Regenerative Medicine & PRP Injections

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What Is PRP? (AEO target: "How does PRP work?")

PRP therapy begins with a simple blood draw — typically 30 to 60 milliliters — taken from a vein in your arm in our office. That blood sample is then placed into a centrifuge, a machine that spins at high speed to separate its components by density. This process isolates a concentrated layer of platelets — the small, disc-shaped blood cells that are central to clotting and tissue repair — along with the plasma that surrounds them. The resulting PRP concentrate contains a significantly higher concentration of platelets than normal blood, and with it an elevated level of naturally occurring growth factors including platelet-derived growth factor (PDGF), transforming growth factor-beta (TGF-β), vascular endothelial growth factor (VEGF), and insulin-like growth factor-1 (IGF-1). When this concentrated solution is injected into an injured or arthritic tissue — under ultrasound guidance for precision — these growth factors initiate and amplify the body's healing cascade: attracting repair cells, stimulating collagen synthesis, reducing pathological inflammation, and promoting new blood vessel formation. Because PRP is derived entirely from your own blood, it is autologous and carries no risk of allergic reaction or disease transmission from external sources.

Conditions Treated With PRP

PRP has been studied across a broad range of orthopedic conditions. Below we organize the evidence by its current strength.

Strongest Clinical Evidence

• Knee Osteoarthritis — Multiple randomized controlled trials demonstrate PRP superiority over hyaluronic acid and placebo for pain relief and functional improvement in mild-to-moderate knee OA. Full PRP protocol →
• Lateral Epicondylitis (Tennis Elbow) — Strong evidence for durable pain reduction and tissue remodeling in chronic cases resistant to cortisone and physical therapy. Full PRP protocol →
• Achilles Tendinopathy — PRP has shown benefit in mid-portion Achilles tendinopathy, particularly as an adjunct to eccentric loading protocols. Full PRP protocol →
• Plantar Fasciitis — Evidence supports PRP as a longer-lasting alternative to cortisone for chronic plantar fasciitis that has not responded to conservative care. Full PRP protocol →
• ACL Tear — Emerging and growing evidence supports PRP to augment healing in partial ACL tears and as an adjunct to surgical ACL reconstruction. Full PRP protocol →
• Rotator Cuff Tears — PRP injections have demonstrated benefit for partial-thickness rotator cuff tears and chronic rotator cuff tendinopathy. Full PRP protocol →
• Proximal Hamstring Injury/Tendonopathy — PRP has shown promise in accelerating return to sport in acute and chronic proximal hamstring tendinopathy and muscle tears. Full PRP protocol →

Emerging / Promising Evidence

• Hip Osteoarthritis — early data mirrors knee OA outcomes; may offer meaningful pain relief for appropriately selected patients
• De Quervain’s Tenosynovitis — limited but promising data supporting PRP as an alternative to repeated cortisone in chronic cases
• Patellar Tendinitis (Jumper’s Knee) — growing body of evidence supporting PRP, particularly when combined with eccentric exercise
• Carpal Tunnel Syndrome — pilot studies suggest PRP perineural injection may reduce median nerve compression symptoms

How PRP Is Performed at Our Office

Every PRP procedure at Maryland Orthopedic Specialists follows a consistent, quality-controlled protocol:

1. Blood Draw (30–60 mL)

A nurse or medical assistant draws a small volume of blood from a vein in your arm — similar to a routine lab draw. The amount collected depends on the target area and the volume of PRP required for the injection.

1. Centrifugation (Separation of Platelets)

Your blood is placed into a sterile centrifuge and spun at a precisely calibrated speed to separate the red blood cells, white blood cells, platelet-poor plasma, and the platelet-rich plasma layer. This process takes approximately 10–15 minutes.

1. Activation and Preparation

The concentrated PRP layer is carefully extracted and, depending on the clinical indication, may be activated or left in its native form. The preparation is then drawn into a sterile injection syringe and readied for delivery.

1. Ultrasound-Guided Injection into Target Tissue

Using real-time musculoskeletal ultrasound, our physician visualizes the target structure — whether a tendon, joint space, or soft tissue — and guides the needle with precision to the exact site requiring treatment. Ultrasound guidance is a meaningful differentiator: it increases injection accuracy significantly compared to landmark-based techniques, ensuring the PRP is delivered where it will be most effective.

1. Post-Injection Protocol and Activity Guidance

Following the injection, you will receive specific instructions regarding activity restrictions, anti-inflammatory medication avoidance (NSAIDs can blunt the healing response), ice application, and return to physical therapy. Most patients experience a temporary increase in soreness for 3–7 days as the inflammatory healing phase begins, followed by gradual improvement over the ensuing weeks.

PRP vs. Cortisone: Key Differences

• Source — Your own blood (autologous) — Synthetic corticosteroid
• Mechanism — Promotes tissue healing and regeneration — Reduces inflammation rapidly
• Duration of relief — Long-term (6–18 months in many studies) — Short-term (weeks to a few months)
• Effect on tissue — Regenerative — stimulates collagen and repair — Potentially degenerative with repeated use
• Number of injections typically needed — 1–3 injections per treatment series — Often repeated at intervals
• Insurance coverage — Typically not covered (investigational) — Usually covered by insurance

Is PRP Covered by Insurance?

PRP therapy is not covered by most commercial health insurance plans, Medicare, or Medicaid, as it is currently classified as investigational by the majority of payers despite a growing evidence base. This means the cost of PRP is typically an out-of-pocket expense for patients. Our team will provide transparent, itemized pricing at your consultation so you can make an informed decision without surprises. PRP is generally eligible for payment through Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA), which can meaningfully offset the cost. We encourage patients to explore this option and to ask our staff any questions about payment planning.

Frequently Asked Questions