The Most Common Mistakes with PRP Injections
ฝัง
- เผยแพร่เมื่อ 22 ก.พ. 2024
- There are three critical mistakes that can undermine the effectiveness of PRP injections and these mistakes directly translate into disappointing outcomes. But here’s the good news, each mistake is completely preventable. I’m going to reveal what these common pitfalls are and how to avoid them. The goal is to ensure you achieve the best possible outcomes from your platelet rich plasma treatments.
pubmed.ncbi.nlm.nih.gov/33597...
pubmed.ncbi.nlm.nih.gov/35124...
pubmed.ncbi.nlm.nih.gov/34812...
pubmed.ncbi.nlm.nih.gov/37509...
pubmed.ncbi.nlm.nih.gov/29511...
pubmed.ncbi.nlm.nih.gov/37509...
pubmed.ncbi.nlm.nih.gov/30888...
pubmed.ncbi.nlm.nih.gov/35420...
► Things my patients have found helpful:
Please note that I get a lot of requests and questions about what equipment is ‘best’ for treating a variety of conditions. The following is not meant to be an exhaustive or definitive list. Please use it as a starting point. If you have questions, please discuss with your healthcare provider. With that said, I have tried a number of the products below, but not all. I have included some based on positive feedback from many of my patients. As an Amazon Associate, Dr Peng earns from qualifying purchases. If you purchase any product using the below affiliate links, you are helping Dr Peng maintain this channel.
Supplements
The following are Thorne supplements which are NSF certified. NSF independently assesses products without being affiliated with the companies that produce them. Not only do they certify that what’s on the label is in the bottle, they also do toxicology review to certify product formulation and contaminant review to ensure the product contains no undeclared ingredients or unacceptable levels of contaminants.
Boswellia Extract: amzn.to/3L00rYn
Turmeric & Curcumin: amzn.to/47NacD9
Glucosamine & Chondroitin: amzn.to/44AVoow
Creatine Monohydrate: amzn.to/45JW9wq
Omega 3 and 6: amzn.to/45LTBh7
Vitamin D 5000: amzn.to/47T8MHs
Vitamin B complex: amzn.to/3L0Bdcm
Magnesium Citrate/Malate: amzn.to/3snHuZc
Magnesium Glycinate: amzn.to/45EZVYa
Soft Tissue & Rehab
Theragun: amzn.to/4363zJG
Massage ball: amzn.to/40BUC9f
Foam roller: amzn.to/4324E5c
Stretching strap: amzn.to/3U9a2iQ
TENS unit: amzn.to/3mcCqnI
Heating pad: amzn.to/40VidSc
Resistance bands: amzn.to/3nFyb4C
Braces & Supports
Hinged knee brace: amzn.to/3U6oyrH
Neoprene knee sleeve: amzn.to/3Zzhsgt
Volar wrist brace: amzn.to/3KawW55
Thumb spica brace: amzn.to/3nHj9vl
Ankle lace up brace: amzn.to/3m6iR0u
Tennis/Golfer’s elbow brace: amzn.to/3ZEGgE1
Superfeet orthotic inserts: amzn.to/436tRf5
Recommended Textbooks & Resources
The Trigger Point Manual: amzn.to/4340cTt
Trigger Point Wall Charts: amzn.to/3zrinVR
► Be Active. Live Healthy. Subscribe for more free videos like this: / @jeffreypengmd
► ABOUT ME
Jeffrey Peng MD is a nonoperative orthopedist and sports medicine specialist. He focuses on maximizing non-surgical treatments for sports injuries and orthopedic conditions. He specializes in using orthobiologics and ultrasound guided minimally invasive techniques to treat osteoarthritis, tendinopathies, and musculoskeletal disorders.
Dr. Peng is board certified in sports medicine and family medicine. He completed residency with the Stanford family medicine residency program and completed his sports medicine training with the Stanford primary care sports medicine fellowship in San Jose. He is an active faculty member for both programs and is excited about training the next generation of physicians.
Dr. Peng’s sports medicine clinic is located in Campbell, California.
