About
Background – Why Bone Marrow PRP?
Platelet-rich plasma (PRP) is usually made from blood taken from a vein in your arm (peripheral blood). Research
suggests that platelets taken from bone marrow may have a greater ability to reduce inflammation and support tissue healing compared to those from peripheral blood. However, it is not yet known whether PRP made from bone marrow provides better pain relief or improved function when injected into a joint. This is because it has not been studied in clinical trials. For this reason, the use of bone marrow–derived PRP for joint injections should be considered experimental. Please note, this is not a stem cell treatment. To follow Health Canada regulations, our bone marrow PRP processing technique removes almost all the stem cells from the PRP.
Procedure
The procedure involves collecting bone marrow blood from the back of your pelvis. This will be done by inserting a
needle into the pelvic bone to access the marrow. Before the marrow is collected, the overlying skin and bone surface will be numbed using a freezing administered via needle, guided by ultrasound. The aspiration needle is then inserted into the bone by either twisting or gently tapping it into place. When frozen, this process is usually painless or only mildly uncomfortable. When the bone marrow is aspirated (drawn out), you may experience a deep, temporary pressure sensation at the back of your pelvis/buttock. Once the bone marrow blood is collected, the site will be bandaged. The marrow sample will then be processed into BM-PRP. This includes removing the stem cells from the bone marrow blood. The bone marrow PRP will then be injected into your painful joint(s) +/- soft tissue structures (i.e.) ligament, tendon or bursa under ultrasound or x-ray guidance. The entire procedure takes approximately 60-90 minutes.
Risks and Discomforts
Apart from the discomfort associated with the freezing needle and bone marrow aspiration, adverse effects are rare. However, there is a small risk of bleeding or infection at the back of your pelvis or at the injected joint(s), and a theoretical risk of a blood clot reaction to the blood thinner used in the PRP (Heparin Induced Thrombocytopenia;
https://my.clevelandclinic.org/health/diseases/24014-heparin-induced-thrombocytopenia#overview). This condition typically presents as a painful swollen leg from a blood clot in the leg or chest pain and shortness of breath from a blood clot in the lung. Heparin Induced Thrombocytopenia occasionally happens in individuals taking heparin (a blood thinner) regularly but has not been described following a single joint injection such as with PRP. Following the PRP injection, your joint(s) will feel stiff and sore for a few days.
Post-procedure Care and Follow-Up
You will have bandages placed over the puncture sites at the back of your pelvis and the joint(s) that were injected. You will receive instructions on how to care for the bandage and the injection areas. Once the soreness from the procedure settles, we strongly encourage you to start or resume an active rehabilitation program. You will be asked to complete questionnaires before the procedure, and periodically afterward. to evaluate the treatment’s effectiveness.