News - Platelet-rich plasma (PRP) as a method to treat cartilage, tendon and muscle damage - Statement of the German working group (2023)

Platelet-rich plasma (PRP) is widely used in orthopedics, but there is still a heated debate. Therefore, the German "Clinical Tissue Regeneration Working Group" of the German Orthopedic and Trauma Association conducted a study to reach consensus on the current therapeutic potential of PRP.

Therapeutic applications of PRP are considered useful (89%) and may gain importance in the future (90%). The most common indications are tendon disease (77%), osteoarthritis (OA) (68%), muscle damage (57%) and cartilage damage (51%). Consensus was reached in the 31/16 statement. The use of PRP in early osteoarthritis of the knee (Kellgren Lawrence II) is considered potentially useful, as well as in acute and chronic tendon disease. In chronic lesions (cartilage, tendons), multiple injections (2-4) are more advisable than single injections. However, there is insufficient data on the interval between injections. It is strongly recommended to standardize the preparation, application, frequency and indication of PRP.

Platelet-rich plasma (PRP) is widely used in regenerative medicine, especially orthopedic sports medicine. Basic scientific research has shown that PRP has many positive effects on many cells of the musculoskeletal system, such as chondrocytes, tendon cells and muscle cells, both in vitro and in vivo. However, the quality of the existing literature is still limited, including basic and clinical studies. In clinical studies, the effect is therefore not as good as basic scientific research.

There are many possible causes. First, there are several manufacturing methods (currently more than 25 different systems on the market) to obtain platelet-derived growth factors, but the final PRP product consists of their heterogeneous compositions and careful efforts. For example, different methods of preparing PRP show different effects on articular chondrocytes. Since basic parameters such as blood composition (red blood cells, white blood cells and platelets) have not yet been reported in all studies, there is an urgent need for standardized reporting of these factors. The final PRP product also has significant individual differences. The issue is complicated by the fact that the dosage, timing and amount of PRP application are not standardized and not fully explored in basic scientific research. Therefore, there is a clear need for standardized platelet-derived growth factor formulations that enable standardized scientific studies of the effects of various parameters such as PRP formulation, PRP injection volume and injection time. In addition, the use of classifications to better describe the PRP products used should become mandatory. Some authors have proposed several classification systems, including Mishra (platelet count, presence of white blood cells, activation) and Dohan Ellenfest (platelet count, white blood cell count, presence of fibrinogen), Delong (platelet count, activation of nails, in ^ Blood count Haide ; PAW classification) and Mautner (platelet count, presence of large eucocytes, presence of R-labeled cells and nail activation; PLRA classification). Magalon et al. The proposed DEPA classification includes OSE lamellar injection, production efficiency, safety and PRP activation. Harrison et al. Another comprehensive classification system has been published, including activation methods used, total volume, frequency of administration and activated subcategories, platelet concentration and preparation techniques, as well as overall mean and range (low-high) white blood cells (neutrophils, lymphocytes and monocytes). ) blood platelet count, red blood cell count and classification. The most recent classification is from Kon et al. Based on expert consensus, the most important factors are described as platelet composition (platelet concentration and concentration ratio), purity (presence of red/white blood cells), and activation (endogenous/exogenous, calcium supplement ).

The use of multiple PRP indicators has often been discussed, such as the fact that the treatment of tendon disorders has been described in clinical trials at several sites [with simultaneous positive and negative results]. Therefore, it is often impossible to obtain conclusive evidence from the literature. This also makes it difficult to include PRP therapy in different guidelines. Due to the many unresolved issues related to the use of PRP, the basic principle of this article is to present the views of the experts of the German "Clinical Working Group for Tissue Regeneration" of the German Association for Orthopedics and Trauma (DGOU) on its use and future of PRP.


The German "Clinical Working Group for Tissue Regeneration" consists of 95 members, each of whom specializes in orthopedic surgery and tissue regeneration (all doctors or physicians, not physiotherapists or sports scientists). A working group of 5 people (blind search) is responsible for promoting the research. After studying the existing literature, the working group prepared possible points of attention that could be included in the first round of research. The first survey was conducted in April 2018 and included 13 questions and general aspects of the PRP application, including closed and open questions, and encouraged experts to suggest additional projects or changes. Based on these answers, a second round of survey was developed and conducted in November 2018 with a total of 31 closed questions in 5 different categories: indications for cartilage damage and osteoarthritis (OA), indications for tendon pathology, indications for muscle damage, use of PRP and future research areas.