Twitter: @JeffreyPengMD; / jeffreypengmd
Website: www.jeffreypengmd.com/
► Disclaimer
My content reflects my own opinion and does not represent the views or opinions of my employers or hospital systems I am affiliated with. They are meant for educational purposes only. They do not substitute for the medical advice of a physician. Always seek the advice of your physician with any questions you may have regarding your health.
I had PRP injections for hip arthritis and 1 year later for severe plantar fasciitis. PRP has given me my life back! What this doctor says is so right on in my opinion. I’m 65 years old and PRP injections in my hips sure beats surgery! My PRP doctor was so good. He repeated told me to avoid pain meds and I recovered very well. Thank you for your clear videos, they helped me navigate my recovery.
Can you share where you had this done?
GOD BLESS YOU PENG ...THIS INFO EXPLAINS MY PRP SECOND DOSE FAILURE.
Thank You for the insightful information Dr. Peng!
Glad it was helpful!
I really apprecated all this very important info. I live in Maui, Hawaii and theres two drs. that provide this treatment and I think both of them MUST WATCH, LISTEN and UNDERSTAND your video!
I just received a PRP injection with 26 mls of blood drawn and 8 mls injected. This is to treat severe knee osteoarthritis. This is day 4 and I am crossing fingers for relief. The lack of Alleve for two weeks will be tough on my arthritis on my hands. This is a very informative video.
Any update???
Thank you for tackling this subject and providing us with vital information regarding PRP treatment. All too often, in my experience, most Orthopedists and even the sports medicine doctors I have gone to have little to no idea or knowledge about the importance of harvesting the ideal Platelet count (10+ billion) for optimal outcome in knee OA treatment.
Your viewers have the right to know so they can choose a knowledgeable provider to administer this procedure. Thanks so much.
Awesome video with lots of great information and guidance. Thank you.
About a year ago I went in for PRP for my arthritic knee at age 65. The Dr. wanted to use stem cell injections instead. I got 3 injections with weekly treatment. After the 3 months if treatment my knee was all, but pain free.
3 days after treatment. I guy blew a stop sign and T-boned me. The pain in my knee was severe right after the crash. I went back to the Dr. who did my injections. I received 2 more injections and treatment on a machine that helped reduce the pain.
I have finished all treatments. I still have pain in my knee. I am starting to think about a knee replacement as I can't do all the things I did prior to the crash.
Looking for advise on what to do.
Hi Jeff
Thanks for the great effort.
Please make a video of sport is injections as well if possible
Thank you for your great information. Had a couple procedures done with Centeno Shultz, they’ve always taken dozens of tubes of blood. With their track record and longevity, they seem to have the system down great. Had one done at another location, which was sub optimal, with only 2 vials drawn.
Thank you so much Dr Jeff Peng . Its only now that I fully understood PRP Treatment.
Awesome!
I am a disabled combat veteran of the U.S. Army. My first PRP in my knees got me out of the wheelchair after my first PRP the VA director stopped all PRP’s because she was missing out on her kickbacks from pharmaceutical companies for medications and joint replacements I was able to get another VA doctor in another city to do the PRP he did PRP two months in a roll and was going to do a third month and so many people had heard how well the PRP’s were working the were traveling to Helena Montana for PRP’s the VA director in Billings Montana orchestrated a champagne to stop all PRP’s state wide. I paid very close attention to how the PRP’s were done so I have ordered my very own centrifuge and all of the materials to do my own. I was not able to get the lidocaine but I am willing to do it without pain meds because it really works and without PRP I have no quality of life. I have also purchased the butterfly infrasound device. I wish it wasn’t so hard to get good treatment. I don’t have the money to pay someone to do the PRP at a cash price either so I will do it myself.
Look into va community care and get it authorized by an outside doc. Good luck
@@LKYDVL the VA won’t allow any veteran to go to care in the community
For PRP
I AM IN THE SAME IMPROPER PRP TRAP.. CANT AFFORD OR CANT OBTAIN INSURANCE COVERAGE FOR EFFECTIVE PRP CURE AND PAIN RELIEF . MY ONLY AVAILABLE OPTION IS TO DO IT MYSELF . THIS IS NOT MY AMERICA THAT I PUT MY LIFE ON THE LINE FOR IN THE MILITARY DURING VIET NAM.
