That is awesome you get the patients input on further PRP's. My MD did the same, the first two PRP's helped, but still not great,. The third injection was life changing, although I still had some pain. The fourth one is making it better. We see definite progress with each new PRP. So I will continue 4 PRP's a year, every three months, indefinitely . Costing $3,000 per YEAR. Not much for having no surgery. Thank you!
Great video. I had one PRP injection on my right knee back in 2017 and got good relief. Then in 2019 I got one PRP injection on my left knee. Now it is Oct 2023 and I’m still doing well with only very minor pain in my knees after exertion. However, I’m thinking of going back and getting a second PRP injection on both knees as a “booster”.
I had my first PRP injection this afternoon after my doctor removed fluid from my knee. It felt better immediately. I will see how the aftermath is. I get another injection next month.
I have tennis elbow on my right elbow since last year. Had Mri done and found that I had a 3mm tear. Had 3 therapy sensions of 9 times each. 9 rounds of acupuncture and got a cortisone shot in August. I was off work for 6 months. After 2 weeks after the cortisone shot, I went back to work and was feeling great. I took it easy at work, but I started to feel my left elbow starting to get strained a month ago. And now my right both my elbows hurt. I ca n't sleep unless I wear my compression sleeves on both arms. It even hurts to lift my blanket at night. Just went with my specialist today, and he ordered a prp injection for my right elbow and a mri for the left side. I'm hoping this relives the pain.
@strovrpwr had a prp shot on April 28th. Shot was a little painful. I took it easy over the weekend and went back to work on Monday. Took it easy as work also. About 1 to 2 weeks after I noticed, I can get more range of motion. And was waking up pain-free in the morning. I still take it easy, not lifting anything too heavy. If I start to use my arm, it feels strained for a few hours. At this time I says it's pain wise it's about 70 percent better. And as for using arm it's about 50 percent better. I'm thinking of getting a other shot in a few months again.
Excellent video. I just need to know the cost. My insurance paid for the 3 series of hyaluronic. I’m scheduled for the single hyaluronic injection soon but after that my next treatment will be PRP.
Very interesting observations! Thank you for the opportunity to get to know the essence of this therapy better! Could you issue a questionnaire to assess the effectiveness of the therapy and the number of injections?
I greatly appreciate your videos! I have been doing a lot of reading and listening to alternative treatments for knee arthritis. Yours are abundant, clear rest, so thank you. Is there a network of physicians who share your philosophy? I’m looking for someone in West Michigan.
Got a PRP injection w/ hyalruronic acid 3 weeks ago for cartilage lesion/ "chondral defect of lateral trochlea." Was this the right decision? Previously got a PRP injection for partial patellar tendon tear and next MRI showed the tendon healed. MRI CONCLUSION, 1 month ago before PRP; -Full-thickness full-thickness chondral defect of the lateral trochlea with subchondral reactive marrow change of the underlying bone. -Small knee effusion. -Tiny Baker cyst
Great video Doctor. I got 2 PRP injections, the 2nd one at the 3 month mark from the 1st dose. Now I feel good. My pain level have come down and the knee function is gradually improving. My doctor suggested not to go for the 3rd one now, but go for yearly booster more from a prevention perspective.
@ Bharath - Did you get your PRP for osteoarthritis or chondronmalacia patella grades? Please specify since I had one PRP plus Hylauronic Acid together on 15th May 2023.
Great Video. I've been shopping around for PRP in my area and discovered 1 Dr. Office that warns against some Doctors using PRP kits that provide a lesser, non effective concentration of platelets in their injections. Was curious what your concentration number is and how can we protect ourselves against getting a "watered down" version. ?
Great question! As a patient, you have every right to ask which kit your provider is using and more importantly, ask WHY they are using that kit. Platelet concentration is one of many factors to consider.
I have just had my meniscus repaired along with a couple other clean up things on my knee. I am going to try this my insurance doesn't cover PRP. I had PRP done in my shoulder and it helped amazing. I had two injections. My shoulder is bad. Need total replacement. I now am careful and have no pain. Would you say take one and wait and do another. I am not concerned about money! I am thinking about trying Stem Cell. What do you think about the two?
@@kakarot4701 I didn't on my knee. It is better than 100% I just worked it hard and finally it regained the strength and now zero pain and it's equal to my other knee if not stronger. I did a lot lot of one leg, leg presses to get where I am today. The PRP most definitely helped my shoulder.
I do HA injections and I find that at the 4 week follow up, they are still having pain, it's often the Pes Anserine Bursa. A steroid into that Bursa gives instant relief. I've dine a few PRP and will be doing more in the future. Thank you for posting this video.
Wonderful video. I had PRP and Hyaluronic acid together last January for knee arthritis. Pain has decreased 80%. Plan for another injection in September. This combination has worked for me. What is your opinion about this combo. Thanks
Can you please speak about 1st generation prp where the platelets are spun for 5 min vs 2nd generation prp where the platelets are spun for 4 hours; what is the benefits of longing spinning time in treatment; thank you Dr. Peng
Thank you for posting, Dr !! I had PRP plus Hylauronic Acid together for chondronmalacia Patella Grade IV treatment on 15th May 2023 in my right knee. Just three days got over. Can I expect the betterment for my chondronmalacia patella Grade IV knee pain. I was asked to take a rest for a week and thereafter to start exercising slowly on VMO, IT band, and hamstring exercises as well. Please provide your input and recommendations.
Great video Dr. Peng! I have psoriatic arthritis and a knee injury which we believe is unrelated. Eleven years ago I had a surgery to repair the meniscus. It was an easy out patient procedure, pain free and successful. A bit more than a year ago I had knee pain and an MRI showed damage to the medial aspect of the meniscus, damage that couldn't be surgically repaired. A PRP shot provided relief but almost a year later pain returned and I got another PRP injection. Do you have experience with PRP injections for a damaged meniscus as vs. osteoarthritis? Thanks!
Love your videos. I had the cortisone shot 3 weeks ago and had little relief. I have requested prp now and have tricare so hopefully, I can get on the mend. I have referenced your findings and my questions are regarding what you have recommended. My only question is do they need to use the ultrasound for a knee for the shot or just for the muscle issues?
Excellent presentation Doc, can i get a second session of prp after 4 months? I received an improvement from first session but still having pain not as bad before prp. Or should i wait 6 months or a year? Is it safe to get it after 4 months?
