PRP injection (Platelet Rich Plasma)

[MarksPoint]

Hi everyone, I'm in need of some advice from this amazing site.

I have been subject to GCA/PMR twice now and am currently on bi-weekly Actemra injections after reducing Prednisone in late 2024. After I came off Pred completely 9 weeks ago all my old aches and pains returned and I can cope with most of them except for my right knee which has been diagnosed as OsteoA Bone on Bone. The pain is debilitating to say the least and I have been advised to have an injection of PRP into the knee.

I had one of these injections 4 years ago when I had the first symptoms of GCA/PMR but was not diagnosed at that point, and it helped my knee pain. Diagnosis came 4 weeks later.

To make PRP the doctor takes a phial of blood, runs it through a machine which separates the blood and the Plasma is taken out and re-used in the injection into the knee. So, the PRP is actually from your own body and the whole procedure takes about 30 mins.

My " fear " is that it may have a negative effect on my immune system and re-start a chain reaction. The specialist says it won't , he has done hundreds without any negative results. I have researched and only come across a small example of immune issues.

Has anyone out there had one of these whilst on Actemra? -

Thanks for reading.

[piglette]

I have been having PRP injections for seven years and I have found them to be brilliant, but pricey.

[MarksPoint in reply to piglette]

So, I take it you have had no problems with the medications or Immune response? That makes me feel a bit better. Thanks.

[piglette in reply to MarksPoint]

The doctor who did it knew about my medical history and never mentioned anything. I found after the injection I had pain for a few days and then I was OK for the next year. The doctor told me that it was first used on tennis elbow!

[MarksPoint in reply to piglette]

Wow, so many people have joined in on this conversation...I'm learning new things all the time....invaluable.

I have my PRP injection this afternoon...I'm in Sydney so will let you know tomorrow and beyond how things have gone. Thanks to everyone for your feedback.

[PMRpro Ambassador in reply to MarksPoint]

Good luck.

[powerwalk in reply to piglette]

Piglet, i was looking into these for my back or knees but read that you cant have them if you're on steroids? Would be great if that was not the case.

[piglette in reply to powerwalk]

The doctor knew I was on steroids. I have heard you should be careful though. I have mine for my knee. I just have one. Perhaps it is like when you have new hips and knees you cannot have the op if you have had steroid injections, but taking oral steroids is OK if not too high.

[powerwalk in reply to piglette]

Crikey i didnt know that about hips and knee steroid injections. Its a minefield at times. Thanks.

[piglette in reply to powerwalk]

You can get steroid injections for the hip, not PRP though. I know hip injections locally cost over a thousand pounds for the hip if ultrasound is used. I assume the NHS do them too.

[powerwalk in reply to piglette]

Ive had one a couple if months ago in my hip, it really helped. But at this stage unfortunately im kind of held together with injections!! Hyaluronic for the knee, now the other knee.

[piglette in reply to powerwalk]

Did you have the hyaluronic acid injections on the NHS?

[powerwalk in reply to piglette]

No, im in Ireland and interestingly my new rheumy used to work for the NHS in the UK and told me she didnt do them cos the NHS in the UK didnt do them so i had to try find someone else here to do it for me.

[piglette in reply to powerwalk]

I know when I first had mine the NHS did not do them apart from tennis elbow! I thought they had started now, although I may be wrong.

[powerwalk in reply to piglette]

Oh maybe. I think they work very well for me, have made my knee liveable!!

[piglette in reply to powerwalk]

They worked for me too. I was actually quite pleased as I was a bit sceptical.

[powerwalk in reply to piglette]

Yes, i would like to cover myself in hyaluronic acid😁. If only!!

[PMRpro Ambassador in reply to powerwalk]

Bit messy ...

[piglette in reply to powerwalk]

You can, hyaluronic acid seems to be in all sorts of creams nowadays too!! I think it needs your blood with it though for its magic pain relief effect though!

[powerwalk in reply to piglette]

Ah yes unfortunately!!

[DorsetLady PMRGCAuk volunteer in reply to powerwalk]

You can still have replacement surgery if you’ve had steroid injections in that joint - I have.. But there should be at least 3months between the last injection and surgery.

