Ligament tears occur due to accidents, prolonged stress, or strenuous physical activity. A torn ligament results in mild to severe pain, swelling in the area, and bruising, and it limits your range of motion and function.
Sometimes, a less severe ligament tear may heal with physical therapy, adequate rest, and medication. For advanced cases, in the Arthroscopy and Sports Medicine fields, the treatment decision comes down to choosing between PRP injections and arthroscopic surgery. The decision boils down to the severity of the issue and the patient’s requirements.
PRP, or Platelet Rich Plasma injections, and arthroscopic surgeries are very different treatment options for treating ligament tears. The indications, procedure, advantages, and limitations for both approaches will be carefully weighed by the best sports ortho doctor to fit your specific needs.
Our guide is an extensive comparison of their efficacy, mechanism, recovery, and candidacy, based on available data and existing knowledge.
Understanding PRP Injections for Treating Ligament Injuries
The PRP approach involves injecting the patient’s own platelets into the damaged ligament to induce healing. Once injected within the body, the platelets release growth factors which can aid in repairing tissue damage and minimising inflammation.
The Mechanism
The patient’s blood is taken and processed to isolate the platelets, which are then injected into the injured ligament. The growth factors present within the platelet sample aid in tissue regeneration and promote healing.
Indications
Doctors may recommend PRP injections for:
- Partial ligament tears and chronic sprains that do not resolve with rest and physiotherapy.
- Common injuries — such as MCL (Medial Collateral Ligament) sprains, injuries of the ankle ligament, and chronic tendinopathy.
- For injuries where conservative management has failed, but surgery is not indicated.
How Many PRP Injections Are Needed For Meniscus?
Doctors may recommend 1–3 PRP injections spaced weeks apart for meniscus injuries. However, the number of injections depends entirely on:
- The extent of the tear
- How the joint reacts to the first injection
Benefits
- The procedure involves no incisions or blood loss. There are very few chances of complications because it involves injecting the patient’s own platelets into the injured ligament.
- An outpatient procedure — generally performed in a healthcare facility with minimal downtime.
- A natural healing process — because it uses the patient’s own cells, thereby minimising the chances of adverse reactions.
- Patients tend to return to routine activities within days or weeks — depending on the severity of the injury.
Limitations
- There is mixed evidence on its efficacy. Some research reveals enhanced healing for injuries like MCL sprains, whereas others show few benefits.
- Not suitable for severe injuries — total ligament tears or complicated injuries.
Who is Not a Good Candidate for PRP?
PRP therapy is not suitable for patients with:
- Active cancers
- Uncontrolled infections
- Blood disorders
- Advanced degenerative conditions
Also, it may not be suitable for patients seeking immediate pain relief because the therapy has a slow response time.
With all the basic details about PRP therapy explored, it is time to move on to the next part — exploring arthroscopic surgery.
Also Read: How To Identify An ACL Tear: A Comprehensive Guide
Understanding Arthroscopic Surgery for Treating Ligament Injuries
Arthroscopic surgery is a minimally invasive procedure. Unlike conventional orthopaedic surgery, this approach uses smaller incisions and a small camera-fitted device called an arthroscope to rebuild/repair torn ligaments.
The Mechanism
Surgeons utilise special instruments to:
- Repair torn ligaments using suture
- Reconstruct torn ligaments using a graft
Indications
Arthroscopic surgery has become the preferred choice for:
- Sport-related injuries of the knee or shoulder.
- Repair of complete Anterior Cruciate Ligament (ACL) and Posterior Cruciate Ligament (PCL) tears.
- Severe injuries affecting multiple structures — for example, ligament damage and meniscus.
- Meniscus tears in the knee.
- Full-thickness tears of the rotator cuff repair.
- Injuries leading to recurrent shoulder dislocations.
- Persistent symptoms such as joint locking or cases in which instability exists.
Benefits
- The minimally invasive surgery effectively repairs structural damage and restores joint stability.
- Arthroscopic ACL reconstruction has an 80–90% success rate in helping patients regain their activity levels before injury.
Limitations
- Although it is minimally invasive compared to conventional surgeries, it requires anaesthesia and incisions.
- Requires around 3–6 months for complete recovery.
- Furthermore, it carries a 1% risk of infection, a 5–10% probability of graft failure, and stiffness of the joint.
Let’s next unpack the differences between PRP and arthroscopic surgery.
PRP vs Arthroscopic Surgery: What’s the Best Treatment for Torn Ligaments?
While minor tears may heal well with PRP injections, rest, and physiotherapy, complete and complex ligament injuries may require arthroscopic surgery for optimal outcomes.
To decide between PRP vs arthroscopic surgery, it is essential to weigh the pros and cons based on several factors:
- Severity of the Ligament Tear: Partial and mild tears and early-stage ligament injuries may heal well with PRP therapy. However, if the ligament is fully torn and when the injury impacts your joint stability, doctors may opt for arthroscopic surgery.
- Patient’s Overall Health Requirements: Sports persons or individuals in need of complete joint stability may fare better with surgery. On the other hand, PRP therapy may suffice for non-sports patients or individuals with lesser physical demands.
- Age and Health Status: Arthroscopic surgery is certainly a better choice for active individuals in the younger age category. Conversely, PRP therapy may be a wiser choice for older individuals and those with comorbidities.
- Proof of Efficacy: There is more evidence supporting surgery for major ligament tears. While the benefits of PRP therapy are less predictable, the treatment delivers promising outcomes for certain cases.
A quick guide to when PRP, arthroscopy, or a combination may be the right choice for joint injuries.
Here’s a quick summary of the PRP vs arthroscopic surgery debate:
- For mild ligament injuries and partial tears — PRP therapy may be a better choice if the injury involves the MCL or ankle ligaments and if conservative approaches have failed to deliver results. Follow your progress with a specialist.
- For complete ligament tears or instability — Arthroscopic surgery is usually recommended — particularly for ACL tears and complex injuries. Consult an orthopaedic surgeon for MRI imaging and further assessments.
- The hybrid approach — where PRP therapy is applied after the arthroscopic surgery, though the evidence is scarce.
Finding the Best Treatment for Ligament Injuries
Many individuals wonder — “How to repair torn ligaments without surgery?” Fortunately, non-surgical options like physiotherapy, bracing, activity modification, and regenerative therapies like PRP are available for mild to moderate injuries.
Moreover, depending on the type, severity, and chronicity of the injury, and the patient's health and lifestyle in general, the decision between PRP and arthroscopic surgery hinges to a significant degree. In addition, PRP can be an appropriate choice for chronic sprains, partial tears, or when patients need to try less intrusive treatments first before resorting to surgery.
It can also be a worthwhile choice for those who are not likely to be good surgical candidates because of other medical issues. Nonetheless, arthroscopic surgery tends to be the final answer in the case of full ruptures, major instability, or after other non-surgical measures have failed.
For advanced treatment of ligament injuries, Sri Balaji Hospital — one of the best ortho hospitals in Chennai — is relied upon for delivering excellence in orthopaedic treatments and care. Book a consultation with doctors at our multispeciality hospital today!
