Autologous Blood Injection (ABI) & Platelet Rich Plasma (PRP) Injection.
Fact Sheets | Interventional Radiology
About Autologous Blood Injection (ABI) & Platelet Rich Plasma (PRP) Injection.
At Melbourne Radiology Clinic, ABI and PRP Injections are most commonly done into a tendon for the treatment of tendinosis or tendinopathy (the medical term for “tendinitis”), though other applications also include injecting ligaments, muscles and joints.
Any tendon in the body may be injected with a patient’s blood products. The most frequent clinical uses of ABI or PRP injections are into the following areas:
- plantar fascia (heel)
- Achilles (ankle)
- patellar (knee)
- gluteal (hip)
- hamstring (buttock)
- common extensor origin (“tennis elbow” or lateral epicondylitis) and;
- common flexor origin (“golfers elbow” or medial epicondylitis).
PRP therapy has also recently found use in treating osteoarthritis. By injecting PRP into joints, it is felt that the healing factors may stimulate cartilage and surrounding soft tissue regeneration, as well as dampen the main symptoms associated with arthritis, that being pain and stiffness. Even if joint surgery, such as joint replacement, is delayed for a year or two, then this is considered a win.
Blood contains many nutrients and substances which are thought to promote healing. Platelets are tiny cells in blood which stick to each other when we cut ourselves to result in the formation of a clot to stop any further bleeding. Platelets contain many powerful growth factors, in particular PDGF (Platelet Derived Growth Factor) which has been shown to promote healing of many types of tissues, including bone, teeth, skin and the tissue lining our eyes. PDGF also promotes healing of tendons which are damaged due to excessive use and/or the aging process.
Patients who suffer from tendinosis usually require a correct diagnosis prior to any procedure. This usually involves an ultrasound and/or an MRI (Magnetic Resonance Imaging) scan.
Following diagnosis and if not already done so, the initial line of treatment is to undergo a period of rehabilitation for 6 weeks supervised by a suitable health care provider. This might be your rehabilitation physician, physiotherapist, podiatrist, chiropractor or osteopath to name a few. If pain persists, then the patient is a candidate for an ABI or PRP injection.
We also strongly recommend that you bring a responsible person to drive you home afterwards.
most of these are minor (<1%), however can be serious (<0.1%) requiring hospital admission, intravenous antibiotics and surgery.
this is fortunately also rare and slightly common in patients with bleeding disorders and on “blood thinning” medication.
from direct needle trauma, or as a consequence of the above mentioned complications.
remains a theoretical risk however has not occurred with this procedure, in our experience.
Autologous Blood Injection /
Platelet Rich Plasma Injection
The procedure of ABI takes approximately 5 minutes and involves the use of an ultrasound machine to guide the needle into the correct location and safely.
First the skin is cleansed and prepared. Local anaesthetic is then injected into the skin overlying the tendon. Blood withdrawn from one of the arm veins is then injected directly into the tendon. The amount of blood injected depends on the size of the tendon. The injection sites are then dressed with a small bandage.
A PRP injection is similar to an ABI, with the only difference being that a larger amount of blood is withdrawn from an arm vein.
The blood is then placed into a tube, which in turn is placed into a machine called a centrifuge, which spins many thousand times a minute. The blood is left to spin for 15 minutes. At this point, the cells in the blood have separated from the fluid component of blood (plasma) into the three main cell types: red blood cells, white blood cells and platelets. The platelets are then selectively removed and used for injection. In this way, the theoretical benefit is that a greater concentration of platelets is delivered into the damaged body part than if whole blood was given alone (approximately 8-10 times greater concentration). There is, however, no scientific research documenting this benefit at the time of writing.
Following your procedure & recovery
Following the procedure you will be provided with clear, written instructions on when to re-commence your rehabilitation. [See the PDF information sheets above].
Patients consistently report a flare up of their pain in the first week following the procedure, however in most cases, this is controlled with some paracetamol and/or an anti-inflammatory medication. Codeine is rarely required.
If your pain persists after 4 weeks following injection, then a repeat injection is strongly recommended.
If your pain remains unchanged following a second injection then no further ABI/PRP injection will be offered and you may instead be offered an alternative injection that is available, or otherwise you may wish to pursue surgery. A third injection is rarely offered.
One of Melbourne Radiology Clinic’s specialist radiologists, a medical doctor specialising in the interpretation of medical images for the purposes of providing a diagnosis, will then review the images and provide a formal written report. If medically urgent, or you have an appointment immediately after the scan to be seen by your doctor or health care provider, Melbourne Radiology Clinic will have your results ready without delay. Otherwise, the report will be received by your doctor or health care provider within the next 24 hours.
Please ensure that you make a follow up appointment with your referring doctor or health care provider to discuss your results.
Your referring doctor or health care provider is the most appropriate person to explain to you the results of the scans and for this reason, we do not release the results directly to you.
Additional Information About Blood Injections (ABI & PRP Injections)
One of the common concerns for blood injection procedures is the patient’s safety. Due to ABI and PRP injections using the patient’s own tissues, these treatments are considered low-risk and safe and can be performed alone or in conjunction with other procedures.
However, it is critical to note that the blood injections cannot be administered to patients with bleeding disorders or those taking anticoagulants. They should also not be used in other blood conditions like leukaemia, where tumour cells may be present or where platelet levels are low. Please inform your doctor of any medical illnesses you have before booking ABI or PRP injections.
There are certain tendon tearing cases wherein ABI may not be recommended. Such situations may deem surgery as a more appropriate treatment.