I had an appointment about 6 weeks before my shoulder replacement where surgeon explained that (they are concerned about infection) but he did offer me one in the other shoulder where I also have AO -and said that may help both! 😊

[powerwalk in reply to DorsetLady]

Oh right. Thank you.

[PMRpro Ambassador in reply to powerwalk]

You have to wait 6 months or so - they are not disallowed forever. But it is only shortterm gain - the op should be a cure so may be worth waiting for in pain.

[PMRpro Ambassador in reply to powerwalk]

My rheumy is talking about them for me - I'm on steroids.

[powerwalk in reply to PMRpro]

Oh thats interesting!! Itis good to have options. I would be interested in them. Im running out of options for all my pain!!!

[PMRpro Ambassador]

I doubt that there is anyone on Actemra who has had them but I am on Actemra and my rheumy mooted them last autumn for the low back pain I have due to SI joint inflammation (I think) so he obvious has no concerns about them. They have only relatively recently been possible here but he has already done quite a few and they will all be in rheumatology patients and many here are on biologics of one sort or another.

I don't quite understand what it is you are concerned about. The PRP is done using your own plasma to derive the platelets - they will have all the same markers as any cell in your body and will be identified as "self" so are far less likely to cause a problem than those from a third party donor in any case plus you are on an immunosuppressant in the form of the Actemra.

My daughter has had the injections on the NHS for mangled meniscus problems and says they have made a LOT of difference.

[MarksPoint in reply to PMRpro]

Thanks so much for your reply, you are much more in-tune with these things than I am and I really do appreciate your help. Ever since I got GCA I have tried to learn about the immune system so that I can help myself heal....if that's possible, but this PRP is hardly mentioned in science papers or in the GCA/PMR websites so I have been feeling somewhat unsure about having it even though I truly believe it will help my bone on bone knee pain and therefore I really want to have the treatment . I had to cancel a knee replacement for April this year because of the flare 5 months ago, hopefully I can have that done in 6-9 months time. Thanks again PMRpro. Your advice and knowledge are invaluable. x

[piglette in reply to MarksPoint]

I think PRP gets a mixed view, as it is used for cosmetic surgery too. It is sometimes called a vampire facelift when used cosmetically!! It is quite a new option. My doctor said that on knees it helps about 83%. If your knee is too far gone I think it may not work too well or not at all.

[Hopelessatbest in reply to piglette]

I have had PRP injections - 3 consecutive weekly injections - on both knees with a top orthopaedic surgeon in Spain. The process was developed originally in Spain. He said he had never used it on stage 4 (end stage) OA and was not sure it would work. I decided to go ahead anyway. It helped only very marginally and the effect lasted barely three months. Apparently everyone is different in their response but for me the cost for a very small, three month benefit (and the pain of the injections themselves) was not worth it, The consultant said I was way past steroid and HA injections being of any assistance. Most of these injections have a very short lived effect (for the knee anyway) unless you are early stage OA.

[piglette in reply to Hopelessatbest]

Mine usually last at least a year. I had three injections the first time, then one a year since. I have never had any pain problems with the injection. In fact the idea of platelets was first mentioned in the 1800s. The term Platelet Rich Plasma was introduced in the 1950s and started to be developed in the 1970s. It has been used for all sorts of things including dentistry and Alopecia. It has a fascinating history. This is a brief history. pmc.ncbi.nlm.nih.gov/articl...

[Hopelessatbest in reply to piglette]

You have been fortunate. Thanks for info. Read everything I could get my hands on before I had the injections. Did try a top up injection but that lasted even less time. When you are stage 4 you live with constant pain. Without a high pain threshold I would not still be walking (although with walking poles.) Orthopaedic surgeon did the injections. He said they are mostly used for stage 1 & 2 OA and I am miles away from that. Still I tried. Had an arthroscopic meniscectomy 24 years ago!! Robotic assisted TKR will be my way forward once other health issues are resolved, for it to go ahead.

[piglette in reply to Hopelessatbest]

I think you are right, you get to a point when surgery is the only answer. That happened with my hips.