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|New Jersey Platelet Rich Plasma Therapy
|Dr. Silberman specializes in regenerative injections, PRP or Platelet Rich
Plasma Therapy and second generation platelet rich plasma, Platelet Rich Fibrin
(PRF or i-PRF=injectable PRF) for degenerative arthritis, rheumatoid arthritis,
tendon, muscle, nerve, cartilage, ligament 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.
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, 5 to 10 times the
number at baseline. Some authors have reported an ideal platelet concentration
of 1 to 1.5 million / mcL.
Dr. Silberman's pioneering method of creating high quality PRP was developed
and researched over years to create a high quality PRP, containing an average
of 1.5 million platelets per microliter (well above the commercial PRP average),
essentially free of RBCs, and containing helpful pro-growth WBCs while
eliminating the inflammatory WBCs. Dr. Silberman's method was validated via
independent clinical laboratory testing. You can be assured that the PRP
injection you receive from New Jersey Sports Medicine is among the highest
quality, purity, and effectiveness available.
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, 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 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) 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 PRP 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 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 Injection:
Most patients can drive home themselves but for right lower extremity PRP a
driver may be preferred. I have not had to place any one on crutches post PRP.
If your achilles was injected with PRP, 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 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.
What is the cost of PRP injection?
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.
PRP Platelet Concentration that may be achieved:
Blood Volume 60 mL
PRP Volume 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, prolozone, stem cells, and/or PRP when they should not have
been treated with these out of pocket treatments.
Literature on PRP:
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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