Mexico or Thailand is an option.
I am about to go for a consultation on PRP injection for my meniscus tear. This is very helpful! Thank you!
Epaulshi: This doctor has brilliantly pointed out some points that I wish that I had heard before I had a $1500 PRP injection. Not only did my money evaporate, but the procedure didn’t make a tiny bit of difference to my knee pain, so pay attention to the guidelines that Dr Peng has so generously outlined here.
Glad it was helpful!
Thanks!
@@JeffreyPengMDWhat is the success rate for degenerative disc disease for L3 L4 L5?
Hello Dr. Peng, This is very helpful as I am scheduled for a knee PRP treatment this coming Monday. I hope all goes well.
Good luck!
1@@JeffreyPengMD
Excellent video and very informative
Hi Dr Peng, you have great information in your videos… thank you. It seems like the key to successful PRP is finding the right doctor. Do you recommend a doctor located in Connecticut? Thank you!
Hi I have been watching your videos for a while now. For about the past year and a half I have had pain on my left side and cannot figure out what it was. I went to my primary care went to two different orthopedic surgeons got a MRI and x-ray and nothing showed up on the MRI or x-rays. So I went and did the typical 12 week sessions of physical therapy, massage therapy, tried 3 rounds of trigger point injections, tried acupuncture, and chiropractic. None of these helped with the pain. I then went to a non surgical orthopedic doctor and they did an ultrasound and showed a tear in my serratus interior muscle. Which is a very rare area to tear I am noticing. So I was injected back in January with PPP. I also did three sessions of shockwave. About two weeks after my injection when the swelling went down my pain came back. I am almost three months out now and my same pain is back. Any suggestions???? Please help 😢 Thank you!!! ❤
As always so pleased with the information you have provided but so frustrating to find a doctor that provides the protocol that you follow. Do you know of anyone in the Phoenix or Chicago area that provides treatments that you follow? If there is a forum of people who have had treatment and would share where they have gone and what were their results? Thanks again for all your great information.
thank you for this information!
My pleasure!
@JeffreyPengMD I have a prp treatment for a small rotator cuff tear this coming Friday. I called the office and they only draw out 15cc of blood and only have the single spin not the double. So I'll be canceling Monday to find another facility that does the right protocols. I found your video right on time. I wish I lived closer to your facility and I would come to you, but I'm on the other end of the states.
Dr. Peng - first off thank you so much for your insightful and efficient review of salient medical information. One question - should we also stop supplementation that acts on similar pathways as NSAIDs around a PRP (e.g., boswellia serrata, turmeric and curcumin)?
Thanks for great informatiom could you please make avideo for the role.of prp for treatment deabtic foot.alcer thank u doctor
Wonderful information! I am 65 and just had my first PRP to hip. I am 10 days out and have zero relief thus far. They drew 40cc of blood. Was this not enough? Too low dose? Thank you.
Dr Peng I appreciate all your videos they have been extremely helpful.
When you say to say away from NSAID medication does that include natural stuff like turmeric…? I will having PRP shot in about two weeks.
Thank you
Excellent
I have a shoulder labral tear and a cyst on spinoglenoid notch and measures approximately 1.5 X 1.4 x 1.3 Cm. I was given a cortisone shot for pain and it has relieved 95% of the pain, but the cyst is definitely pressing up on my nerve cashing severe pain when i didn't have cortisone. Doc suggested shoulder surgery but i cant do that RIGHT now. I'm seeking to try Ultrasound-guided cyst aspiration to prevent it pressing on my nerve... then we can talk surgery but I'm cannot do surgery right now but the pain without cortisone was the worse pain i've ever felt in my life. I'd like to try PRP before full fledged surgery as well.
