Platelet Rich Plasma or PRP Shots

All, would appreciate your advice: as a result of an ankle injury (a torn tendon) now in its 6th month my foot surgeon want to give me a PRP injection in the tendon, fit me for a boot and then physio to get it to heal.  My Haematologist (who is an authority on APS, and who diagnosed me) does not want me to take the PRP shot.  Her concern is that there is no experience with the consequences of PRP shots (a reasonably new technology) on APS.  My ankle is swollen and uncomfortable.  I am limping.  Even though I wear a brace, it does not help the healing.  I am leaning toward the shot but am worried about my hematologist's concerns.  Any thoughts would be most welcome!

10 Replies

  • Has the tendon been repaired ?

    I tore three of my knee ligaments, 2 of which were totally severed and a surface tear on the other. I had an operation on friday and the ligaments were re attached and it hurts like hell but a bit less than before. It's still very swollen but it's early days yet, I tore the ligaments on 10th of November and it's taken all this time to get it fixed but I've never been offered jabs to heal it but ligaments can't heal themselves if severed, mine were actually bent back on themselves so no chance, but I was intrigued and read up on the jabs but everything said good for tennis elbow but not proven to work for anything else. Does raising your leg and icing it not reduce the swelling? Not exactly comfortable I know as I'm sitting with my legs raised above my hips during the day and sleeping at night with both legs elevated and the swelling is gradually going down.

  • Thanks very much for replying.  If I may ask, do you have APS?  Did the surgery for your ligaments impact it at all?

  • PS: The tendon has not been repaired; this is an effort to do so.

  • I have Aps and polycytheamia and apart from stopping my Warfarin and bridging with clexane It hasn't impacted my Aps yet. I had day surgery, the op itself took about 45 mins although I was there from 12-5, they were very attentive and tried hard to make things as smooth as possible. I was told I'd be on crutches for 2 weeks because the pain would be unbearable but actually it's not, I'm walking round the house without the crutches although won't venture out either with or without them yet. I got myself a wheelchair for venturing outside. My Inr is still too low at the minute to stop the clexane and I've had a headache all week but that seems to be it so far.

    Are they offering any alternative to the jab at all ?

  • Well, the specialist feels that given the tear in the tendon a boot and physio is unlikely to produce much of an outcome. He wants to prevent it from getting worse and because of my APS wants to avoid surgery. My haematologist is worried that the PRP will active coagulation and hence the risk of a clot even though I am on warfarin (9 mg daily).

  • The first surgeon I saw said there was nothing that could be done and I should get used to the pain and being unable to walk. He kept referring to me being on Warfarin as the problem and how dangerous surgery would be. I saw red after waiting 6 months for help and being told to get on with it so insisted on a second opinion. I got the 2nd opinion a week later and the Dr looked at the mri I'd had done and said obviously you can't stay like that, I can't promise you a perfect knee but we'll go in and have a look and I'll fix everything that can be fixed. I've already had 2 strokes so was well aware of the risks but if I needed open heart surgery they'd do it without flapping about Warfarin. It seems to have gone well so far, just need to get my Inr back where it belongs. I've followed all the advice re compression stockings, doing my exercises and elevating my legs etc so if I do have a clotting incident I will have done everything possible to avoid it. Sometimes you just have to bite the bullet.

    I had arthroscopic surgery and would opt for the same again should I ever need to, if it hasn't healed in six months it's unlikely to heal without assistance. It depends how much pain you're in too as mine was agony.

    Surely you can come off the Warfarin for the duration of the treatment and take an alternative.

  • Can I just ask where you are located? I broke my ankle a few years ago and also tore the ligaments. I eventually had to have arthroscopic surgery on my ankle but was told that the ligament was gone for good but the ankle could manage quite well without it - and so it has.

    My surgeon is very well respected and is actually replacing my other half's knee in a weeks time. He is known for his skills and some well known sports people have used him so I trust what he says. My ankle made a complete recovery - slow about 9 months, but now Id never know Id ever had a problem. If I were you id wait a bit longer and perhaps do the physio to see how you go. The boot is not a bad idea as they help the swelling.

  • I'm based in London and am seeing a specialist at the London Orthopaedic Clinic. My left ankle tendon is torn (2cm) and to try and prevent surgery, the surgeon is recommending the PRP shot. The ankle has been swollen and uncomfortable for 6 months now; I damaged my right ankle three years ago (it took 2 years to recover) but didn't tear anything.

  • I'm assuming it's the achilles tendon? If so, you have to imagine a wide piece of elastic where some of the bits have inside the material cover (ie the fibres that make up the tendon) have snapped and retracted so only part oft he elastic now works. I put up with mine for a year (before I knew I had APS) and had various treatments includin a cast for 6 weeks and U/S before biting the bullet and having it repaired. It was no walking for a couple of weeks and in a 'moon boot' for about 3 months with Pyhsio twice a week. I also had a large bony spur which was shaved off and then the tendon reattached with a kind of nylon cord. I was warned it would take about 6 months to properly reattach and I might still have some pain after but this was done about 7 years ago and it's great and no trouble walking now.

    You can always swap to Clexane for the duration but get another opinion as to whether this treatment is a fix or putting off the inevitable.

  • my new orthopedic surgeon gave me the first in what he planned to be an experimental series of steroid shots in my bum knee. but i went into anaphylactic shock from that supposedly inconsequential injection. now he doesnt want any more steroid shots, no prp injections, . . . nada. in fact, he assured me that even if/when the osteoarthritis advances to the point of total weight baring collapse, he can then fix it. at this point I told him of my plans to hike the W. Highland Way in the summer of 2016 – yes coming up next month – and that if my knee collapsed then, "the Scots doctors will have to fix it over there in Scotland."

    Reassuring? No?

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