Recent Australian study somewhat put a pin in the prp hype. It was a double blinded study which found no difference between PRP and saline injections in terms of long term improvement.
The RESTORE trial and the more recent PEAK study both had fatal flaws. Both studies used LOW DOSE platelet rich plasma. It's like saying acetaminophen doesn't work for reducing fevers when compared to saline placebo because a study used 10mg of acetaminophen whereas the therapeutic dose is 500mg or even 1000mg. The conclusion of those studies should have stated "low dose PRP is no more effective than placebo". All the latest clinical trials report platelet counts and concentrations. What's CLEAR in the literature is high dose PRP provides incredible results. Here's more info: th-cam.com/video/NPrNeyx6Bv8/w-d-xo.html
I am 52 and have a degenerative lateral meniscus with mild/moderate arthritis, resulting in continuous pain. I had one prp a year ago and it helped a bit but not enough to be pain-free. My consultant has recommended a course of 3 prp's, which I'm happy to do, but he suggested weekly intervals between prp's and I'm concerned from research, that weekly is too quick for optimum impact. (I've been told surgery isn't recommended). What is your opinion on the timing apart to really get the absolute best benefit?
I 100% agree. My goal is to get the word out, educate people, and support more studies. Once more and more studies show benefit, insurances will start covering. Thanks for your comment.
How did it go for your hip? I thought I needed one for both hips as well..instead however it was both of my Sacroiliac joints that I needed to get prp on. Just had them done 4 days ago
1) All PRP injections are made in Gerdy's tubercle independly of the knee condition? 2) Whats the frequency of the PRP injections? 1 per week? In the study cited by you said 3 injections (one week interval of each other).
1. Not sure what you mean here. 2. The frequency of PRP injections in studies administering more than 1 shot is once a week. However, other studies have shown that 1 shot also gives excellent benefits. In the real world (ie. outside a clinical trial), the frequency of shots is often individualized.
I have severe knee osteoarthritis. I got a PRP injection 1 month ago. The injection met all of the criteria you mentioned in your videos(including 10 Billion double spinned platelets and ultrasound). There has been no change in my pain since then. I am trying to answer the question about wether I should get a knee replacement or keep waiting to see if the PRP starts to work. Any comments would be very much appreciated.
When you have a second and third injection do you you have to go back to square one with regard to what exercise you can do or can you continue from where you are at?
My husband has been dealing with a knee issue which flares up off and on after doing something to it about 5 years ago. He is normal weight, no chronic health issues and the X-ray shows no arthritis. For specific reasons, he does not want an MRI or CAT scan, and we already know it's soft tissue, so that would be a very expensive redundancy and the only info we would potentially get would be for PT, which isn't an option right now. I wonder if/how prp injections would help him? He does get a chiropractic adjustment to make sure all the leg joints are in alignment and that helps some. The pain SEEMS to be mostly in the PA bursae area but the swelling is on the other side of his knee, which is interesting.
How many treatments should I get if I got acl surgery about 2 weeks ago? I really want to help the healing to improve and I read that prp or stem cell injections can really help with healing even after knee surgery! Do you think this would be good for me and how many treatments so my knee can have more flexibility? It feels so stiff from surgery!! Thanks and great video!!! 🤩😍
Does PRP heal a complex 4mm meniscus tear on medial horn root with full baring weight because the surgeon said too and wants to address the arthritis first
In general, go for the lighter impact surfaces. That's going to be a sports track and even some good high end treadmills. Concrete running will be the hardest on the knees. Grass and dirt such as trail running can be good but tends to be uneven which, for people returning from injury, can sometimes cause problems. Hope that helps!
Hi Dr. Peng, do you have a good referral to a orthopedic specializing in knee/sports injury in the San Diego area? Thank you for the great material you put up.🙏
At what stage of arthritis is prep effective. I have quite a bit of narrowing in space in my knee cartilidge/meniscus. I have had visco supplementation mixed with cortisone and this has seemed to improve my stiffness.
Thanks for your comment. As far as I am aware, MACI is not used for the treatment of osteoarthritis. It really is reserved for those with a focal osteochondral defect. This is because those with more diffuse arthritis need a fairly large graft surface area. My guess is one day this will happen, but not at this time.
Hi doctor, 2 years ago I was daignosticated to have shoulder osteoarthritis. I got during the first year 4 cortison injections, but that wasnt long term. Now I've got 3 prp injections and expecting a fourth, and Im feeling good, altough my rotator is still poping on some movements. Can I expect of the prp injections to heal my osteoarthritis once for all? I appreciate your time, thanks in advance!
If you’re bone on bone in at least one compartment of your knee, will PRP do any good? I had a total knee replacement on my right knee, which was even worse, bone on bone in the medial and middle part and a lot of scar tissue. I just want something to hold me out another 6 months to a year before I get my left knee replaced. I like to ski in the winter and don’t want to burn up what’s left of my sick leave, which is why I want to delay. I got cortisone in both knees a little over a year ago and they put a bandaid on it for a short time.
If someone has Chondromalacia along with mild cartilage thinning, does PRP re attach the wear and tear of cartilage to the patella and prevent the cartilage from tearing?
PRP does not regenerate anything, rather it helps change the microenvironment of the joint to decrease symptoms and protect the cartilage from getting worse
@@JeffreyPengMD thank you Doc.This is Patrick from Down under Melbourne Australia.Your you tube are very educational.Thanks God bless you and always at good health.
Hi Jeffrey - I have been watching all your videos. I am curious to learn your opinion as to whether I would benefit from PRP in view of the condition of my right Knee. Yes or No would suffice! This may also help many of your subscribers.... Findings: A moderate joint effusion is seen and there is a large popliteal cyst. There is evidence of chronic synovitis in the lateral suprapatellar pouch. This is associated with generalised loss of retropatellar cartilage and chondral thinning across the trochlea but no gross subchondral signal change. There is complex degenerative tearing of the posterior horn of the medial meniscus with a developing parameniscal cyst. There is narrowing of the medial joint space compared to the lateral joint space which is well-maintained with a normal meniscus. The cruciate and collateral ligaments, popliteus tendon and iliotibial band remain normally attached Conclusion: The scans confirm the presence of a complex degenerate tear of the posterior horn of the medial meniscus associated with generalised chondral volume loss in the medial compartment and a prominent popliteal cyst. There is also established chondral loss in the patellofemoral compartment with chronic suprapatellar synovitis.