Dr Pang. My husband has got thru 2 of 3 PRP sessions here in Anchorage, Alaska on both knees. (tear in one, near bone-on-bone in the other) They drew 10 tubes and the platelets were still red when Doctor divided it into both knees. Said it was ok for there to be a little red still there. There was also a 2 hour wait from the time they drew it, until it was administered. We just watched your recent video on the 3 mistakes Dr's make and we're worried this is all for nothing. I know this is new here in Anchorage but do you have a recommendation on someone here that follows the right protocol? He could fly to you or someone closer for treatment if necessary, but it would be nice to have someone here. Please respond. Thank you.
1. High dose PRP
2. Double centrifuge process.
Do you carry a boombox with you to play background music whenever you talk? Do you play background music on patient consults? Did your professors in the med school play background music as they were lecturing?
I wonder if there is a way to find doctor that knows what you know. Any suggestions?
Thanks
Dr. Peng...I assume that acetaminophen is alright to use in in conjunction with PRP. Correct? Thank you.
Thanks for this. By chance does someone recommend a clinic in Utah?
Dr Peng do you know of any providers doing PRP therapy correctly in Philadelphia area ?
Thank you
Dr. Peng, who would you suggest in Houston, Texas?
Hi Mr Peng you mention not taking various tablet prior/ after treatment … how about alcohols do these have detrimental effect to treatment thanks 🇬🇧🏴
Great Channel !
Wish you did lower back facet joint. Any recommendations ?
PRP can work very well for facet injections...there is a long history of using it for that purpose
can you imaging I as the patient tell my doctor how many cc blood should withdraw? I probably land outside of the office very fast! my suggestion is to dr. Penguin to publishing and talking in medical symposiums and educate the other experts
This is all great information - its a shame most doctors dont know this! On a similsr note, how do you feel about amniotic stem cell injections? Are there any similar requirements for those?
Thanks. I don't recommend stem cells at this time. Here's why: th-cam.com/video/ILi_7KVqmEk/w-d-xo.html
@@JeffreyPengMD that video is looking at it for osteoarthritis, do you know about their use for tendinopathies? Thanks for the reply!
After PRP injection it is recommended to stay away from from NASID’s. What about Serratiopeptidase is a proteolytic enzyme that has been used for reducing inflammation, it has antiedemic, analgesic, fibrinolytic and caesinolytic properties. Can I still be on this supplement??
So what's the best dosage / kit to use??? I will be getting one tomorrow.
Dr. Peng, could you recommend an excellent PRP Doctor in Houston Please? Thank you in advance!
can you take low dose netroxon before, after. and during your prp procedure
Do you do mild sedation anesthesia at surgery center for Achilles PRP?? I’ve just had this advised by doctor but it sounds aggressive and expensive. Is it necessary for Achilles?
Within the myriad commercial brands of PRP kits available, numerous professionals utilizing various PRP kits assert notable differences in the degree of pain sensation. What could be the underlying cause of this variation? Is it possible that certain companies incorporate local anesthesia into their tubes to mitigate pain levels, despite the recognized compromise in the effectiveness of PRP treatment?
Dr Peng, what about local anesthetic numbing shots given prior to the PRP injection?
Are there any good PRP Drs in Kansas City you would recommend?
Hello Dr Peng. Where r u located? I can’t find a Dr in my area that will follow ur recommendations.
Is it necessary to use PRP Tube which contained ACD, for Hair treatment.
Hey Dr. Ping, have you ever seen PRP for IT band syndrome?
Question??? would PRP treatments be of any value for OA of the hip?????
Great video, thanks.
Yes pls look.at topmost comment
I was wondering if supplements that have anti-inflammatory properties ie turmeric would cause the same issues for PRP
Great advice!
Looking for any referrals to a PRP injection using your advice for a torn rotator cuff in the SD County area.
In Rapid City South Dakota there are 2 places that I know of that do PRP. Do a search for health concepts. There's also a Doctor at memorial health who does sports medicine and he also does PRP and prototherapy.
You seem like an amazing dr. The problem is I live in Ohio. Do you have any recommendations of a PRP provider in Ohio or nearby?
I live in Ohio on the Indiana border, I’m meeting with Dr.Kinne in Decatur Indiana at the end of the month, he came highly recommended for PRP/ Stem Cells.