It was agreed through an online survey (Survey Monkey, USA) that respondents would be able to assess whether the project should be subject to minimum reporting requirements and give five possible Likert response scales: 'Strongly agree'; Agree; Neither agree nor against; I do not agree or strongly disagree. The study was led by three experts on face reliability, understanding, and acceptability, and the results were slightly modified. A total of 65 experts participated in the first round and a total of 40 experts in the second round. For the second round of consensus, the a priori definition is that if more than 75% of respondents agree, the draft will be included in the final consensus document, and less than 20% of respondents disagree. 75% of participants agree that this is the most common consensus decision used in our study.


In the first round, 89% of people responded that the PRP application is useful, and 90% believe that PRP will become more important in the future. Most members are familiar with basic science and clinical research, but only 58% of members use PRP in their daily practice. The most common reasons for not using PRP are the lack of suitable facilities, such as university hospitals (41%), expensive (19%), time-consuming (19%) or insufficient scientific evidence (33%). The most common indications for the use of PRP are tendon disorders (77%), osteoarthritis (68%), muscle damage (57%) and cartilage damage (51%), which forms the basis of the second round of research. The indication for intraoperative use of PRP is 18% cartilage repair and 32% tendon repair. Other indications are observed in 14%. Only 9% of people said that PRP has no clinical benefit. PRP injection is sometimes used in combination with hyaluronic acid (11%). In addition to PRP, experts also injected local anesthetics (65%), cortisone (72%), hyaluronic acid (84%) and Traumel/Zeel (28%). In addition, experts overwhelmingly stated the need for more clinical studies on the use of PRP (76%) and the need for better standardization (formula 70%, indications 56%, time 53%, injection frequency 53%). For details about the first round, please refer to the appendix. The vast majority of experts stated that more clinical studies on the use of PRP are needed (76%) and better standardization should be achieved (preparation 70%, indications 56%, duration 53%, injection frequency 53%). For details about the first round, please refer to the appendix. The vast majority of experts stated that more clinical studies on the use of PRP are needed (76%) and better standardization should be achieved (preparation 70%, indications 56%, duration 53%, injection frequency 53%).

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Based on these responses, the second round focuses more on the topic that generates the most interest. Consensus was reached in the 31/16 statement. It also shows areas where there is less consensus, especially in the area of ​​indication. It is generally agreed (92%) that there are significant differences in the different indications for PRP (such as osteoarthritis, tendon disease, muscle damage, etc.).

[The stacked diagonal bar chart shows the breakdown of the degree of agreement in the second round of the survey (31 questions (Q1 - Q31)), which well represents the areas of disagreement.

The bar to the left of the Y-axis indicates disagreement and the bar to the right indicates agreement. Most confusion arises in the indication area.]

Indications for cartilage damage and arthrosis

There is general agreement (77.5%) that PRP can be used in early knee osteoarthritis [Kellgren Lawrence (KL) Level II]. For less severe cartilage lesions (class KL I) and more severe stages (class KL III and IV), there is still no consensus on the use of PRP during or after cartilage regeneration surgery, although 67.5% of experts believe that this is promising territory is.

Indications for tendon injuries

In the study, experts represented the vast majority (82.5% and 80%) that the use of PRP is helpful in acute and chronic tendon disorders. For rotator cuff repair, 50% of experts believe that intraoperative use of PRP can be helpful, but 17.5% of experts disagree. A similar number of experts (57.5%) believe that PRP plays a positive role in postoperative healing after tendon repair.

Indication of muscle damage

However, no consensus has been reached on the use of PRP to treat acute or chronic muscle damage (such as over 75% consensus).

Practical aspects of using PRP

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I agree with three statements:

(1) Chronic lesions require more than one PRP injection

(2) Insufficient information on the optimal interval between injections (no consensus on weekly intervals)

(3) The variability of different PRP preparations may play an important role in their biological effects

Future research areas

The production of PRP needs to be better standardized (95% consistency) and its clinical use (such as injection frequency, application time, clinical indications). Even in areas such as osteoarthritis, where there is supposedly good clinical data, experts believe there is still a great need for more basic scientific and clinical research. This also applies to other indications.