Unfortunately, I can't give medical advice over the internet. All I can say is that your MRI describes a knee that has osteoarthritis. Please seek the advice of your trusted health care provider. Best of luck!
Thanks for your question, unfortunately there are very few clinical trials looking to answer this question. So right now, we don't know if PRP can be used in the setting of rheumatoid arthritis.
I had two PRP on my knee and my ankle. The first injection is great both, feel a lot better, so I did a second injection 6 month later. However, the second injection didn’t do much. I’m now 9 months from the second PRP. Should I get a third injection? I’m ok with the cost as long as it make me feel better
Thanks for your comment. Unfortunately I cannot give medical advice over the internet. Please seek the advice of your trusted health care provider. Best of luck!
My orthopaedic dr is leaning heavily on hyaluronic acid injections for my mild knee arthritis issues. He told me that PRP isn't covered by insurance, whereas the other treatment is. To me, cost shouldn't be the primary driver for choosing the medical solution, and I sense he's not very forward thinking. Do you see that as a common issue in the field?
How many PRP injections needed for chondromalacia Patella Grade 4 and one of the doctor has advised me for sanakin injection please let me know about this ?
Good question -- we don't know! I've had people with grade 4 arthritis who only need one PRP shot, and others who need 3. Only way to know is to try and see how you feel. I know that's not the answer you wanted to see, but the reality is everyone's body is different and has different amounts of growth factors and platelets.
@@JeffreyPengMD I have the same problem. I got 1 PRP injection and I was completely pain free - the problem is that the 1 injection only lasted 4 months. I was hoping for a longer outcome so I'm not sure if I should try 2 injections going forward?
Exosomes have not been studied extensively in randomized controlled trials. No orthobiologic therapy to date (including 'stem cells') have been shown to make anything regenerate. Rather, the cells help change the toxic environment of an arthritic joint to make it more neutral and 'healthy'.
No consensus kit is "best". Lots of different types of kits though, each with its own pros and cons! I think it should be fair game to ask your doctor why he/she has chosen to use a particular kit.
Hi Doc, So i got an ACL sprain/tear with a mucoid degeneration of posterior horn medial meniscus along with a Tibiofibular joint arthrosis.The docs that i consulted with first hand had asked me to rest for a couple weeks and take physiotherapy if needed and then see if i feel alright.else we ll discuss arthroscopy. Its been three weeks of rest and physio and even though the shooting pain that made get an MRI have significantly reduced..i feel that it's gotten worse,dk if that's even possible but i could walk properly and everything even though with painbefore i saw the reports and went on complete rest ..now i can't stand longer than 15ins..i feel like my knees just can't stand my weight.. i can't bend the knee while walking..and I'm nt able to walk properly..and even when I'm resting i always this weird sensation..sometimes muscle spasms..sometimes discomfort..sometimes tightness .. and the pain sometimes is in the centre.msometimes near the proximal tibiofibular joint. I'm just 28 and these are early signs of osteoarthritis..since the space seems to be reduced..i want to go back to dancing and Idk if PRPs are right for me and if there are even doctors here in India that are proficient enough. Some people said that it may affect my hormones and shoot my already existing weight issues. Do u have any suggestions?
Why do some patients report swelling/stiffness and pain (for a few days) after a PRP injection while this is rare with steroid injections? Is the PRP injection more invasive than a steroid injection? Or is the pain due to the body's response to the growth factors?
Thanks for your comment. Think of it this way. When you get a cut on your skin, it starts off red and hot and can be swollen. This is a local inflammatory response that is initiated by platelets. This can happen after a PRP injection and will resolve in a few days. I have not found this to have any negative effect on outcomes.
Patient had PRP in both legs. Now has developed extreme swelling in both legs without any relief. More painful than prior to injections. Both legs are swollen all the way through ankles and feet. Should legs be drained? Inflammation appears similar to lymphedema. Suggestions please? Have you encountered extreme inflation after injections. Weeks later?
Issue I have with mu MD, his PROP is slightly red, I talked to him about this and he said its because he uses 7X concentration, and draws 60 CC of blood. Per you other videos, you state yes on 60 CC of blood, but 10 to 20 X concentration. And You feel amber PRP is better for joints because the red blood cells can cause inflammation. Any comments? thx
I'm 62 years old I did a MRI and it shows complete medial meniscus tear and also medium to severe osteoarthritis. I don't want surgery I was listening to your PRP treatment, will it help with my tear ?
PRP does not help the meniscus tear heal. Unfortunately, nothing can. PRP helps treat the microenvironment inside an arthritic joint to reduce inflammation and improve symptoms.
If you have already had 1 steroid and 3 gel injections for a knee with moderate arthritis which is not yet bone on bone, would you then recommend PRP injections? So far I have had some relief but still must walk slowly to avoid pain. Also doing PT exercises daily.
I’m a athlete, I’m suffering from Patellar Tendinopathy. And Trochlear Cartilage grade 3. 1 PRP injection done, Is I need to take one more PRP r any other medications? Please help me doctor
Thanks for your comment. Unfortunately I cannot give medical advice over the internet. Please discuss your situation with your trusted health care provider. Best of luck!
Both of my knees are bone on bone..My orthopedic mentioned PRP. I got home and researched it. Seems it wont be much good for me ,my knees are too far gone. Am I correct.And i wonder why he even revomended it.
hi Doc My father has got one prp injection 3 days ago , he had felt extreme pain for first night and day after the injection. The doctor has suggested us 3 prp injections after every two weeks, but my father felt so much pain , should we /can we delay the second injection and how to avoid extreme pain during the second prp which is scheduled on 13th of this month Would be really thankful if you can give a detailed answer
@@medicinenews4351 hi There has been slight improvement , but I think after each injection he had to take rest and not walk , because the doctor told us that its like a wound so let it settle then start walking , but my father started walking during the course of injections because he felt like it has recovered
Hi Doctor, I have been watching your videos,i am big fan of your work. I have been diagnosed of Knee Cartilage fissuring and on MRI below is the result " Patella is normal in position. Extensor mechanism is intact. Mild lateral patellofemoral chondral softening. Focal high grade inferior central and lateral patellar high grade chondral fissuring measuring 2.2 cm transverse by 1.2 cm craniocaudal with subtle subchondral cystic change and marrow oedema. articular cartilage otherwise and patellofemoral ligaments are intact. " Per Doctor Advice, I am taking supplements like Collagen and Omega 3 to repair followed by knee exercise , do you think it will repair of its own. I have seen improvement over time but will i recover fully . Will PRP treatment help ? I am a sportsperson , i play basketball . Please advice.
