How is the procedure performed?
The procedure is performed under local anaesthesia. 15 - 30 ml of venous blood is drawn and spun in a centrifuge for 5-15 min. This yields a portion containing plasma rich in platelets. The skin over the tendon will be cleaned with antiseptic and will be numbed by injection of local anaesthetic. Approximately 2-3 ml of platelet-rich plasma is injected into the tendon under ultrasound guidance. At the same time the tendon may be treated with needling by multiple puncture. This may cause some pain during and after the procedure.
Benefits
The main benefit of the procedure is to relieve pain, which in turn allows an improvement in the function of the elbow. Platelets are the blood cells that normally play an important role in promoting clotting. Platelets also contain a variety of specialised chemicals called growth factors, which play an important role in tissue healing. Injection of platelet-rich plasma is believed to deliver a high concentration of growth factors into the painful area of the tendon to facilitate healing.
Risks
Pain - The elbow may be painful for some days after the procedure. This is usually managed by taking appropriate pain relieving medication and activity modification.
Infection – Infection is a possibility but rare after this procedure.
Aftercare
Following the procedure the injection site will be covered with a shower-proof dressing. The dressing may be removed the day after the procedure. You should avoid strenuous use of the arm for at least 10 days after the procedure. You may resume physiotherapy after that time. You may use paracetamol or codeine-based medication for pain relief. You should avoid taking non-steroidal inflammatory medication such as nurofen for at least 3 weeks after the procedure. It may take some weeks for the benefit of the procedure to become apparent.
Follow-up
An appointment will be arranged for you to be seen in the outpatient clinic six weeks after the procedure.