The results of the study indicate that there is still widespread debate about the use of PRP in orthopedics, even in national expert groups. Of the 31 speeches, only 16 reached a common consensus. There is the broadest consensus in future research indicating that there is a strong need to generate extensive evidence by conducting many different future studies. In this regard, the critical evaluation of available evidence by expert working groups is one way to improve medical knowledge.

Indications for osteoarthritis and cartilage damage

According to the current literature, PRP may be suitable for early and moderate osteoarthritis. Recent evidence suggests that intra-articular injection of PRP can alleviate symptoms in patients regardless of the degree of cartilage damage, but proper subgroup analysis based on the classification of Kellgren and Lawrence is usually lacking. Therefore, due to insufficient available data, experts currently do not recommend the use of PRP for KL level 4. PRP also has the potential to improve knee joint function, perhaps by reducing inflammatory responses and slowing down the degenerative process of articular cartilage remodeling. PRP usually performs better in young male patients with less cartilage damage and a lower body mass index (BMI).

When interpreting published clinical data, the composition of PRP appears to be a key parameter. Due to the demonstrated cytotoxic effect of platelet-rich plasma on synovial cells in vitro, LP-PRP is mainly recommended for intra-articular administration. A recent basic scientific study compared the effects of PRP with poor white blood cells (LP) and PRP with rich white blood cells (LR) on the development of osteoarthritis in a mouse model after meniscectomy. LP-PRP showed better efficacy in preserving cartilage volume compared to LR-PRP. A recent meta-analysis of randomized controlled trials showed that PRP had better results compared to hyaluronic acid (HA), and a subgroup analysis showed that LP-PRP had better results than LR-PRP. However, there was no direct comparison between LR and LP-PRP, requiring further investigation. In fact, the largest study comparing LR-PRP to HA shows that LR-PRP has no side effects. In addition, a clinical trial directly comparing LR-PRP and LP-PRP showed no clinical differences in outcomes at 12 months. LR-PRP contains more pro-inflammatory molecules and higher concentrations of growth factors, but also contains higher concentrations of anti-inflammatory cytokines such as interleukin-1 receptor antagonists (IL1-Ra). Recent studies have described the "inflammatory regeneration process" of white blood cells secreting pro-inflammatory and anti-inflammatory cytokines, demonstrating a positive effect on tissue regeneration. Further clinical trials with a prospective randomized design are needed to determine the optimal formulation formulation or PRP and the ideal protocol for use in osteoarthritis.

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Therefore, some suggest that HA and PRP may be better treatments for patients with mild osteoarthritis and low BMI. Recent systematic reviews have shown that PRP has a better therapeutic effect compared to HA. However, unanimously proposed open points include the need for standardized PRP preparation, application doses, and the need for additional randomized clinical trials with high quality water. Therefore, current official recommendations and guidelines are often ambiguous with regard to support or opposition to the use of knee osteoarthritis. In summary, based on the current evidence, different preparation regimens limit the high methodological variability and PRP may lead to pain relief in mild to moderate osteoarthritis. The expert group advises against the use of PRP in severe cases of osteoarthritis. Recent studies have shown that PRP also contributes to the placebo effect, especially in the treatment of osteoarthritis or lateral epicondylitis. PRP injection may be just one part of an overall treatment strategy to address the biological issues of OA. In addition to other important factors such as weight loss, sprain correction, muscle training and knee pads, it can help relieve pain and provide patients with better outcomes.

The role of PRP in cartilage regenerative surgery is another hotly debated area. Although basic scientific research has shown a positive effect on chondrocytes, there is still insufficient clinical evidence for the use of PRP during surgery, cartilage regeneration surgery or rehabilitation phases, reflecting our results. In addition, the optimal timing of postoperative PRP treatment remains uncertain. But most experts agree that PRP can help promote biological cartilage regeneration. Taken together, the current critical review results suggest that further evaluation of the potential role of PRP in cartilage regenerative surgery is needed.

