PRP Therapy in Orthopedics: What Is It and Does It Work?

What Is PRP Therapy?

Platelet-Rich Plasma (PRP) therapy is a regenerative treatment using concentrated platelets derived from a patient's own blood. Platelets are blood cells that contain growth factors — proteins that signal cellular repair, proliferation, and regeneration. By concentrating platelets and injecting them into an injured tissue, PRP aims to amplify the body's natural healing cascade.

PRP has gained widespread popularity in sports medicine, orthopedics, and aesthetics over the past 15 years, and is used by many elite professional athletes. However, the scientific evidence for PRP is evolving — some conditions have strong evidence, others have weak or conflicting data.

How PRP Is Prepared

Blood draw: 30–60 ml of venous blood is drawn from the patient (similar to routine blood tests)
Centrifugation: Blood is placed in a centrifuge and spun at high speed, separating blood components by density
PRP extraction: The platelet-concentrated layer is collected; platelet concentration is typically 3–5x above baseline blood levels
Activation (optional): Some systems add calcium chloride or thrombin to activate platelets before injection
Injection: PRP is injected into the target tissue — often guided by ultrasound for precision

The entire process takes approximately 30–45 minutes in the office.

Types of PRP

PRP formulations vary significantly by preparation system — these variations affect outcomes and make study comparisons difficult:

Leukocyte-rich PRP (LR-PRP): Contains white blood cells in addition to platelets; pro-inflammatory; may be better for tendons
Leukocyte-poor PRP (LP-PRP): White cells largely removed; anti-inflammatory; may be better for joints
Growth factor concentration varies by preparation system

Conditions with PRP Evidence

Strongest Evidence

Lateral epicondylitis (tennis elbow): PRP shows superiority over corticosteroid injection at 3–12 month follow-up in multiple randomized trials; particularly effective for chronic cases (>3 months)

Knee osteoarthritis: Multiple randomized trials and meta-analyses show PRP superior to hyaluronic acid (viscosupplementation) and comparable or superior to corticosteroids for symptom relief at 6–12 months

Moderate Evidence

Plantar fasciitis: PRP shows benefit for chronic plantar fasciitis; comparable or superior to corticosteroid injection at long-term follow-up

Achilles tendinopathy: Inconsistent results in the literature; may benefit select patients

Rotator cuff tendinopathy/partial tears: Some evidence for benefit; insufficient evidence to recommend routinely

Patellar tendinopathy (jumper's knee): Emerging evidence suggests benefit over competing treatments

Limited or No Established Evidence

Complete rotator cuff tears after repair (augmentation)
Labral repairs
Bone healing augmentation

What to Expect During Treatment

Blood drawn from your arm
Blood processed in the office (30–45 minutes)
Target area may be numbed with local anesthetic (lidocaine)
PRP injected under ultrasound guidance for precision
Brief period of increased soreness expected for 3–7 days after injection (as the inflammatory cascade is activated)
Activity restriction: Light activity for 1–2 weeks; avoid NSAIDs and ice for 1–2 weeks (these suppress the inflammatory healing response that PRP triggers)
Most patients see improvement beginning at 4–8 weeks; full effect at 3–6 months

A series of 1–3 injections may be recommended depending on condition severity.

Limitations and Considerations

Not covered by most insurance: PRP is considered investigational by many payers; expect out-of-pocket cost of $500–2,000 per injection
Standardization: Variable preparation protocols across providers make outcomes unpredictable; ask about platelet concentration and leukocyte content
Not a cure-all: PRP works best as part of a comprehensive treatment plan including physical therapy and activity modification
Time to effect: Benefits take weeks to months — PRP is not an immediate-relief treatment

Finding PRP Treatment

PRP injections are performed by orthopedic surgeons, sports medicine physicians, interventional physiatrists, and in some areas by rheumatologists. Ultrasound guidance improves accuracy of injection — ask whether guidance is used.