Battling severe arthritis, Charlotte Marsden had a total knee replacement scheduled for last September. The pain was so bad that Marsden, 61, couldn’t endure walking on concrete floors or on the beach near her Cape May, N.J. home. In a last-ditch effort to avoid surgery, she tried an increasingly popular procedure – platelet-rich plasma therapy, which included injections of her own concentrated platelets, protein-releasing bodies that help heal wounds.

Now, after the platelet therapy, Marsden, says she can again work in her garden, climb steps, ride a bike – and walk anywhere. Platelet injections also eased the pain in her shoulder and big toe.   

“I’m pain-free after 15 to 20 years of suffering,” she says.

The platelet-rich plasma therapy, or PRP, procedure takes a small amount of a patient’s blood and rotates it in a centrifuge to separate red blood cells from platelets. Then the concentrated platelets are re-injected into the damaged area – elbows, knees, shoulders, hips and Achilles tendons. The platelets release growth factors that theoretically help the tissue recover, with the patients ideally improving within a few weeks.

Physicians report that the demand for PRP has soared after pro golfer Tiger Woods received injections to accelerate healing after knee surgery. And two Pittsburgh Steelers, Troy Polamalu and Hines Ward, had the procedure before the team’s Super Bowl victory in 2009.

But despite such positive personal stories and high-profile successes, some orthopaedic surgeons remain cautious about the spread of PRP, saying that not enough substantial research has been done on its effects to push it widely.

A study published in January 2010 in the Journal of the American Medical Association, for example, one of the first rigorous tests of this technique, found that PRP injections were no better than placebo shots of salt water for patients with Achilles tendinopathy, a condition that causes pain just above the heel bone.

“It’s clearly hyped too much,” says Stephen C. Weber, MD, an orthopaedic surgeon in Sacramento, Calif.

But others have embraced PRP, saying science simply hasn’t caught up to what they are seeing in their patients.

Platelet-rich plasma therapy represents “the beginning of a seismic change in orthopaedics,” says Rocco Monto, MD, an orthopaedic surgeon in West Tisbury, Mass. “Most of my colleagues have dipped their toes in the water and are finding early success.” 

This week, the debate will likely intensify as the results of four new studies are presented at the annual meeting of the American Academy of Orthopaedic Surgeons (AAOS) in New Orleans. The research at the AAOS conference includes three studies that show more promising results.