Indications for tendon injuries

The use of PRP in the treatment of tendinosis is a controversial topic in the literature. A review of basic science research indicates that PRP has positive effects in vitro (such as increased tendon cell proliferation, promotion of anabolic effects such as increased collagen production) and in vivo (increased tendon healing). In clinical practice, many studies have shown that PRP treatment has both a positive effect and no effect on various acute and chronic tendon conditions. For example, a recent systematic review pointed to the controversial results of using PRP in various tendon injuries, with a positive effect mainly on lateral elbow tendon injuries and patellar tendon injuries, but not on Achilles tendon or rotator cuff injuries. The vast majority of RCT surgical records show no beneficial effects and there is still no conclusive evidence for its conservative use in rotator cuff disease. For external epicondylitis, the current meta-analysis shows that corticosteroids have a positive effect in the short term, but the long-term effect of PRP is better. Based on current data, the patellar tendon and lateral elbow showed improvement after PRP treatment, while the Achilles tendon and rotator cuff do not appear to benefit from PRP. Therefore, the recent consensus of the ESSKA Basic Sciences Committee showed that there is currently no consensus on the use of PRP in the treatment of tendinosis. Despite the controversy in the literature, as recent studies and systematic reviews show, PRP plays a positive role in the treatment of tendon disorders, both from a scientific and clinical point of view. Especially considering the possible side effects of using corticosteroids in tendon disorders. The results of this study indicate that the current opinion in Germany is that PRP can be used in the treatment of acute and chronic tendon disorders.

Indication of muscle damage

More controversial is the use of PRP to treat muscle injuries, which are among the most common injuries in professional sports, accounting for about 30% of days off the field. PRP has the potential to improve biological healing and speed up the pace of recovery exercise, which has received increasing attention in recent years. Although 57% of first-round responses indicated muscle damage as the most common indication for PRP use, solid scientific evidence is still lacking. Several in vitro studies have observed the potential benefits of PRP in muscle injuries. The acceleration of satellite cell activity, the increase in the diameter of regenerated fibrils, the stimulation of myogenesis and the increased activity of MyoD and myostatin have been well tested. More information on Mazoki et al. An increase in the concentration of growth factors such as HGF, FGF and EGF was observed in PRP-LP. Tsai et al. highlighted these results. In addition to demonstrating increased expression of the proteins cyclin A2, cyclin B1, cdk2 and PCNA, skeletal muscle cell viability and proliferation have been shown to be increased by the transition of cells from the G1 phase to the S1 and G2&M phases. A recent systematic review summarized the current scientific background as follows: (1) In most studies, PRP treatment increased muscle cell proliferation, growth factor expression (such as PDGF-A/B and VEGF), white blood cell recruitment, and angiogenesis in muscles compared to model control group; (2) the technology of PRP preparation is still inconsistent in studies in the basic scientific literature; (3) Evidence from basic in vitro and in vivo scientific studies suggests that PRP can serve as an effective treatment method that can accelerate the healing process of muscle damage compared to the control group, based on the effects observed at the cellular and tissue level in the treatment group.

Although full recovery was reported in one retrospective study and time away from the center was not considered a significant benefit, Bubnov et al. in a cohort study of 30 athletes observed that pain was reduced and the rate of post-competition recovery became significant accelerated. Hamid et al. A randomized controlled trial (RCT) comparing PRP infiltration to conservative treatment regimens reported significantly faster recovery after competition. The only double-blind multicentre RCT involved hamstring injuries in athletes (n=80) and no significant infiltration of placebo was observed compared to PRP. The above promising biological principles, positive preclinical results and successful early clinical experiences with PRP injection have not been confirmed by recent high-level RCTs. The current consensus among GOTS members has evaluated conservative therapies for muscle injuries and concluded that there is currently no conclusive evidence that intramuscular injections can be used to treat muscle injuries. This is consistent with our findings and there is no consensus on the use of PRP to treat muscle injuries. There is an urgent need for further research on the dose, timing and frequency of PRP in muscle injuries. Compared to cartilage damage, the use of treatment algorithms, especially PRP, for muscle damage can be related to the level and duration of the damage, distinguishing between involvement of the damaged muscle diameter and possible tendon damage or sprain damage.