Great videos, doctor. I have a question for you. I saw couple videos about PRP treatment, some PRP tube(after spinning)have darken red color liquid where other video has light yellow liquid one? What is the difference from that?
Excellent question! I will be making a video on this soon, but it has to do with cell type inclusion. Different tubes include different cell types and concentrations, which of course matters to outcomes!
Thanks for your comment. Unfortunately I cannot give medical advice over the internet. Please seek the advice of your trusted health care provider. Best of luck!
New to your videos and finding them helpful! I have my first PRP injection coming up for chronic pes ansirine bursitis. I also had runner’s knee. Is it recommended to have a few areas in same knee injected at once? If the bursae is injected, will it be spread to other areas of knee?
Thanks for your comment and glad you find the videos useful! It really depends on what's going on in your knees, so you'll want to discuss with your health care provider. With that said, if the PRP is put in the bursa, it stays in the bursa and will not go into other areas of the knee.
If you have a fear of needles and injections, they should put you out for local anesthesia for PRP injections. I had synvisc injections and they were torture! And they didn’t do any good.
How painful the injections are really depends on technique. Doing them ultrasound guided really minimizes pain and guarantees correct placement of the PRP into the joint.
I got my 1st steroid on my left knee last August much better i feel than before my question is if i have pain which is not worst can i take Predisone your explanations are very clear thank you from Philippines
PRP has not been extensively studied for the treatment of stage 4 arthritis. With that said, smaller studies have shown benefits to pain reduction and improvements to function. The effects do not seem to last as long as for those with mild to moderate arthritis.
I just recently learned about PRP. I have knee arthritis in both knees and I am getting scheduled for injections. Should I do one knee at a time. I have seen videos and I know it is painful. Thanks for the great videos. I am nervous but hopeful it helps.
Thanks for your comment. For the most part it's fine to do both knees at the same time, but please discuss with your health care provider. Best of luck!
Hey Chris it's not that painful,but after prp your knee may become swelling and for two days you you may need crutches this is what happened to me but now I'm okay, I think that swelling makes pressure on nerves that's why
That is awesome you get the patients input on further PRP's. My MD did the same, the first two PRP's helped, but still not great,. The third injection was life changing, although I still had some pain. The fourth one is making it better. We see definite progress with each new PRP.
So I will continue 4 PRP's a year, every three months, indefinitely . Costing $3,000 per YEAR. Not much for having no surgery. Thank you!
Great video. I had one PRP injection on my right knee back in 2017 and got good relief. Then in 2019 I got one PRP injection on my left knee. Now it is Oct 2023 and I’m still doing well with only very minor pain in my knees after exertion. However, I’m thinking of going back and getting a second PRP injection on both knees as a “booster”.
Can you please tell me the Hospital name and the Doctor name details where you got the PRP injection. Thanks.
@@maheshreddy6624 I had my PRP injections done at the Mayo Clinic in Phoenix, AZ. The doctor was Dr. Bryan Ganter.
If its only a 15 procedure using your own blood why do they charge over one thousand British pounds per injection.
Your age ?
@@maheshreddy6624 I had the PRP injections done at the Mayo Clinic hospital in Phoenix Arizona. Sorry, didn’t see your question earlier
I had my first PRP injection this afternoon after my doctor removed fluid from my knee. It felt better immediately. I will see how the aftermath is. I get another injection next month.
I have tennis elbow on my right elbow since last year. Had Mri done and found that I had a 3mm tear. Had 3 therapy sensions of 9 times each. 9 rounds of acupuncture and got a cortisone shot in August. I was off work for 6 months. After 2 weeks after the cortisone shot, I went back to work and was feeling great. I took it easy at work, but I started to feel my left elbow starting to get strained a month ago. And now my right both my elbows hurt. I ca n't sleep unless I wear my compression sleeves on both arms. It even hurts to lift my blanket at night.
Just went with my specialist today, and he ordered a prp injection for my right elbow and a mri for the left side. I'm hoping this relives the pain.
Good luck!
Any updates?
@strovrpwr had a prp shot on April 28th. Shot was a little painful. I took it easy over the weekend and went back to work on Monday. Took it easy as work also. About 1 to 2 weeks after I noticed, I can get more range of motion. And was waking up pain-free in the morning. I still take it easy, not lifting anything too heavy. If I start to use my arm, it feels strained for a few hours. At this time I says it's pain wise it's about 70 percent better. And as for using arm it's about 50 percent better. I'm thinking of getting a other shot in a few months again.
Thank you, Dr. Peng.
This is real hope.
Thanks for posting. It’s good to hear other physicians treating patients similarly regarding PRP
Just trying to spread the word!
Does prp regenerate meniscus?
Excellent video. I just need to know the cost. My insurance paid for the 3 series of hyaluronic. I’m scheduled for the single hyaluronic injection soon but after that my next treatment will be PRP.
Very interesting observations! Thank you for the opportunity to get to know the essence of this therapy better! Could you issue a questionnaire to assess the effectiveness of the therapy and the number of injections?
I greatly appreciate your videos! I have been doing a lot of reading and listening to alternative treatments for knee arthritis. Yours are abundant, clear rest, so thank you. Is there a network of physicians who share your philosophy? I’m looking for someone in West Michigan.
Got a PRP injection w/ hyalruronic acid 3 weeks ago for cartilage lesion/ "chondral defect of lateral trochlea." Was this the right decision? Previously got a PRP injection for partial patellar tendon tear and next MRI showed the tendon healed.
MRI CONCLUSION, 1 month ago before PRP;
-Full-thickness full-thickness chondral defect of the lateral trochlea with subchondral
reactive marrow change of the underlying bone.
-Small knee effusion.
-Tiny Baker cyst
Great video Doctor. I got 2 PRP injections, the 2nd one at the 3 month mark from the 1st dose. Now I feel good. My pain level have come down and the knee function is gradually improving. My doctor suggested not to go for the 3rd one now, but go for yearly booster more from a prevention perspective.
That's great! Glad to hear your pain has improved with PRP. Definitely mark on your calendar when you need the booster.
