PRP is made from a small sample of your blood

The exam comes before the PRP

First, the doctor or nurse asks when the ache began. Movement and strength checks help locate the sore tissue.

An X-ray or another test may add useful facts. PRP won't fit every cause found during the exam.

Tell the office what care you've already tried. The answer may include exercise, medicine, a brace or surgery instead.

The blood sample is prepared at the clinic

The syringe size doesn't show how many platelets it holds. It also can't say whether the joint will feel better.

A platelet count tells how many of those blood pieces are present. Research has not set one sure count for relief.

White blood cells can vary too. Some PRP mixes have caused more brief soreness and swelling.

Concentrated PRP is among the regenerative treatments available at QC Kinetix, where trained medical providers prepare and place it. Have the office describe the blood mixture and explain the choice.

A written quote makes the cost clear

Patients usually pay this bill themselves. A written quote should say whether it covers one visit or a course.

The quote should also list the follow-up care. Before paying, ask how the bill changes when the exam rules PRP out.

Keep the quote while you think about the choice. Compare its full cost with exercise, medicine, a brace or surgery.

Ask when payment is due and whether unused visits can be canceled. Don't sign until every charge and follow-up duty is clear.

Sources

1. The DEPA classification was built because platelet and leukocyte counts alone do not describe an injection. Applied retrospectively to 20 published PRP preparations, the dose of injected platelets ranged from 0.21 billion to 5.43 billion - a 25-fold spread. No device recovered more than 90% of the platelets in the blood drawn, and most preparations were contaminated with red blood cells: only three of the devices reached a purity score corresponding to more than 90% platelets relative to red cells and leukocytes.

   Magalon J, Chateau AL, Bertrand B, et al. — DEPA classification: a proposal for standardising PRP use and a retrospective application of available devices. BMJ Open Sport & Exercise Medicine, 2016. DOI: 10.1136/bmjsem-2015-000060.

2. A prospective cohort of 253 patients with KL 1-3 knee OA treated with three injections of 5 mL of autologous PRP found that platelet concentration positively correlated with clinical outcome. KOOS Pain improved more with higher platelet concentration at 2 months (P=.036), 6 months (P=.009) and 12 months (P=.014), with the same trend across other KOOS subscales and IKDC. The failure rate was 15.0% in the low-platelet group versus 3.3% in both the medium- and high-platelet groups, with no difference in adverse events.

   Boffa A, De Marziani L, Andriolo L, et al. — Influence of Platelet Concentration on the Clinical Outcome of Platelet-Rich Plasma Injections in Knee Osteoarthritis. American Journal of Sports Medicine, 2024. DOI: 10.1177/03635465241283463.

3. A systematic review of 29 randomized trials of PRP for knee OA that reported a platelet count, concentration or dose found that the 28 treatment arms with statistically significant positive outcomes at 6 months had a mean platelet dose of 5,500 (+/-474) x 10^6, while the three arms without a positive difference averaged 2,302 (+/-437) x 10^6 (P<.01). The same separation held at 12 months: 5,464 versus 2,253 x 10^6 (P<.05).

   Berrigan WA, Bailowitz Z, Park A, et al. — A Greater Platelet Dose May Yield Better Clinical Outcomes for Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis: A Systematic Review. Arthroscopy, 2025. DOI: 10.1016/j.arthro.2024.03.018.

4. A systematic review and meta-analysis of platelet dosage across musculoskeletal conditions identified a potential dose-response relationship in knee osteoarthritis, with an apparent threshold above 10 billion platelets for favourable clinical outcomes, and the effect more pronounced for function than for pain. For conditions other than knee OA the authors found the literature too unclear to identify an optimal dose.

   Berrigan W, Tao F, Kopcow J, et al. — The Effect of Platelet Dose on Outcomes after Platelet Rich Plasma Injections for Musculoskeletal Conditions: A Systematic Review and Meta-Analysis. Current Reviews in Musculoskeletal Medicine, 2024. DOI: 10.1007/s12178-024-09922-x.