The scope of PRP is one of the most discussed areas and the lack of standardization is currently one of the major problems in clinical trials. Most experts have not noticed an increase in PRP use, but some studies have shown that supplemental use of hyaluronic acid is comparable to a single use of PRP for osteoarthritis. There is a consensus that multiple injections should be given in chronic diseases, and the field of osteoarthritis supports this, with multiple injections being more effective than single injections. Basic scientific research examines the dose-effect relationship of PRP, but these findings have yet to be translated into clinical trials. The optimal concentration of PRP has yet to be determined and studies have shown that higher concentrations can have negative effects. Similarly, the function of white blood cells depends on the indication, and some indications require PRP with weak white blood cells. The variability of the individual PRP composition plays an important role in the effectiveness of PRP.

Future research areas

It was unanimously recognized that according to recent publications there is a need for further research on PRP in the future. One of the main problems is that PRP formulations need to be better standardized (with 95% consistency). One possible aspect to achieve this could be platelet aggregation for larger volumes, which is more standardized. In addition, several parameters of clinical use are unknown, such as the number of injections to be administered, the time between injections and the dose of PRP. This is the only way to conduct high-level research and assess which indications are most appropriate for the use of PRP, which necessitates basic scientific and clinical studies, preferably randomized controlled trials. Although consensus has been reached that PRP may play an important role in the future, more experimental and clinical research now seems necessary.


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A possible limitation of the attempt to address the much-discussed topic of PRP use in this study is its ethnic characteristics. Availability of terms and differences in compensation between countries can affect performance and regulatory aspects. Moreover, the consensus is not interdisciplinary and only includes the opinion of orthopedic surgeons. However, this can be seen as an advantage as it is the only group actively implementing and overseeing PRP injection therapy. In addition, the conducted study has a different methodological quality compared to the rigorously conducted Delphi process. The advantage is the consensus formed by a group of orthopedic specialists with extensive professional knowledge in their field from a basic science and clinical practice perspective.


Based on the consensus of at least 75% of the participating experts, reach consensus on the following:

Osteoarthritis and cartilage damage: Mild osteoarthritis of the knee (KL II stage) may be helpful.

Tendon pathology: The use of acute and chronic tendon conditions may be helpful

Practical tip: In chronic lesions (cartilage, tendons), it is better to perform several injections (2-4) at intervals than a single injection.

However, there is insufficient data on the interval between individual injections.

Future research: Standardization of production, preparation, application, frequency and range of PRP indications is strongly recommended. More basic and clinical research is needed.


The general consensus is that there are differences between the different indications for PRP use and that there is considerable uncertainty about the standardization of the PRP program itself, especially between indications. The use of PRP in early knee osteoarthritis (class KL II) and acute and chronic tendon disorders may be useful. In chronic (cartilage and tendon damage) multiple injections (2-4) at intervals are preferable to single injections, but data on the interval between single injections are insufficient. A serious problem is the variability of the individual composition of PRP, which plays an important role in the role of PRP. Therefore, the production of PRP needs to be better standardized, as well as clinical parameters such as injection frequency, time between injections and precise indications. Even osteoarthritis, which is currently the best area of ​​research for PRP, needs more basic and clinical research, as well as other proposed indications.

(The content of this article has been reprinted and we make no express or implied warranties as to the accuracy, reliability or completeness of the content of this article and we are not responsible for the statements made in this article, please understand.)

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Application Deadline: May 24, 2023


What is the treatment of tendon and muscle using platelet rich plasma? ›

Platelet-rich plasma (PRP) therapy uses injections of a concentration of a patient's own platelets to accelerate the healing of injured tendons, ligaments, muscles and joints. In this way, PRP injections use each individual patient's own healing system to improve musculoskeletal problems.

Can PRP fix cartilage damage? ›

PRP also has the potential to improve knee function, possibly by reducing the inflammatory response and slowing the degenerative remodeling process of the articular cartilage.

What is platelet rich plasma therapy used for? ›

PRP treatment can help support wound healing in trauma and joint injury. The technique can address male pattern baldness, stimulate the growth of hair transplants and enhance other cosmetic procedures.