My surgeon group from OIO Lima recommended HA injection after taking X-Rays.
Hi Dr.Jeffrey, I have chondromalacia patella and 3 days ago i had a prp shot.Can i take glucosamine sulfate after prp procedure?Thanks in advance.
Supplements shouldn't interfere with PRP
Oh my...just got I think 4 PRP injections in my neck today and it was not done via imaging. 3 vials of blood was taken. Was not told about not taking NSAID. Feeling anxious now
You said no NSAIDS before/after PRP, but what about Curcumin or Boswellia?
Supplements should be fine as they do not have anti-platelet effects
Hello Dr Peng, thank you for the video. I live in the Los Angeles area and would like to fly up to get the PRP injections from you. Do you do same day injections as the consultion? I have a MRI CD of my shoulder. OR Do you do video consultation first?
Intact his office .. not sure what you mean go up but he is close to Burbank which next to LA..
Does any of this apply to psoriatic arthritis or is it only for osteoarthritis?
Hi Dr. Peng, I would like to ask about frequency of prp injections for slowing arthritis. I have had several shoulder surgeries for dislocations and the surgeon told me after my last surgery that the joint looked quite arthritic. I had two prp injections 6months after my last surgery and they noticably helped my pain/discomfort. I am only 33yrs old and wanted to ask if I should consider getting an annual prp injection into the shoulder joint to slow down the arthrits progression? (Trying to save and care for the cartilage that I have left)
Hi Dr. Peng any general views on the above comment?
Doc thank you so much for the video. What do you think of prolotherapy or stem cell injections as alternative to PRP or other alternative injections in your opinion!
Dr. Peng, What is the success rate for degenerative disc disease L3 L4 L5?
Hey Dr. thanks for the video I just had a PRP injection in my L4 L5 disc for a disc bulge. What do you know about the success rate of PRP in the disc?
I’ve had it for a herniated disc in those some areas. Two different times, the first time it shrunk it about 80 percent. I went back for a second to see if I could get it back to normal but it didn’t do much. Overall a feel ALOT better. I would try one more time.
Dr. Peng, I have a few questions that I hooe you can help me with. First is it possible yo use donar blood indyead of your own for PRP? I ask this as I believe I have seen studies recenty that I believe were done on mice both using fecal transplant and blood that had a regenerative effect when the donar was younger. So, I can only wonder if say an older male say 55 - 65 for example would not benifit more from donor blood from say a healthy athletic 18 year old. Thoughts on this please.
Also, I am currently externing as a surgical assistant in the dental field. We use PRF and bone graphs in many cases after extraction and for implants. I am not positive and I will have to pay more attention and I will question the next time I go in, if we are giving 800 mg of ibuprphen prior to surgery and if we writting a script for ibuprohen after surgery or not. Would this not be contradictory to the PRF? Thank you for your reply in advance.
No, it is not safe using someone else's blood. Using ibuprofen before/after PRP or PRF will diminish it's effects.
Thanks doc for your response.
Thanks for the info Dr Peng!
Does PRP injections work for herniated lumbar discs? Is it safe and effective to do it intradiscally? Thank you!
Anyone wanting to learn more about PRP and prolotherapy, Should get the book Prolo Your Pain Away by Doctor Ross Hauser M. D.
A couple of comments that some patients may not understand though and that may not fully translate - on mistake number
1. Also having too MANY platelets can reduce efficacy of PRP, and some doctors concentrate too much -- (and some patients have variable platelet concentrations - like for instance one side of my family has idiopathic thromobocytosis) and some doctors ignore medical conditions that in concentrate can lead to factorial problems for platelet levels that without education / math skills could lead to overconcentration. Furthermore there are other factors aside from PRP like leukocytes and other aspects of healing that can affect different healing for different types of procedures. Depending on what condition a person is having treated it may be beneficial to know these things. High platelets only as a focus could put some platelets at risk, as some doctors advertise platelets that are too high for healing for some or even most patients, and that can also inhibit healing. Also some preps may be inappropriate for some conditions, or some patient underlying conditions - medically complex patients are more likely to seek out PRP, so this is an important factor to consider -- patients with EDS/ MCAS and autoimmune disorders are all likely to be overrepresented in regenerative medicine clinics.
