"How Can PRP Therapy Help with Ankle Injuries?"

PRP has been increasing media attention for cosmetic-related conditions but in an April 2024 article in the Foot and Ankle Surgery discussed its surprising role in ankle injuries. Basciani et al from  Rome, Italy looked at a systematic literature search to select clinical studies analyzing the efficacy of platelet-rich plasma (PRP), hyaluronic acid (HA), and bone marrow concentrate (BMC) procedures with a total of 464 patients.

The purpose of this study was to evaluate the effectiveness of the treatments for osteochondral lesions of the talus, analyzing the addition of other procedures to arthroscopic microperforations to establish a better strategy of treatment, that could influence the clinical outcomes. Patients who struggle with chronic pain from ankle injuries may have what's called an osteochondral defect (OCD) That is typically diagnosed with an MRI. Injuries to the ankle cartilage can be devastating creating instability, clicking, popping chronic pain, and limiting any activity specifically to vertical stresses and side-to-side motion. 1

These injuries should be looked at as soon as possible as they typically do increase in size due to the pressure from running and walking directly on a small joint surface. PRP is a therapy produced from the patient's own blood that is made up of plasma and a high concentration of platelets. It is injected into the injured area, thereby introducing a high concentration of platelets (as well as growth factors and cytokines) to the injury site, helping it heal. In this study, it was utilizing conjunction with an ankle scope that is performed in the hospital or surgery center environment. 2

The PRP method involves collecting whole blood in tubes that contain anticoagulants. The first centrifugation spin step separates the red blood cells (RBCs) from the remaining whole blood volume. Subsequently, the whole blood is separated into three layers: an upper plasma layer that contains mostly platelets and white blood cells (WBCs), an intermediate thin layer known as the buffy coat, which is rich in WBCs, and a bottom layer that consists mostly of RBCs.2

In general, PRP is a safe alternative treatment option for OCD however diagnosing the condition is the most important before undergoing this type of treatment. Does PRP work for all ankle injuries; no, but can be used in conjunction with other treatments.

Reference

1. Susanna Basciani a,b , Umile Giuseppe Longo a,b,⁎ , Giuseppe Francesco Papalia a,b , Rocco Papalia a,b , Andrea Marinozzi. Arthroscopic microfracture and associated techniques in the treatment of osteochondral lesions of the talus: A systematic review and metanalysis. Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy b Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200, 00128 Rome, Italy

2. Kian Bagheri ·, Alexandra Krez ·, Albert T. Anastasio and Samuel B. The use of platelet-rich plasma in pathologies of the foot and ankle: A comprehensive review of the recent literature Adams Foot and Ankle Surgery, 2023-12-01, Volume 29, Issue 8, Pages 551-559, Copyright © 2023 European Foot and Ankle Society

Darryl Martins DPM Board Certified Foot and Ankle Surgeon/ Podiatrist