What is PRP treatment for tendon repair? ›

PRP and tendon injuries

PRP has been used extensively to treat chronic and acute tendon injuries in athletes as well as non-athletes. After injection, the PRP growth factors begin “signaling” cells and chemicals involved in tissue repair, activating natural healing responses near the injection site.

What is the success rate of PRP for tendonitis? ›

“They both work and approximately 70% to 80% of patients show improvement regardless of which treatment they receive.” Similar outcomes have also been found for whole blood injections, in which blood is removed from the patient and injected into the site of the injured tendon without any additional preparation.

How long does it take for PRP to work on tendons? ›

PRP can be injected deep into joints to reach ligaments and attachment points on tendons with no immobilization required. This improves patient outcomes considerably, with most patients finding results within 4 weeks.

How much does PRP cost? ›

The cost of a single PRP treatment will typically be in the range of $ 500–2,500. People may also require repeat treatments. Costs can vary depending on location, facilities, and the expertise of the doctor performing the treatment. It is also of note that few insurance plans cover the cost of PRP treatment.

Can you take anything to rebuild cartilage? ›

Dietary supplements: Dietary supplements such as glucosamine and chondroitin are the non-surgical treatment options for cartilage restoration. Chrondroitin sulphate and glucosamine are naturally occurring substances in the body that prevent degradation of cartilage and promote formation of new cartilage.

Does anything rebuild cartilage? ›

Because cartilage does not have a blood supply, it has limited ability to repair itself. Cartilage regeneration, along with strengthening muscles around the joint, can help some patients delay joint replacement surgery for damaged joints.

Who should avoid PRP treatment? ›

While PRP is considered safe for most people, it's not recommended for anyone who has one of the following medical conditions:
  • Hepatitis C.
  • HIV or AIDS.
  • Any type of blood cancer.
  • Cardiovascular disease, which requires taking a blood thinner.
  • Skin cancer in the area to be treated.

Are PRP injections covered by insurance? ›

Although platelet-rich plasma injections are not covered by insurance, they could be the long-term solution to your problem, saving you hundreds to thousands of dollars on other necessary potential treatments.

How painful is PRP? ›

DO PRP INJECTIONS HURT? Because the injured area is first anesthetized with lidocaine, the actual injections are only slightly uncomfortable. The lidocaine wears off in a few hours, and there is usually mild to moderate pain for the next few days.

How long is recovery from PRP tendon? ›

PRP injections are utilized in various procedures but mainly treat muscle, tendon, ligament and joint injuries. Sustaining musculoskeletal injuries requires a significant amount of recovery time. Most patients need three to six months of rest before returning to regular activities.

How long does PRP recovery take? ›

In general, the usual recovery time for any PRP treatment is about 4 to 6 weeks. PRP injections that are used for musculoskeletal issues, particularly injuries to the joints, usually require 6 weeks or more.

How long does pain last after PRP injection? ›

What should I expect immediately after PRP injections? You may have some soreness and tenderness at the area of the injections for a few days. This soreness and some swelling can last three to seven days, and then movement and comfort at the joint gradually increases over two weeks.

Can PRP repair torn tendon? ›

Many experts believe that the natural healing properties found in platelets and plasma facilitate healing and repair in damaged tendons. When treating a damaged tendon with platelet-rich plasma, the doctor injects PRP directly into the affected area. The goal is to: Reduce pain.

Is PRP better than cortisone? ›

Cortisone Injections have immediate pain relief but is primarily a temporary solution. With PRP on the other hand, it offers not only pain relief but also tissue regeneration and healing but has a longer healing and pain relief time.

Can PRP regenerate ligaments? ›

Tendons and ligaments generally heal very slowly because they have very little blood flow. However, with PRP injections, tendons and ligaments have been shown to increase their regeneration and increase the strength of the tissues after healing.

What can you not do after PRP? ›

Any kind of exercise after PRP injection must be avoided for at least two weeks after the procedure, as this can impact the injection's efficacy and even cause complications.

What foods to avoid after PRP treatment? ›

After your Platelet Rich Plasma (PRP) treatment you should: • Avoid alcohol, caffeine, hot drinks and spicy food for 24 hours, as these may exacerbate bruising and swelling.

