Platelet-Rich Plasma (PRP)
Concentrated autologous platelets delivered under ultrasound guidance to accelerate soft-tissue healing in tendons, ligaments, and early joint disease.
What It Is / How It Works
Platelet-Rich Plasma is derived from a small sample of the patient's own blood. After centrifugation, platelets are concentrated 3–10x above baseline levels. This concentrate is rich in growth factors — including PDGF, TGF-β, VEGF, and IGF-1 — that signal tissue repair, reduce inflammation, and promote angiogenesis at the treatment site. PRP is delivered via ultrasound-guided injection directly to the area of pathology, ensuring precise placement and minimizing procedural risk.
PRP is autologous — meaning derived from the patient's own biology — eliminating concerns about immune rejection or disease transmission. It represents a first-line biologic option for patients seeking alternatives to corticosteroid injections, which can cause tissue degradation with repeated use.
Who Is a Candidate
Good candidates for PRP are patients with tendinopathies such as rotator cuff disease, lateral epicondylitis, and patellar or Achilles tendinopathy, as well as those with early-to-moderate knee osteoarthritis or select ligament injuries, particularly patients who have not responded adequately to physical therapy, activity modification, or oral anti-inflammatory medication. It is also a reasonable option for patients who wish to avoid the tissue effects associated with repeated corticosteroid injections, or who have had an incomplete response to a prior corticosteroid course.
PRP is generally avoided in patients with active local or systemic infection, certain hematologic malignancies, severe thrombocytopenia or platelet dysfunction disorders, and in those on therapeutic anticoagulation where the harvest or injection itself may pose bleeding risk without careful coordination with the prescribing physician. Patients with unrealistic expectations about the pace or magnitude of improvement, or advanced structural joint disease better suited to surgical management, are typically counseled toward other options.
What to Expect
The procedure is performed in the office setting. A small volume of the patient's blood is drawn, similar to a routine lab draw, and processed in a centrifuge to separate and concentrate the platelet-rich layer, a process that takes roughly fifteen to twenty minutes. The concentrated PRP is then injected under ultrasound guidance directly into the area of pathology, allowing the physician to visualize the target tissue and needle placement in real time.
The entire visit typically takes under an hour from blood draw to discharge. Patients may experience transient soreness or swelling at the injection site for several days, which is expected as part of the localized inflammatory response PRP is designed to stimulate. Activity is generally modified for a short period afterward, with a gradual return to loading and physical therapy guided by the treating physician.
Evidence Base
- Platelet-Rich Plasma Augmentation of Arthroscopic Rotator Cuff Repair Lowers Retear Rates and Improves Short-Term Postoperative Functional Outcome Scores: A Systematic Review of Meta-Analyses. PMID: 35494273 ↗
- Efficacy and Safety of Intra-articular Platelet-Rich Plasma (PRP) Versus Corticosteroid Injections in the Treatment of Knee Osteoarthritis: A Systematic Review of Randomized Clinical Trials. PMID: 40260368 ↗
- Comparing efficacy of a single intra-articular injection of platelet-rich plasma combined with different hyaluronans for knee osteoarthritis: a randomized-controlled clinical trial. PMID: 36329428 ↗
- Intra-articular platelet-rich plasma injection for knee osteoarthritis: a summary of meta-analyses. PMID: 31775816 ↗
- Efficacy of the combination therapy of platelet-rich plasma and hyaluronic acid on improving knee pain and dysfunction in patients with moderate-to-severe KOA: a protocol for a randomised controlled trial. PMID: 37336540 ↗
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