Platelet Rich Plasma (PRP) Injections : Safety


This section address potential adverse effects and contraindications to platelet rich plasma (PRP) injections. The 2011 World Anti-Doping Code (WADA) has deemed all musculoskeletal PRP injections to be considered legal with no notification required. However, if you are an athlete and in a registered testing pool, always confirm with your practitioner the latest WADA regulations as they may have changed.
Platelet rich plasma (PRP) is prepared from autologous or the patient’s own blood so there is no risk of developing a growth of tumour or cancer (1). Adverse effects are rare but as with any injection there is always the small risk of infection or injury to nerves or blood vessels. Scar tissue formation and calcification at the injection site are also possible (2).

If your doctor uses local anaesthetic such as lignocaine or bupivicaine with your PRP injection, then uncommonly an adverse reaction to the agent may be triggered. Please inform your doctor if you have any allergies to medical equipment or medications particularly in relation to local anaesthetics.

Is it painful?
It is usual that you may feel some pain during and following the injection. Our doctors prefer that you use paracetamol (e.g. Panadol) for pain relief or paracetamol combined with codeine (e.g. Panadeine) should you require something stronger.

If you experience persisting severe pain or an adverse reaction following the injection, please contact your PRP practitioner.

References
1. Everts P, Knape J, Weirich G, Schonberger J, Hoffman J, Overdevest E, et al. Platelet-rich plasma and platelet gel: a review. JECT. 2006;38:174–87.
2. Sampson S, Gerhardt M, Mandelbaum B. Platelet rich plasma injection grafts for musculoskeletal injuries: a review. Curr Rev Musculoskelet Med. 2008 Dec;1(3-4):165-74.
You should not have a PRP injection if you have the following (2):
  • Cancer or metastatic disease
  • An active infection
  • A low platelet count

You should also not have a PRP injection if you are pregnant or are breastfeeding. (2)

Please inform your doctor if you have an allergy to a local anaesthetic agent.
You should not have a PRP injection if you have used non-steroidal anti-inflammatory medications (NSAID’s - examples include Nurofen, Voltaren, Mobic) in the 7-10 days leading up to your appointment. If you are considering having this injection, please switch to another painkiller such as paracetamol or for other options, check with your local doctor or chemist.
The World Anti-Doping Authority (WADA) has deemed all musculoskeletal PRP injections for athletes legal to use with no notification required.(3)

Click here to view the official WADA status for Platelet-Derived Preparations.

Despite the presence of some growth factors, platelet-derived preparations were removed from the [Prohibited] List as current studies on PRP do not demonstrate any potential for performance enhancement beyond a potential therapeutic effect.

Before having an injection, always ask your doctor for the latest information on the WADA.
References
1. Everts P, Knape J, Weirich G, Schonberger J, Hoffman J, Overdevest E, et al. Platelet-rich plasma and platelet gel: a review. JECT. 2006;38:174–87.
2. Sampson S, Gerhardt M, Mandelbaum B. Platelet rich plasma injection grafts for musculoskeletal injuries: a review. Curr Rev Musculoskelet Med. 2008 Dec;1(3-4):165-74.
3. World Anti-Doping Agency [online]. Available from URL: http://www.wada-ama.org/en/Resources/Q-and-A/2011-Prohibited-List/ [Accessed July 21, 2011]