.  

Prior to a PRP or PRF Injection:
Eat clean.  You are what you eat.  You do not NOT want a lipemic or fatty blood
sample (see photo).  Your plasma should be clear, yellow.  Do NOT take any
NSAIDS (anti-inflammatories) such as ibuprofen, motrin, advil, naproxen, aleve,
aspirin, etc. for at least 1 week prior to the PRP or PRF procedure.  Do not stop
any prescribed medications without consulting the prescribing physician.  Stop
any supplements that may affect platelets such as tumeric, flaxseed oil, primrose
oil, black currant seed oil, krill oil, etc.

Post PRP or PRF Injection:
Most patients can drive home themselves but for right lower extremity PRP or
PRF a driver may be preferred.  I have not had to place any one on crutches
post PRP. If your achilles was injected with PRP or PRF, a boot may be worn
until pain subsides in a few days.  Do not take any NSAIDs or
anti-inflammatories listed above for at least 2 weeks after your PRP or PRF
injection.  Pain medication may be prescribed for the small percentage
(estimated 1 in 10) who get severe pain for 1-2 days.  I do not recommend icing
after PRP injection.  Compression wrap may provide relief.   For the first week
you should lay low, even if you feel great; we have had patients return to activity
too soon and then feel as if they undid the work of the PRP.  Most can resume
therapy exercises and light sport activity after week 2.  Every case is unique.  
Follow-up appointment is made 4 weeks post PRP or PRF.

What is the cost of PRP or PRF injection?
Cost for one PRP Platelet Rich Plasma or PRF Platelet Rich Fibrin joint,
ligament, muscle, labrum, cargilage or tendon injection is $600.  Multiple
injections may be discounted.  It is not covered by insurance.

Is PRP (platelet rich plasma) or PRF (platelet rich fibrin) for everyone?  
No.  I have seen many athletes and patients come from other locations treated
with prolotherapy, prolozone, adipose tissue stem cells, and/or PRP when they
should not have been treated with these out of pocket treatments.

Other injection therapies that Dr. Silberman may discuss with you:
Bone Marrow Aspirate Stem Cells

Dr. Silberman specializes in ultrasound guided injections for the treatment of
degenerative arthritis, inflammatory arthritis (RA), tendon, muscle, cartilage,
ligament, nerve injuries and chronic pain conditions.  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.

Please call to schedule a consultation 908-647-6464.
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Lipemic, milky, cloudy, fatty plasma
layer.  What you DO not want.  
Platelet Pellet at bottom of
clear platelet rich plasma
for PRP injection