2. Along with these medically complex patients, sometimes diffusion techniques are warranted to help them heal, but there are ways to get the best of both worlds. In hypermobility, for example - the dose specific may be great for OA or a tear, but getting as much of the surrounding tissue instability treated as possible may be necessary to treat those tears or arthritic areas, as the instability is often the underlying cause and continuing contributor to the injury. A great option for this is to use other serums like leftover PPP and an adjunct like prolotherapy and to actually treat those scattered areas. When the surrounding instability isn't treated, tears and OA often cannot heal, and a lot of targeted injection doctors can miss this, and the PRP can still fail even if the location and dosing is proper.
Since we make up 20% of the population -- whether properly diagnosed or not, and are overrepresented in seeking out care in regenerative medicine due to bad outcomes with conventional treatments, it's probably helpful for patients and doctors alike to know this.
Thank you so much. Any courses do you recommend for providers?
@@ofroaddude5859 This may be too advanced to be offered in a course necessarily. I'm not sure I've seen courses offered specifically on this -- I've just seen some of it in research.
Probably the best way to learn is to stay in the loop with good mentors in regen organizations. I think one that I've respected is IART and they have a few good doctors who try to keep on top of some of this. No single doctors knows everything, but hopefully at some point some of these topics will become more common knowledge.
We don't have a single clinical study showing a PRP dose that is too high. We routinely have platelet counts in the 3000s per microliter for tendinopathies with excellent outcomes. PRP does not change genetic conditions...there is no biological mechanism for that to happen.
@@donbufordmd For one - there are absolutely studies that show that some concentrations (not volume, but CONCENTRATIONS) can cause problems in there being too little supply ratio of "nutrients" to platelets for adequate healing to occur, or at least a suppression effect of healing. I'd be surprised if you've never seen these studies.
And there are more uses for PRP than just for tendiopathies, and it's important to know what types of PRP preps work better for those vs. other conditions for those providing or seeking more comprehensive care for complex injuries.
I never said "PRP changes genetic conditions" - that's absolutely a ludicrous statement to make. I said (in other words) that understanding genetic and other medically complex conditions and their needs is important in serving patients that will be overrepresented in regenerative medicine clinics, since they will be those most likely to fail conventional medical interventions and are more likely to seek it out. There are a lot of us, underdiagnosed and undiagnosed, and recognizing our needs is important. And some of us may absolutely need more comprehensive treatments than "just one tendinopathy injection" to heal since our injuries tend to be more widespread due to our genetics. I didn't say PRP changes our genetics - I said our genetics may change how a doctor needs to approach treatment. If you're a full time regenerative medicine "expert" you should know this, and should know better than to twist my words.
@@Tcheerapost the link to one such study and let’s look at it together. I was referring to the many clinics that charge patients for PRP although the patients has a genetic collagen disorder like EDS leading to instability or even shoulder MDI. A proper informed consent makes sure the patient’s expectations are realistic and they are not paying for PRP expecting an outcome not clinically proven.
Good afternoon. I just called your office and they informed me that you don’t perform PRP injections in the spine. I have severe OA in my lower back. Would you have any suggestions on what kind of doctors I should contact for these injections? I’m located in Southern California. Thank you.
If you're in the LA area, consider Dr Steven Sampson
Wow, thank you. I remember my doctor saying he pulled only 10 CC of blood for my PRP's in my hip and knee. The hip responded about two months after the third PRP, the knee responded about 3 months after one PRP in my shoulder same as my knee. I need 60 CC injections
Do yo use both fluoroscopy and ultra sound imaging guidance? What levels of concentration do you get? 10X 14X 20X? Other? thank you!
Concentration can be varied simply by changing the plasma volume so it is not a very good comparison metric. The platelet dose is a better comparison metric... dose = volume injected x concentration.