Definitely, thanks for your kind guidance Doc.
Amazing video just asking Dr.are you in the US I live in Japan it seems to me no one knows the PRP injections don’t why thanks
And how much would it cost me thanks a lot
@ Bharath - Did you get your PRP for osteoarthritis or chondronmalacia patella grades? Please specify since I had one PRP plus Hylauronic Acid together on 15th May 2023.
Thank you for sharing such important information.
You're welcome! Thanks for your comment
Great Video. I've been shopping around for PRP in my area and discovered 1 Dr. Office that warns against some Doctors using PRP kits that provide a lesser, non effective concentration of platelets in their injections. Was curious what your concentration number is and how can we protect ourselves against getting a "watered down" version. ?
Great question! As a patient, you have every right to ask which kit your provider is using and more importantly, ask WHY they are using that kit. Platelet concentration is one of many factors to consider.
Wat is the correct concentration of platelets?
@@JeffreyPengMD what is the right concentration?
Why does the cost of PRP vary location to location?
@@JeffreyPengMD what is the ideal concentration when it comes to PRP
Absolutely fabulous video. Very informative and exactly the way my specialist is providing me PRP treatment. Thank you
Thanks for commenting!
Could you please share the symptoms sheet you carry on for the patient follow ups
I use the WOMAC and VAS pain scores
Hey Jeff. Thanks for the videos. Can you please create a video about cold laser, low light level laser therapy for pain?
Thanks .
How many times should PRP treatment be done for knee osteoarthritis ?
How many days apart is it good to do it.
I have just had my meniscus repaired along with a couple other clean up things on my knee. I am going to try this my insurance doesn't cover PRP. I had PRP done in my shoulder and it helped amazing. I had two injections. My shoulder is bad. Need total replacement. I now am careful and have no pain. Would you say take one and wait and do another. I am not concerned about money! I am thinking about trying Stem Cell. What do you think about the two?
Did you get the PRP?
@@kakarot4701 I didn't on my knee. It is better than 100% I just worked it hard and finally it regained the strength and now zero pain and it's equal to my other knee if not stronger. I did a lot lot of one leg, leg presses to get where I am today. The PRP most definitely helped my shoulder.
One of my doctor suggested PRP injection together with Gel. Thereafter, get a knee brace. Is this a good idea?
Hi Jeffrey, what is the kit to get the most platelets out? That what we are interested in.
I do HA injections and I find that at the 4 week follow up, they are still having pain, it's often the Pes Anserine Bursa. A steroid into that Bursa gives instant relief. I've dine a few PRP and will be doing more in the future. Thank you for posting this video.
Thanks for commenting
Wonderful video. I had PRP and Hyaluronic acid together last January for knee arthritis. Pain has decreased 80%. Plan for another injection in September. This combination has worked for me. What is your opinion about this combo. Thanks
You may find this helpful! th-cam.com/video/KlPiJTyweV4/w-d-xo.html
How was your and your knee pain I am suffering this pain please reply and help me
Can you please speak about 1st generation prp where the platelets are spun for 5 min vs 2nd generation prp where the platelets are spun for 4 hours; what is the benefits of longing spinning time in treatment; thank you Dr. Peng
Does this work for a thickening of the synovium, leading to fluid buildup? This was offered as an alternative to plica surgery.
It will be great if you can share the PRP prep technique and the type of kit you use.
Thanks for your comment. New kits are always coming out and we are open to testing them so these change from time to time.
Thank you for posting, Dr !!
I had PRP plus Hylauronic Acid together for chondronmalacia Patella Grade IV treatment on 15th May 2023 in my right knee. Just three days got over. Can I expect the betterment for my chondronmalacia patella Grade IV knee pain. I was asked to take a rest for a week and thereafter to start exercising slowly on VMO, IT band, and hamstring exercises as well.
Please provide your input and recommendations.
Best to discuss with your doc
Great video, doc! What about supplementation? I guess glucosamine, HCL, collagen (type 2) might help, right?
You may find this helpful: th-cam.com/play/PLrX971rgONtooFRotwN9sADDLwYWXMvoz.html
Great video Dr. Peng! I have psoriatic arthritis and a knee injury which we believe is unrelated. Eleven years ago I had a surgery to repair the meniscus. It was an easy out patient procedure, pain free and successful. A bit more than a year ago I had knee pain and an MRI showed damage to the medial aspect of the meniscus, damage that couldn't be surgically repaired. A PRP shot provided relief but almost a year later pain returned and I got another PRP injection. Do you have experience with PRP injections for a damaged meniscus as vs. osteoarthritis? Thanks!
Love your videos. I had the cortisone shot 3 weeks ago and had little relief. I have requested prp now and have tricare so hopefully, I can get on the mend. I have referenced your findings and my questions are regarding what you have recommended. My only question is do they need to use the ultrasound for a knee for the shot or just for the muscle issues?
Excellent presentation Doc, can i get a second session of prp after 4 months? I received an improvement from first session but still having pain not as bad before prp. Or should i wait 6 months or a year? Is it safe to get it after 4 months?
Hi doctor is N stride a better treatment then prp
Recent Australian study somewhat put a pin in the prp hype. It was a double blinded study which found no difference between PRP and saline injections in terms of long term improvement.
The RESTORE trial and the more recent PEAK study both had fatal flaws. Both studies used LOW DOSE platelet rich plasma. It's like saying acetaminophen doesn't work for reducing fevers when compared to saline placebo because a study used 10mg of acetaminophen whereas the therapeutic dose is 500mg or even 1000mg.
The conclusion of those studies should have stated "low dose PRP is no more effective than placebo". All the latest clinical trials report platelet counts and concentrations. What's CLEAR in the literature is high dose PRP provides incredible results.
Here's more info: th-cam.com/video/NPrNeyx6Bv8/w-d-xo.html
what is the maximum amount of PRP solution can you inject in a the knee? thank you
I am 52 and have a degenerative lateral meniscus with mild/moderate arthritis, resulting in continuous pain. I had one prp a year ago and it helped a bit but not enough to be pain-free. My consultant has recommended a course of 3 prp's, which I'm happy to do, but he suggested weekly intervals between prp's and I'm concerned from research, that weekly is too quick for optimum impact. (I've been told surgery isn't recommended). What is your opinion on the timing apart to really get the absolute best benefit?
