Platelet Rich Plasma and Hyaluronic Acid Injections

This information is intended to help prospective patients understand the role of Platelet Rich Plasma (PRP) and Hyaluronic Acid (HA) Injections, including the process, risks and benefits. It is not intended to be medical advice nor take the place of a consult with a doctor.

PRP Overview

(Scroll Down for Hyaluronic Acid Injections)

– PRP (Platelet Rich Plasma) is a completely natural product, derived from your own blood.
– PRP injections can lower inflammation and pain
– PRP can be used for knee arthritis and some inflamed tendons

Golf player preparing to swing the ball

Frequently Asked Questions

  • How does PRP Compare to other Injections?
  • How do I prepare for a PRP injection?
  • How is the Injection done?
  • What is the Recovery like After the Injection?
  • Can I Work after a PRP Injection?
  • How long does it Take for PRP to Work?
  • What are the Risks of PRP Injection?
  • Is PRP Covered by Insurance?
How does PRP Compare to other Injections?

Scientific studies suggest that PRP has longer lasting effects compared to both cortisone treatment or hyaluronic acid treatment. PRP however does not have the side effects of cortisone such as tendon rupture, increased blood sugar or increased blood pressure. Like any injection, however, PRP does not work equally well for everyone. It is difficult to know for whom PRP will work and for whom it will not.  Pre-existing conditions such as fibromyalgia, chronic pain syndromes or very severe arthritis typically lower the effectiveness of this kind of injection.

How do I prepare for a PRP injection?

Patients are encouraged to be well hydrated before the blood draw. Drink plenty of water or other low calorie fluid in the few hours before the treatment.        

Avoid taking anti-inflammatory medication for pain (eg ibuprophen, diclofenac, naproxen, aspirin) for 1 week prior to your injection.  Anti-inflammatories make platelets less functional, so PRP injections may not work as well if you’re taking these medications.  If you must take anti-inflammatories (like aspirin) for another reason, perhaps choose a Hyaluronic Acid Injection.

If you are taking a blood thinner that affects your platelets, you may want to opt for a Hyaluronic Acid injection instead.  These types of medications can lower the effectiveness of PRP injections.

How is the Injection done?
  1. In order to extract platelets, you will have some blood taken (about 15 mL – a test tube size) from a vein in the arm. This can cause some brief pain and bruising in the area of the blood draw.   
  2. The blood is then centrifuged (spun down) for 5 minutes under high speeds to separate the blood into its components mentioned above.  
  3. The plasma with platelets from your blood is then injected back into the area of concern. No blood comes from other patients or from a laboratory.  There is a risk that the area injected can be sore for few days afterwards. There is a risk that the area injected can be sore for few days afterwards.
What is the Recovery like After the Injection?

The entire procedure takes about 20 minutes. You will go home the same day. Dr. Cayen recommends that someone drive you home, if you are getting an injection into the right knee or hip.

You are instructed to rest the knee after an injection, since it might be sore.

Take Tylenol for your discomfort. Avoid anti-inflammatory medication for 2-3 days after the injection as it can theoretically decrease the effect of PRP.

Can I Work after a PRP Injection?

If you have a sedentary job, you can go back to work after the injection.

If you have a walking job or are a manual laborer, Dr. Cayen suggests you take the rest of the day off after your injection or go back to work on modified/light duties for the rest of the day.

How long does it Take for PRP to Work?

It can take up to 1-3 weeks for PRP to start to work.  Improvement of pain as a result of a series of PRP injections can last up to 6 months, sometimes longer.  Pain relief is more reliable when a series of 3 injections are given.

What are the Risks of PRP Injection?
  • Pain and bruising at the site of the blood draw or the site of the injection
  • PRP (or any other type of knee injection) does work for everyone
  • Temporary worsening of the pain
  • Flushing or dizziness as a reaction to the blood draw or injection
  • Exceptionally rare risk of infection
Is PRP Covered by Insurance?

PRP is not covered under OHIP.  Most extended health benefit programs do not cover the cost of PRP injections at this time.  

Comment from Dr. Cayen: The policies of most insurance companies have not yet responded to the mounting evidence that PRP injections are at least as effective as hyaluronic acid injections for the treatment of knee arthritis. With increased pressure from patients, hopefully policies will start to reflect this evidence and start to cover PRP injections. Feel free to ask your insurance company if they will cover PRP injections for you. You may forward this Position Statement from the Arthroscopy Association of Canada to help bolster your request.  