Does PRP injection regenerate cartilage? ›

The PRP accelerates and boosts healing, so your body can actually repair significant amounts of damage that it can't handle by itself. Research has shown that PRP can actually help you regenerate cartilage that's been degraded by osteoarthritis or rheumatoid arthritis.

How many times a year should you do PRP? ›

However, many patients choose to undergo routine rounds of PRP therapy about 1 – 2 times per year to maintain consistent hair growth over a longer period of time.

What is the best PRP treatment cost? ›

The cost of Hair Re-growth treatment in India per session ranges from ₹ 5,000 to ₹ 15,000.

Is PRP lifelong? ›

Let's Talk about Longevity. How Long Does PRP for Hair Really Last? You'll need to complete a series of four to six treatments to achieve real PRP hair treatment results, and you'll be able to enjoy new hair growth for about 18 to 24 months. Because PRP is not permanent, touch-up treatments are recommended once a year.

What is the best vitamin for cartilage repair? ›

Vitamins D and K are both important for bone strength, and vitamin K is involved in cartilage structure. Supplementing these two nutrients may be helpful if you're deficient in them. When you take supplements as directed and under your doctor's supervision, they're generally safe.

What supplement gives more cartilage? ›

Glucosamine is one of the substances in your body that is used to build cartilage.

Does walking rebuild cartilage? ›

Exercise can help rebuild the joint, Robertson says. "Cartilage is like a sponge, and it gets nutrients from the compression and decompression of your body weight as you walk."

What can you take to rebuild cartilage naturally? ›

Glucosamine Sulfate

Glucosamine, like hyaluronic acid, is a basic component of cartilage and synovial fluid. While the body produces glucosamine naturally, dietary glucosamine could help to boost the body's stores of this substance, supporting cartilage synthesis.

What supplements to avoid with PRP? ›

Continue to avoid using NSAIDs (Ibuprofin, Aspirin, Naproxen, Aleve, Motrin, Advil) for one week after your PRP procedure. Continue to avoid these nutritional supplements for one week after your procedure: Vitamin E, Flax Oil, Fish Oil, Vitamin A, Curcumin, Turmeric, Aloe, and Astaxanthin.

What causes PRP to fail? ›

When PRP doesn't work, it is usually not the solution used during treatment, but how the treatment itself is given. PRP methods vary by practitioner. Research consistently points to PRP ineffectiveness as being caused by the way the treatment is given and poor patient selection. PRP does not work for everyone.

Why no caffeine after PRP? ›

Caffeine can cause blood to flow faster and worsen bruising. There are no major side effects to caffeine. However, patients who have PRP injections under their eyes should make sure they don't get a big bruise. You can normally consume small amounts of caffeine.

Is PRP worth it? ›

“Research shows that PRP not only decreases hair shedding and stimulates new hair growth, but it also increases the thickness of the hair follicle itself. That's a huge win for many of my patients. I find myself recommending and performing hair PRP about five times per day at the office.

How long does it take for PRP injections to work? ›

How long does it take for PRP injections to work? The benefits of PRP injections may take between four and six weeks to be noticeable to the patient. Even beyond this window, the platelet-rich plasma will continue to aid in further healing for anywhere from six and nine months.

Does PRP work for rotator cuff tears? ›

Partial rotator cuff tears may heal with non-operative management, including platelet rich plasma or PRP injections. A review of your MRI and a diagnostic ultrasound can help determine if a partial tear will respond to PRP. Ultrasound guided injections are the best way to ensure the PRP is placed in the tear.

Can PRP cause nerve damage? ›

PRP injections for the treatment of partial UCL injuries of the elbow may place some patients at risk of developing postinjection cubital tunnel syndrome from increased fibrosis around the ulnar nerve.

Should you rest after PRP injection? ›

We recommend that patients take a rest day after their PRP Therapy session. We recommend that patients rest for the next two days. However, movement is encouraged. As the injection is absorbed into the surrounding tissues, this helps to heal the joint.

How many times do I have to do PRP to see results? ›

We recommend starting with 4 treatments, four weeks apart for best results for most people with thinning hair as an initial treatment. You will need maintenance treatments every one to two years thereafter to maintain the results of your PRP hair regeneration treatment.