Now how are you and your knee pain
From your experience how many PRP shots are required to heal the ligaments in the cervical neck? (C4/5/6) Thank you.
Do you have a video of recommended exercises for a 71 year old that sees improvement from my 3 injections?
Insurance companies should cover these but unfortunately don’t which makes no sense to me. I am getting a prp next Month for my hip.
I 100% agree. My goal is to get the word out, educate people, and support more studies. Once more and more studies show benefit, insurances will start covering. Thanks for your comment.
How did it go for your hip? I thought I needed one for both hips as well..instead however it was both of my Sacroiliac joints that I needed to get prp on. Just had them done 4 days ago
Thank you for good information
1) All PRP injections are made in Gerdy's tubercle independly of the knee condition?
2) Whats the frequency of the PRP injections? 1 per week? In the study cited by you said 3 injections (one week interval of each other).
1. Not sure what you mean here.
2. The frequency of PRP injections in studies administering more than 1 shot is once a week. However, other studies have shown that 1 shot also gives excellent benefits. In the real world (ie. outside a clinical trial), the frequency of shots is often individualized.
I have severe knee osteoarthritis. I got a PRP injection 1 month ago. The injection met all of the criteria you mentioned in your videos(including 10 Billion double spinned platelets and ultrasound). There has been no change in my pain since then. I am trying to answer the question about wether I should get a knee replacement or keep waiting to see if the PRP starts to work. Any comments would be very much appreciated.
When you have a second and third injection do you you have to go back to square one with regard to what exercise you can do or can you continue from where you are at?
where do you practice Dr. Peng?
My husband has been dealing with a knee issue which flares up off and on after doing something to it about 5 years ago. He is normal weight, no chronic health issues and the X-ray shows no arthritis. For specific reasons, he does not want an MRI or CAT scan, and we already know it's soft tissue, so that would be a very expensive redundancy and the only info we would potentially get would be for PT, which isn't an option right now. I wonder if/how prp injections would help him? He does get a chiropractic adjustment to make sure all the leg joints are in alignment and that helps some. The pain SEEMS to be mostly in the PA bursae area but the swelling is on the other side of his knee, which is interesting.
How many treatments should I get if I got acl surgery about 2 weeks ago? I really want to help the healing to improve and I read that prp or stem cell injections can really help with healing even after knee surgery! Do you think this would be good for me and how many treatments so my knee can have more flexibility? It feels so stiff from surgery!! Thanks and great video!!! 🤩😍
This is something you'll need to discuss with your surgeon!
Does PRP heal a complex 4mm meniscus tear on medial horn root with full baring weight because the surgeon said too and wants to address the arthritis first
PRP does not "heal" anything or "repair" anything. It changes the micro-environment of the joint to decrease symptoms.
@@JeffreyPengMD Thank you so much for the clarification , helping me understand the reason for the shot. 🙏🥰
@@JeffreyPengMD but it could help in the regenetarion of cartilage, isnt it?
@@noxer88 no, it doesn’t. It delays cartilage degeneration
Great videos Dr Peng. I’m just curious what PRP kit you like to use for tennis elbow and knee OA. thanks.
I currently use Emcyte PRP kits.
Best one double spun there are studies that it’s super effective compared to single spun machine.
Do you have this in Sri Lanka. I have G4 in my left knee.
When getting back to running, is a treadmill turf or track (dirt or rubber ) or grass better on knees?
In general, go for the lighter impact surfaces. That's going to be a sports track and even some good high end treadmills. Concrete running will be the hardest on the knees. Grass and dirt such as trail running can be good but tends to be uneven which, for people returning from injury, can sometimes cause problems. Hope that helps!
Would this help stage 4 arthritis with a messed up
Meniscus?
Hi Dr. Peng, do you have a good referral to a orthopedic specializing in knee/sports injury in the San Diego area?
Thank you for the great material you put up.🙏
UCSD sports medicine!
You recommend or start PT at 3 weeks post PRP injection for knee OA or tendinosis?
Dr. Peng: Is it a good assumption to make that what you present for knees also apply to shoulder osteoarthritis?
Hello Dr. Peng ,
Can PRP injection be used on my hip ?
Thanks
Depends on the indication, you may find these helpful:
th-cam.com/video/0sZEvvPWq88/w-d-xo.html
th-cam.com/video/DrDrMSh-Y5Y/w-d-xo.html
Yes it can, my son had a hip replacement with bursitis and tendinitis afterwards.
He has had his first injection and will have 4 two weeks apart.
At what stage of arthritis is prep effective. I have quite a bit of narrowing in space in my knee cartilidge/meniscus. I have had visco supplementation mixed with cortisone and this has seemed to improve my stiffness.
PRP is most effect at grades 1 and 2. It still works for grade 3 as well as grade 4, but not as robust for grade 4.
Hi Dr, Where would you put MACI in your matrix?
Thanks for your comment. As far as I am aware, MACI is not used for the treatment of osteoarthritis. It really is reserved for those with a focal osteochondral defect. This is because those with more diffuse arthritis need a fairly large graft surface area. My guess is one day this will happen, but not at this time.
Hi doctor, 2 years ago I was daignosticated to have shoulder osteoarthritis. I got during the first year 4 cortison injections, but that wasnt long term. Now I've got 3 prp injections and expecting a fourth, and Im feeling good, altough my rotator is still poping on some movements. Can I expect of the prp injections to heal my osteoarthritis once for all? I appreciate your time, thanks in advance!
Hi Dr. Peng, would you recommend to try PRP Injections for someone aged 69 with severe OA?
If you’re bone on bone in at least one compartment of your knee, will PRP do any good? I had a total knee replacement on my right knee, which was even worse, bone on bone in the medial and middle part and a lot of scar tissue. I just want something to hold me out another 6 months to a year before I get my left knee replaced. I like to ski in the winter and don’t want to burn up what’s left of my sick leave, which is why I want to delay. I got cortisone in both knees a little over a year ago and they put a bandaid on it for a short time.
If someone has Chondromalacia along with mild cartilage thinning, does PRP re attach the wear and tear of cartilage to the patella and prevent the cartilage from tearing?
PRP does not regenerate anything, rather it helps change the microenvironment of the joint to decrease symptoms and protect the cartilage from getting worse
Hi Doc.Do they do it PRP Here in Australia?Thanks for info
Yes they do!
