Originally written on Pirates Prospects  |  Last updated 12/18/12
At Friday night’s general Question and Answer session for season-ticket holders at Pirate Fest, one gentleman asked about the status of Josh Bell’s recovery from his knee problems.  GM Neal Huntington talked about how his knee did not respond to the original procedure, so they took a step back and re-evaluated things.  He then added “the knee responded well to the PRP injection he recently had.” Probably 1.5% of the audience knew what a PRP injection was and nodded approvingly.  The other 98.5%, including this writer, nodded approvingly and wondered what exactly a PRP injection was. PRP stands for Platelet Rich Plasma.  The procedure involves extracting platelets from the patient’s own blood via a vein.  This blood is taken out and put in a centrifuge in order to concentrate the platelets for extraction and separate them from other factions of blood cells.  Platelets help to stimulate a healing response in normal blood; by injecting concentrated amount of platelets it can help accelerate the healing process, especially for chronic or slow-healing injuries in tissue and even bone. Josh Bell originally tore his meniscus early in the 2012 season and was expected back in August.  However, his knee experienced repeated swelling and he ended up missing the remainder of the season and the fall instructional league.  PRP injections are commonly used for all forms of tendonitis, both in knees and elbows, to reduce inflammation. Huntington did not specify when the PRP injection was given, but it sounded relatively recent from his answer to the question. The procedure itself appears to be low-impact to the patient.  Blood is withdrawn from the patient and spun in the centrifuge for 30 minutes, and then re-injected into the appropriate area.  For the non-squeamish among you, here is a Youtube link showing the procedure being done on a patient for tendonitis in the elbow.  This is a general video and not, presumably, the same doctor who performed the PRP injection for Bell. In terms of the sports medicine world, PRP injections are still in the nascent stage.  A 2009 pilot study was published in the medical journal Injury by Doctors Kon, Filardo, and Delcogliano on their work with 20 athletes experiencing patellar tendonitis and swelling.  Six months after the PRP injection, 6 showed complete recovery, 8 showed marked improvement, 2 showed mild recovery, and 4 had no improvement.  This group of doctors made the conclusion that their results, albeit a small sample, were encouraging for short-term relief of tendonitis and swelling. All parties involved in the situation with Bell expect him to be ready for Spring Training and for an Opening Day assignment to full-season ball.  If his knee is still not ready by March/April, then it will be time to start worrying about his long-term health.
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