When does PRP not work? ›

PRP failure may also result from a doctor who is inexperienced in using the technology. For example, many physicians who inject toxic anesthetics like Marcaine/Bupivicaine, or harmful high dose steroids, may continue to use these noxious drug chemicals with PRP, counteracting much of its healing effects.

How can I make PRP more effective? ›

There are some steps you can take to ensure you get the most out of your PRP therapy.
  1. Eat Dark, Leafy, Green Vegetables. ...
  2. Increase Your Iron And Vitamin B Intake. ...
  3. Engage In High-Intensity Cardio Exercise. ...
  4. Refrain From Smoking And Drinking. ...
  5. Avoid Food And Drinks That Reduce Platelets. ...
  6. Follow Your Provider's Instructions.
Jan 14, 2022

Does PRP cure tendonitis? ›

PRP accelerates healing of tendonitis

Once platelets reach the damaged tissues, they release substances that are essential for healing, including proteins called growth factors that trigger tissue regeneration.

What is platelet rich plasma injections for arthritis and tendonitis? ›

PRP treatments involve collecting a small amount of your blood and spinning it in a centrifuge machine to separate the platelets from the red blood cells. In the case of knee OA, the collected platelets are then injected into the knee to stimulate healing and regeneration.

Do platelets repair muscle? ›

The platelets of the individual are concentrated. They are then used to accelerate the healing of damaged muscles and tissues. The platelets contain proteins and growth factors to accelerate the repair of degenerative tissues, including muscles, ligaments and tendons.

How long does PRP last? ›

Clinical studies have shown that PRP injections can be effective for up to nine months. Nevertheless, the precise amount of time that PRP injections last essentially varies from person to person. Overall outcomes vary from situation to situation, as well.

Can PRP heal rotator cuff? ›

In the past, patients would often need surgery to treat a rotator cuff tear, but that isn't the case anymore. Thanks to the advancement of medical technology, platelet-rich plasma or PRP therapy can help you restore your rotator cuff through natural regenerative therapy.

How long does pain last after PRP? ›

You may have severe pain at the PRP site for 24 to 48 hours. Please use Tylenol or Ultram (tramadol) as needed, but do not take more than 3,000 mg of Tylenol in 24 hours. You may be given narcotic pain drugs. NOTE: Some narcotic pain drugs have Tylenol in them.

How painful are PRP injections? ›

DO PRP INJECTIONS HURT? Because the injured area is first anesthetized with lidocaine, the actual injections are only slightly uncomfortable. The lidocaine wears off in a few hours, and there is usually mild to moderate pain for the next few days.

How soon can I walk after PRP injection? ›

How long after PRP can I exercise? Any kind of exercise after PRP injection must be avoided for at least two weeks after the procedure, as this can impact the injection's efficacy and even cause complications.

Can I take PRP for lifetime? ›

Unfortunately, PRP can't cure hair loss. It can only temporarily restore your follicles' ability to regrow hair. So, it can't be considered a permanent solution.

Why am I losing more hair after PRP? ›

Because of the natural cycling of hair follicles (on and off, essentially) when you stimulate the hair follicle using a strong hair regrowth treatment like PRP, Minoxidil etc. it is very common to see a short term shedding phase.

How many times can you do PRP? ›

PRP injections are usually given every one to four weeks, depending on the condition being treated. Injections of PRP are often used to rebuild cartilage. A single round of injections can give the knees a life expectancy of 10 years.


1. Dr Garcia lectures on orthobiologics and PRP
(Orthopedic Specialists of Seattle)
2. FAQs About PRP Injections With Guest Dr. Mike Baria
(More 4 Life)
3. Regenerative Medicine, Stem Cell, PRP, Exosomes in Knee: Prof. Nicola Maffulli
(Global Regenerative Medicine Experts)
4. Dr Lucas Furtado; Stem Cells, PRP, Bone Marrow Concentrate in Foot & Ankle, Orthoregen
(Global Regenerative Medicine Experts)
5. Thomas Barnes, M.D. discussing PRP Skin Therapy Newport Beach withRandy Alvarez
(The Wellness Hour)
6. Steroid Injections for the Knee and Shoulder: Indications, Risks, Benefits - Brian Feeley, MD
(UCSF Orthopaedic Surgery)


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