Courtesy:
Dr Vijay Shetty, Consultant Orthopaedic Surgeon, Specialist in Hip Arthroscopy and Joint Reconstruction, Hiranandani Hospital, Powai, Mumbai, India

 

Introduction

Platelet-Rich Plasma (PRP) injections are commonly performed in an outpatient setting.

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Importance of Documentation

Proper documentation is essential because:

• PRP indications are still evolving
• Data collection supports future research and standardization

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PRP Preparation System

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Commercial Kits

PRP is typically prepared using a commercial preparation system
(e.g., Harvest Technologies PRP kit)

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Components of the Kit

1. Processing Chamber

• Used for:
  • Blood separation
  • Centrifugation

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2. PRP Collection Chamber

• Used to collect the final platelet-rich concentrate

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Anticoagulation

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Agent Used

• ACD-A (Anticoagulant Citrate Dextrose)

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Purpose

• Prevents clot formation during processing
• Preserves platelet integrity

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Blood Collection

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Procedure

• Blood drawn from a peripheral vein (usually arm)
• Collected in a syringe pre-filled with ACD-A

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Typical Blood Volumes

• 20 mL system
• 60 mL system

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Optional Step

• Baseline laboratory analysis may be performed if required

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Transfer to Processing Chamber

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Steps

• Blood is slowly transferred into the processing chamber
• Chamber is placed in a centrifuge machine

Important:

• Ensure proper balancing of centrifuge

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Centrifugation Process

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Two Phases

1. Soft Spin

• Separates blood into layers

2. Hard Spin

• Concentrates platelets

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Duration

• Approximately 15 minutes

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Blood Layer Separation

After centrifugation, three layers are formed:

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Top Layer

• Platelet-Poor Plasma (PPP)
• Yellow in color

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Middle Layer

• Platelet-Rich Plasma (PRP)

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Bottom Layer

• Red Blood Cells (RBCs)

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Isolation of PRP

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Procedure

• PPP is carefully removed using a syringe
• A small amount is left behind

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Purpose

• Facilitates resuspension of platelet pellet

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Resuspension of Platelets

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Technique

• Gentle mixing performed 3–4 times

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Purpose

• Prevents platelet adherence to chamber walls
• Ensures uniform platelet distribution

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Final PRP Composition

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Platelet Concentration

• Approximately 5–6 times baseline

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Contents

• Platelets
• Growth factors
• Cytokines involved in healing

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Laboratory Analysis (Optional)

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Purpose

• Platelet count
• Quality assurance

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Injection Procedure

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Local Anaesthesia

• May be administered before injection

Reason

• PRP injections often require large-bore needles
• Improves patient comfort

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PRP Administration

PRP is injected into the target tissue, depending on indication:

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Common Injection Sites

• Tendons
• Ligaments
• Joints
• Muscle injuries

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Post-Injection Care

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Immediate Care

• Apply occlusive dressing

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Medications

• Analgesics for 1–2 days

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Patient Advice

• Mild pain or swelling may occur
• Symptoms are temporary and self-limiting

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Patient Counseling

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Important Points to Explain

• Temporary discomfort at injection site
• Mild swelling or soreness
• Expected short-term inflammatory response

 These effects are part of the healing process

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Summary Points

• PRP injections are simple outpatient procedures
• Require careful preparation and standardization
• Platelet concentration typically 5–6× baseline
• Proper technique ensures:
  • Effective delivery
  • Optimal outcomes
  • Patient safety