Please contact our office if you’d like to discuss PRP injections.

HA Overview

Hyaluronic acid injections, also known generally as “Viscosupplementation” are used to help decrease knee and hip arthritis pain.


Frequently Asked Questions

  • What is Hyaluronic Acid?
  • How does Hyaluronic Acid Injection compare to other injections?
  • What is the recovery like after the injection?
  • Can I work after a HA injection?
  • Can I Work after a PRP Injection?
  • How long does it take for HA injection to work?
  • What are the risks of HA injections?
  • Is HA covered by Insurance?
What is Hyaluronic Acid?

Hyaluronic Acid (HA) is a naturally occurring molecule found in cartilage and in normal joint fluid.  It’s role is believed to be as joint lubricant and to regulate cellular activities within the joint.  It feels like a thick gel.  With arthritis, HA within the joint becomes thinner (the gel becomes more runny).  This decreases the cushioning ability of the joint fluid.

It is thought that HA injections help decrease pain from arthritis by improving the cushioning within the joint and by acting as an anti-inflammatory.  

Hyaluronic Acid taken by mouth gets broken down in your gut and does not “travel” to your joints.  There is thought however that these medications may act as an anti-inflammatory agent, which may help some people with their arthritis pain.

How does Hyaluronic Acid Injection compare to other injections?

There is ample evidence that HA injections last longer and are more effective than cortisone injections, and more effective than doing nothing. HA injections however do not have the side effects of cortisone such as tendon rupture, increased blood sugar or increased blood pressure.  Like any injection, however, HA does not work equally well for everyone.  It is difficult to know for whom HA will work and for whom it will not.  Pre-existing conditions such as fibromyalgia, chronic pain syndromes or very severe arthritis typically lower the effectiveness of any kind of injection. 

What is the recovery like after the injection?

After the injection, your knee or hip can feel sore and stiff.  This may be troublesome for up to 3-4 days after the injection.  You are encouraged to take Tylenol and anti-inflammatories if you can after the injection to help with the soreness.  

Dr. Cayen recommends that someone drive you home, if you are getting an injection into the right knee or hip.

You are instructed to rest the leg after an injection, since it might be sore.

Can I work after a HA injection?

If you have a sedentary job, you can go back to work after the injection.

If you have a walking job or are a manual labourer, Dr. Cayen suggests you take the rest of the day off after your injection or go back to work on modified/light duties for the rest of the day.

Can I Work after a PRP Injection?

If you have a sedentary job, you can go back to work after the injection.

If you have a walking job or are a manual laborer, Dr. Cayen suggests you take the rest of the day off after your injection or go back to work on modified/light duties for the rest of the day.

How long does it take for HA injection to work?

It can take up to 3 weeks for HA to start to work. Improvement of pain as a result of an HA injection can last up to 6 months, sometimes longer. 

What are the risks of HA injections?
  • Pain and bruising at the site of the injection
  • HA (or any other type of joint injection) does work for everyone
  • Temporary worsening of the pain
  • Flushing or dizziness as a reaction to the injection
  • Exceptionally rare risk of allergy or infection
Is HA covered by Insurance?

HA injections are not covered under OHIP.  Most extended health benefit programs do cover the cost of HA injections at this time.  

Please contact our office if you’d like to discuss HA injections.

DISCLAIMER: The information on this website is intended to help current and prospective patients of Dr. Cayen understand joint disease as well as treatment options available.  It is also meant to provide background information to prospective patients such that their visit with their doctor is most helpful. This website is not meant to provide specific medical advice, treat or diagnose any medical condition.  It is not meant to take the place of a visit with your doctor or Dr. Cayen.



About Dr. Cayen


Dr. Barry Cayen is an orthopedic surgeon at Humber River Hospital, specializing in adult hip and knee replacements, sports surgery of the knee, and trauma. He performs Total Hip Replacement Surgery using the Direct Anterior approach with a Hana table.




Contact


Phone:
(416) 479-8969

Address:
3695 Keele St., 2nd Fl.
North York, ON M3J 1N2
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