5. A randomized study of 150 patients compared PRP standardised to an absolute count of 10 billion platelets against hyaluronic acid, following patients for one year. Adding a 1-micron filtration step raised platelet recovery to about 90%. WOMAC, IKDC and 6-minute pain-free walking distance were all significantly better in the PRP group at one year, and the authors concluded that an absolute count of 10 billion platelets is the critical variable for a sustained effect in moderate knee OA.

   Bansal H, Leon J, Pont JL, et al. — Platelet-rich plasma (PRP) in osteoarthritis (OA) knee: Correct dose critical for long term clinical efficacy. Scientific Reports, 2021. DOI: 10.1038/s41598-021-83025-2.

6. A triple-blind randomized trial in 99 knees with early (KL 1-2) knee OA compared a conventional 4 mL PRP dose (mean 2.82 billion platelets) with an 8 mL 'superdose' (mean 5.65 billion), both leukocyte-depleted and prepared identically. Both groups improved on WOMAC, VAS and KOOS over six months. The trial is a direct demonstration that 'a PRP injection' is not one intervention: the same preparation at two volumes delivers a two-fold difference in platelet dose.

   Patel S, Gahlaut S, Thami T, et al. — Comparison of Conventional Dose Versus Superdose Platelet-Rich Plasma for Knee Osteoarthritis: A Prospective, Triple-Blind, Randomized Clinical Trial. Orthopaedic Journal of Sports Medicine, 2024. DOI: 10.1177/23259671241227863.

7. A meta-analysis of seven high-quality randomized trials (575 patients) comparing single-dose with multiple-dose PRP for knee osteoarthritis found triple-dose PRP produced significantly better VAS scores than a single dose at 12 months (P<.0001), while double-dose did not differ significantly from single-dose at 12 months. Adverse events did not differ significantly between the double-dose or triple-dose arms and single dose.

   Tao X, Aw AAL, Leeu JJ, et al. — Three Doses of Platelet-Rich Plasma Therapy Are More Effective Than One Dose of Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-analysis. Arthroscopy, 2023. DOI: 10.1016/j.arthro.2023.05.018.

8. An earlier meta-analysis of five randomized trials (301 patients) found that at six months, single and multiple PRP injections produced similar pain improvement with no significant difference, while knee function favoured multiple injections. The two meta-analyses together support a modest functional advantage for a course of injections rather than one, without settling the number.

   Vilchez-Cavazos F, Millan-Alanis JM, Blazquez-Saldana J, et al. — Comparison of the Clinical Effectiveness of Single Versus Multiple Injections of Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis: A Systematic Review and Meta-analysis. Orthopaedic Journal of Sports Medicine, 2019. DOI: 10.1177/2325967119887116.

9. A systematic review that screened 876 studies and extracted standardised data from 33 commercially available PRP systems and protocols found that final product concentrations of platelets, white cells and growth factors varied widely between systems, as did the preparation protocols themselves. Platelet concentration correlated directly with the volume of blood drawn and with the centrifugal force of the device. The authors called the heterogeneity between separation systems something that 'must be resolved for proper study of this promising treatment'.

   Fadadu PP, Mazzola AJ, Hunter CW, et al. — Review of concentration yields in commercially available platelet-rich plasma (PRP) systems: a call for PRP standardization. Regional Anesthesia and Pain Medicine, 2019. DOI: 10.1136/rapm-2018-100356.

10. Medicare's national coverage policy covers autologous platelet-rich plasma ONLY for patients with chronic non-healing diabetic, pressure and/or venous wounds, and only within an approved coverage-with-evidence-development clinical study. There is no Medicare national coverage for PRP in osteoarthritis or tendinopathy, which is why these injections are billed to the patient as cash-pay.

    Centers for Medicare & Medicaid Services — Autologous Platelet-rich Plasma (Coverage with Evidence Development). CMS.gov, 2024.