Often my colleagues in the primary care disciplines have a knee jerk reaction regarding the safety of PRP (Platelet-Rich Plasma) and PRF (Platelet-Rich Fibrinogen). They always ask, “What about the risk of infection?” It’s an understandable question, as an infection is the biggest complication of any injection. An infected joint is a big deal. Septic arthritis is treated with a surgical washout and weeks of IV antibiotics. However, it typically only takes a few probing questions from me before my colleagues realize that their concern about regenerative injections is not very well founded.
When we inject a joint with a steroid, we are inhibiting the inflammatory processes within that joint. Great for pain relief, not great for joint regeneration and not great for the immunity of the joint. While it is uncommon, the risk for infection is very real.
When we use regenerative injection treatments like PRP and PRF we are stimulating the inflammatory system, and we are stimulating the immune system. The risk of infection is exceedingly low because the Platelet-Rich substances we use are actively anti-microbial.1,2 The platelets themselves are little messenger bombs that create an acute inflammatory environment in which few microbes would stand a chance. This is yet another reason why I enjoy treating patients with regenerative therapies. Like all things in medicine, we must weigh the risk and the benefits of our treatments. I have been hard-pressed to find a set of pain-reducing procedures with a better risk-to-benefit ratio than what we provide here at ORM.
Dr. Kristian Flores, MD, ND, began his medical journey as a Naturopathic Doctor. He then earned his Medical Degree, completing an Internal Medicine internship as well as a residency in Physical Medicine and Rehabilitation (also known as Physiatry). As a Board Certified Physiatrist, Dr. Flores specializes in the prevention, diagnosis, and rehabilitation of people disabled by disease, disorder, or injury. He works extensively with patients suffering from acute and chronic pain conditions such as spine pain and sports injuries. His practice also includes helping patients with disabling conditions such as brain injury, long-covid, and hypermobility disorders.
Sources
1. Cl K, Jeyaraman M, Jeyaraman N, Ramasubramanian S, Khanna M, Yadav S. Antimicrobial Effects of Platelet-Rich Plasma and Platelet-Rich Fibrin: A Scoping Review. Cureus. 2023 Dec 30;15(12):e51360. doi: 10.7759/cureus.51360. PMID: 38292974; PMCID: PMC10825076.
2. Balaji, V. R.; Thiagarajan, Rama Krishnan1; Niazi, Thanvir Mohamed2; Ulaganathan, G.2; Manikandan, D.. Antimicrobial Effects of Platelet Rich Fibrin: A Systematic Review on Current Evidence of Research. Journal of Interdisciplinary Dentistry 11(1):p 2-10, Jan–Apr 2021. | DOI: 10.4103/jid.jid_66_20