@@JeffreyPengMD thank you Doc.This is Patrick from Down under Melbourne Australia.Your you tube are very educational.Thanks God bless you and always at good health.
Is there any data for people suffering with arthritis in the hip joints?
Hi Jeffrey - I have been watching all your videos. I am curious to learn your opinion as to whether I would benefit from PRP in view of the condition of my right Knee. Yes or No would suffice! This may also help many of your subscribers....
Findings: A moderate joint effusion is seen and there is a large popliteal cyst. There is evidence of chronic synovitis in the lateral suprapatellar pouch. This is associated with generalised loss of retropatellar cartilage and chondral thinning across the trochlea but no gross subchondral signal change. There is complex
degenerative tearing of the posterior horn of the medial meniscus with a developing parameniscal cyst. There
is narrowing of the medial joint space compared to the lateral joint space which is well-maintained with a
normal meniscus. The cruciate and collateral ligaments, popliteus tendon and iliotibial band remain normally
attached
Conclusion: The scans confirm the presence of a complex degenerate tear of the posterior horn of the
medial meniscus associated with generalised chondral volume loss in the medial compartment and a
prominent popliteal cyst. There is also established chondral loss in the patellofemoral compartment with
chronic suprapatellar synovitis.
Unfortunately, I can't give medical advice over the internet. All I can say is that your MRI describes a knee that has osteoarthritis. Please seek the advice of your trusted health care provider. Best of luck!
Is Plasma therapy also helpful in rhemutoid arthritis as well.
Thanks for your question, unfortunately there are very few clinical trials looking to answer this question. So right now, we don't know if PRP can be used in the setting of rheumatoid arthritis.
Hi Doctor, How is your PRPclinical trials on Rheumatoid arthritis!!...
Does PRP work with Chondromalacia and some cartilage thinning?
Yup! That's actually the best studied indication (mild knee osteoarthritis)
@@JeffreyPengMD does PRP re attach the wear and tear of cartilage to the patella and prevent the cartilage from tearing?
I had two PRP on my knee and my ankle. The first injection is great both, feel a lot better, so I did a second injection 6 month later. However, the second injection didn’t do much. I’m now 9 months from the second PRP. Should I get a third injection? I’m ok with the cost as long as it make me feel better
Thanks for your comment. Unfortunately I cannot give medical advice over the internet. Please seek the advice of your trusted health care provider. Best of luck!
Answer the question
Make ADSC MSC with BMP2
My orthopaedic dr is leaning heavily on hyaluronic acid injections for my mild knee arthritis issues. He told me that PRP isn't covered by insurance, whereas the other treatment is. To me, cost shouldn't be the primary driver for choosing the medical solution, and I sense he's not very forward thinking. Do you see that as a common issue in the field?
Dose anyone know if any side affects from PRP injections, would be most grateful for reply
How many PRP injections needed for chondromalacia Patella Grade 4 and one of the doctor has advised me for sanakin injection please let me know about this ?
Good question -- we don't know! I've had people with grade 4 arthritis who only need one PRP shot, and others who need 3. Only way to know is to try and see how you feel. I know that's not the answer you wanted to see, but the reality is everyone's body is different and has different amounts of growth factors and platelets.
@@JeffreyPengMD I have the same problem. I got 1 PRP injection and I was completely pain free - the problem is that the 1 injection only lasted 4 months. I was hoping for a longer outcome so I'm not sure if I should try 2 injections going forward?
Hi Dr. Peng, my wife has early signs of osteo arthritus in her left hip. can this treatment help? Weare able to pay for treatment.
PRP can help treat symptoms related to hip osteoarthritis: th-cam.com/video/0sZEvvPWq88/w-d-xo.html
How much ml of blood to draw per knee joint?
What’s more potent prp injection or exosome injection ?
Which of them can help regenerate cartilage damage in chondromalacia grade VI ?
Exosomes have not been studied extensively in randomized controlled trials. No orthobiologic therapy to date (including 'stem cells') have been shown to make anything regenerate. Rather, the cells help change the toxic environment of an arthritic joint to make it more neutral and 'healthy'.
Can PRP be used for shoulders?
So how many you think are required for herniated discS in the back lower back specifically and is it a permanent or temporary fix
Unfortunately PRP has not been extensively studied for spinal conditions. You may find this helpful: th-cam.com/video/_YZAZ7Vt2As/w-d-xo.html
Is there a specific kit that is the best...I’m not sure how to ask the question about concentration when talking to my doctor?
No consensus kit is "best". Lots of different types of kits though, each with its own pros and cons! I think it should be fair game to ask your doctor why he/she has chosen to use a particular kit.
Hi Doc,
So i got an ACL sprain/tear with a mucoid degeneration of posterior horn medial meniscus along with a Tibiofibular joint arthrosis.The docs that i consulted with first hand had asked me to rest for a couple weeks and take physiotherapy if needed and then see if i feel alright.else we ll discuss arthroscopy. Its been three weeks of rest and physio and even though the shooting pain that made get an MRI have significantly reduced..i feel that it's gotten worse,dk if that's even possible but i could walk properly and everything even though with painbefore i saw the reports and went on complete rest ..now i can't stand longer than 15ins..i feel like my knees just can't stand my weight.. i can't bend the knee while walking..and I'm nt able to walk properly..and even when I'm resting i always this weird sensation..sometimes muscle spasms..sometimes discomfort..sometimes tightness .. and the pain sometimes is in the centre.msometimes near the proximal tibiofibular joint. I'm just 28 and these are early signs of osteoarthritis..since the space seems to be reduced..i want to go back to dancing and Idk if PRPs are right for me and if there are even doctors here in India that are proficient enough. Some people said that it may affect my hormones and shoot my already existing weight issues. Do u have any suggestions?
Why do some patients report swelling/stiffness and pain (for a few days) after a PRP injection while this is rare with steroid injections? Is the PRP injection more invasive than a steroid injection? Or is the pain due to the body's response to the growth factors?
Thanks for your comment. Think of it this way. When you get a cut on your skin, it starts off red and hot and can be swollen. This is a local inflammatory response that is initiated by platelets. This can happen after a PRP injection and will resolve in a few days. I have not found this to have any negative effect on outcomes.
Patient had PRP in both legs. Now has developed extreme swelling in both legs without any relief. More painful than prior to injections. Both legs are swollen all the way through ankles and feet. Should legs be drained? Inflammation appears similar to lymphedema. Suggestions please? Have you encountered extreme inflation after injections. Weeks later?
