Dr. Alan Hirahara performs an intra-tendinous PRP injection using ultrasound guidance to bring pain relief to a patient suffering from lateral epicondylitis.
so today we're going to be doing a prp injection to the lateral epicondyle this patient has lipocondylitis has failed conservative management and so we're going to be going into the tendon using ultrasound guidance to make sure we're able to be accurately placing the prp exactly where we want to give him the best chance of healing and resolution of his pain the first step is going to be to simply draw the blood so we'll be taking in 15 cc's of his blood right now then using the centrifuge to spin it remove the red cells in white cells and only have the platelets and growth factors for use as an injection as a leukocyte-poor prp injection okay so now we're going to spin this for five minutes in the centrifuge and we'll have it ready for injection in five minutes okay so this is the prp it's now been centrifuged and what we're looking at is we're seeing below the red cells and white cells so the red cells are here the white cells are close to the center area then above this yellow is the plasma the platelets and growth factors we're going to take this off and titrate that out and we're going to stop early so we don't grab the white cells so we'll stop there and that's it and that's what we're going to use i have my clarius uh l15 it's really good for looking at msk and we can see very nicely already the exact area we want to see here still out of condyle and that's exactly where we want to go that it's got a little bit of a hypoechoic area to it a little bit of signal change right in there and that's exactly where we want to go my entry point is going to be right here we're going to numb it up with a cold spray ethyl chloride keep the transducer away from the area as the cephaloquad can actually damage the unit i'm going to get back in position to see where we want identify our region again move over so i can see well i'm going to bring my needle in plane and there's my needle there exactly where i want it right at the epicondyle i'm injecting now i'm going to take a picture start the video and we can see nicely into the area and we're injecting into the whole region i feel carter good as you can see i'm spreading it over the whole region to make sure i get it infiltrated to the whole spot and that's it we're done and that's a injection to the epicondyle using platelet-rich plasma for lateral epicondylitis you
