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Blood Patch

This is done into a tendon for the treatment of tendinosis (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, with the most frequent clinical uses of ABI or PRP injections used for the 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). Approximately 80% of patients obtain complete or significant pain relief following this procedure.

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.

Why inject Blood?

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 ageing process.

Preparation

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.

  • An appointment is made and we recommend bringing someone to drive you home
  • No specific preparation is required on the day of treatment

Procedure

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 procedure is at this point over and the needle injection site is then dressed with a small bandage.

What are the Risks?

Complications from interventional procedures performed under image guidance are rare, but can include:

  • Bleeding – at the intervention site. A small amount of bleeding is common, however high risk patients include those with bleeding disorders and taking blood-thinning medication may experience excessive bleeding. High risk patients should notify staff at the time of booking so blood-thinning or anti-coagulation medications, such as Warfarin, Aspirin or Platelet Inhibitors are stopped before the procedure.
  • Nerve Damage – can occur as a result of trauma from direct needle contact with the nerve. We use image guidance to minimise this risk.
  • Infection – is rare but potentially serious. If you experience fever, localised heat, swelling or increase pain at the intervention site more than 48 hours later, you should consult your doctor without delay. Antibiotic treatment may be necessary.

Whilst every effort is made to keep your appointment time, the special needs of complex cases, elderly and frail patients can cause unexpected delays. Your consideration and patience in these circumstances is appreciated.

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