For 1 PRP how much cc is recommended.
Issue I have with mu MD, his PROP is slightly red, I talked to him about this and he said its because he uses 7X concentration, and draws 60 CC of blood. Per you other videos, you state yes on 60 CC of blood, but 10 to 20 X concentration. And You feel amber PRP is better for joints because the red blood cells can cause inflammation.
Any comments?
thx
I'm 62 years old I did a MRI and it shows complete medial meniscus tear and also medium to severe osteoarthritis. I don't want surgery I was listening to your PRP treatment, will it help with my tear ?
PRP does not help the meniscus tear heal. Unfortunately, nothing can. PRP helps treat the microenvironment inside an arthritic joint to reduce inflammation and improve symptoms.
@@JeffreyPengMD Thank you 😊
Thank you if you answer my comment..
If you have already had 1 steroid and 3 gel injections for a knee with moderate arthritis which is not yet bone on bone, would you then recommend PRP injections? So far I have had some relief but still must walk slowly to avoid pain. Also doing PT exercises daily.
You mean one injection of low dose PrP vs 3 low prp or 1 high dose Prp vs 3 low dose prp?
I’m a athlete, I’m suffering from Patellar Tendinopathy. And Trochlear Cartilage grade 3. 1 PRP injection done, Is I need to take one more PRP r any other medications? Please help me doctor
Thanks for your comment. Unfortunately I cannot give medical advice over the internet. Please discuss your situation with your trusted health care provider. Best of luck!
@@JeffreyPengMD thanks doctor
Thanks!!!
No problem! Thanks for your comment
Both of my knees are bone on bone..My orthopedic mentioned PRP. I got home and researched it. Seems it wont be much good for me ,my knees are too far gone. Am I correct.And i wonder why he even revomended it.
Did you end up doing it?? That’s the boat I’m in
hi Doc
My father has got one prp injection 3 days ago , he had felt extreme pain for first night and day after the injection.
The doctor has suggested us 3 prp injections after every two weeks, but my father felt so much pain , should we /can we delay the second injection and how to avoid extreme pain during the second prp which is scheduled on 13th of this month
Would be really thankful if you can give a detailed answer
Hallo how was your father knee pain after take PRP injection
@@medicinenews4351 hi
There has been slight improvement , but I think after each injection he had to take rest and not walk , because the doctor told us that its like a wound so let it settle then start walking , but my father started walking during the course of injections because he felt like it has recovered
is there any painkiller to be taken for more relief ?
It has decreased slightly
@@tutor4519 I am not able to understand what you are saying, please tell me whether I can recover from meniscus tear and what is its treatment?
Hi Doctor, I have been watching your videos,i am big fan of your work.
I have been diagnosed of Knee Cartilage fissuring and on MRI below is the result
" Patella is normal in position. Extensor mechanism is intact. Mild lateral patellofemoral chondral softening.
Focal high grade inferior central and lateral patellar high grade chondral fissuring measuring 2.2 cm transverse
by 1.2 cm craniocaudal with subtle subchondral cystic change and marrow oedema.
articular cartilage otherwise and patellofemoral ligaments are intact. "
Per Doctor Advice, I am taking supplements like Collagen and Omega 3 to repair followed by knee exercise ,
do you think it will repair of its own. I have seen improvement over time but will i recover fully . Will PRP treatment help ?
I am a sportsperson , i play basketball . Please advice.
Best to discuss with your docs!
How long after a prp injection, would I feel pain relief in my knee, I have a torn meniscus.
You may find this helpful: th-cam.com/video/_7HU_-YDfQY/w-d-xo.html
They could give one group one PRP and two saline injections and give the other group three PRP injections.
Great videos, doctor. I have a question for you. I saw couple videos about PRP treatment, some PRP tube(after spinning)have darken red color liquid where other video has light yellow liquid one? What is the difference from that?
Excellent question! I will be making a video on this soon, but it has to do with cell type inclusion. Different tubes include different cell types and concentrations, which of course matters to outcomes!
I have knee oa level 2. Should i take prp or ha?
Thanks for your comment. Unfortunately I cannot give medical advice over the internet. Please seek the advice of your trusted health care provider. Best of luck!
New to your videos and finding them helpful! I have my first PRP injection coming up for chronic pes ansirine bursitis. I also had runner’s knee. Is it recommended to have a few areas in same knee injected at once? If the bursae is injected, will it be spread to other areas of knee?
Thanks for your comment and glad you find the videos useful! It really depends on what's going on in your knees, so you'll want to discuss with your health care provider. With that said, if the PRP is put in the bursa, it stays in the bursa and will not go into other areas of the knee.
Can my blood plasma be converted to prp knee injection
Thanks for your comment. Yes -- PRP is made from your own blood!
If you have a fear of needles and injections, they should put you out for local anesthesia for PRP injections. I had synvisc injections and they were torture! And they didn’t do any good.
How painful the injections are really depends on technique. Doing them ultrasound guided really minimizes pain and guarantees correct placement of the PRP into the joint.
what is the duration in between 2 injections
Anywhere between 1 week and 4 weeks. Unfortunately there is not enough data behind this
@@JeffreyPengMD thank you
If I had a cortisone injection, how long after this would I need to wait for a prp injection??
We don't know the best timing. Some doctors will wait 1 month, others want to wait 3 months.
I got my 1st steroid on my left knee last August much better i feel than before my question is if i have pain which is not worst can i take Predisone your explanations are very clear thank you from Philippines
Best to discuss with your health care provider, good luck
Is this also helpfull in last stage of arthritis ?
PRP has not been extensively studied for the treatment of stage 4 arthritis. With that said, smaller studies have shown benefits to pain reduction and improvements to function. The effects do not seem to last as long as for those with mild to moderate arthritis.
I just recently learned about PRP. I have knee arthritis in both knees and I am getting scheduled for injections. Should I do one knee at a time. I have seen videos and I know it is painful. Thanks for the great videos. I am nervous but hopeful it helps.
Thanks for your comment. For the most part it's fine to do both knees at the same time, but please discuss with your health care provider. Best of luck!
Hey Chris it's not that painful,but after prp your knee may become swelling and for two days you you may need crutches this is what happened to me but now I'm okay, I think that swelling makes pressure on nerves that's why