PRP Preparation Guidelines for Gluteal Tendinopathy

Blood Collection Protocol

The American Society of Clinical Oncology recommends drawing blood directly into plastic tubes using trisodium citrate, ACD, or CPD as anticoagulant to avoid premature platelet activation 1
Collect 4-8 tubes of 9-10 mL blood using a 21G butterfly needle, rotating tubes immediately after draw to increase contact between inner tube surface and blood 2
Use a gentle tourniquet only for vein location, maintaining minimal pressure during collection to prevent blood cell activation and hemolysis 3
Discard the first milliliter(s) of blood to avoid tissue factor contamination, ensuring blood flows without intermediate stopping 3
Process blood at room temperature as soon as possible, preferably within 1 hour of collection 1, 3

The International Society on Thrombosis and Haemostasis recommends a double-spin technique for gluteal tendinopathy as it achieves higher platelet concentrations and better clinical outcomes compared to single-spin methods 1
Centrifuge at low G force (approximately 150-200g) for 10-15 minutes to separate platelet-rich plasma from red blood cells 1, 3
Transfer the PRP to a new tube and centrifuge at higher G force (approximately 2500g) for 10 minutes 3
Remove most of the platelet-poor plasma, leaving concentrated platelets in residual plasma 4

Maintain room temperature throughout processing to avoid cold activation and protein precipitation 1, 3
Complete centrifugation on a stable surface to prevent vibration that could affect platelet quality 2
For patients on anticoagulant medication, extend centrifugation time to 18-20 minutes 2

Use freshly prepared PRP within 4 hours for optimal results 1
Activate PRP with calcium chloride, autologous thrombin, or collagen type I depending on clinical application 1

Leukocyte-rich PRP is specifically recommended for gluteal tendinopathy based on superior outcomes compared to corticosteroid injection, with benefits continuing to improve through 2 years 5
The double-spin leukocyte-rich protocol has the strongest evidence for gluteal tendinopathy with symptoms >4 months and confirmed intratendinous pathology on ultrasound or MRI 5