Make video on GFC also
Dr Peng, My surgery was yesterday- My question is WRT efficacy of the PRP injection given to treat my patellar osteoarthritis while administering post op- what about post op and pre injection, I was given a NSAID after meniscus surgery,(Partial medial posterior complex tear, same procedure still on operating table) and right before the injection of PRP. My blood draw was Prior to the NSAIDs, so the shot was given at the end of the operation , so my NSAID clean PRP injection blood was then injected into my knee and the Tramodol was given IV. the NSAID application was NOT supposed to happen...the team just dropped the ball. there was lots of briefing to the Surgeon Dr. Anesthesiologist and the nurse . they just dropped the ball on the NSAID administration. What does this do or might do to the efficacy of the PRP shot?
If NSAIDs are given before or after the injection, the efficacy of the treatment will be diminished.
What about daily L thiroxin ?
Could you please give me a name of a good Dr that give me PRP in Miami, Fl Thanks.
How can I find a PRP provider in Tucson, AZ that is at your professional level?
Sorry, don't know anyone there
I am also looking for a PRP doc that offers Dr Peng's protocol in Phoenix area and be willing to go to Tucson Az, if you find someone. I am in search!
# 3 inject entire sample in a single area. Also, accurate site injection but imaging guidance.
Hello doc. I have a question. Does the quantity matter on how severe the cartilage damage is ? Thanks in advance.
If by quantity you mean the platelet dose then most likely yes. Platelet dose is very different from platelet concentration. For someone with advanced knee arthritis we routinely draw 120cc of blood and inject 6 cc and out platelet counts are around 3000 and our platelet dose is around 18 Billion platelets.
@@donbufordmd thak you very much for your reply.
I am suffering with rheumatoid arthritis, both my knees effected now i am not able to walk and climb steps. I went through PRP for both knee joints, it is okay now for me to walk still i am not able to take long steps and climb steps, can i go with 3 PRP injections to single knee joint at once if that so how much time i have to wait to take 3 shots from first PRP shot
Do lifestyle modifications. Willhelp
Can't find any provider in my area that will provide high dose PRP. Is there a website to search for high dose providers?
The easiest way for a patient to get the info is to ask how much blood is drawn per joint. It is simplistic but the easiest way unless the patient understands the differences between the PRP kits used
What's your opinion on different variants of PRP such as PRF or PRGF+ ?
PRF and PRGF are low dose versions of PRP basically. Primarily in Spain they have been used for a long time but the long term and high level research clearly favors much higher dose PRP
@@donbufordmd I don't get it then if they are lower doses of standard PRP what is the supposed advantage?
@@thanosfisherman I can not think of a condition where lower dose has been shown to be an advantage over higher dose in a high level clinical trial. The only advantage is that those kits are cheaper. Most of Europe uses single spin lower dose kits....
@@donbufordmd Hello again. Here's the official response from the Spanish company who produces PRGF kits. "PRGF is nothing more and nothing less than leukocyte-free PRP activated with a platelet concentration of 3x." So it turns out it isn't lower dose of PRP.
@@thanosfisherman Common mistake. Dose = platelet count x PRP volume. The concentration has nothing to do with the dose directly. The PRGF could be high or low dose based on the platelet count and PRGF volume. I know that the blood draw for PRGF is low....less than the 60cc I would typically draw. Both systems can concentrate 3x BUT if one system started with 5 times more platelets that system will have a far higher platelet dose.
Can suitable donor players also help
Recovery?
PRP is autologous, meaning it's your own platelets.
Why do you never discuss N-Stride versus PRP injection?
not US FDA approved yet might be the reason. wish it was.
Yea enough people are asking about it that I should probably make a video on it. It's just not high on my list
Dr. Peng kindly give me a good Dr. to give me PRP in Newyork
HSS
Dr. Peng I called HSS for PRP. In your opinion is 1000.00 per injection from HSS a fair price? Thank you!
how does a "well designed and well executed" study have a "fatal flaw"?
Trust the science journals LOL
clickbait title - come on doc
Looking at the table at 7:44 I really just want to know what study did those landmark hip joint injections 🫣