Treating arthritic joints and stubborn tendon pain with your own platelets.
Platelet-rich plasma concentrates the growth factors already circulating in your blood and delivers them into the exact tissue causing your pain — placed under live ultrasound, not by feel. The goal is different from a steroid shot: not just quieting inflammation for a few weeks, but changing how the tissue behaves over months.
What it treats
PRP is most useful for two problems that overlap constantly in clinic: cartilage-related joint pain, and tendon that has degenerated rather than simply become inflamed.
Arthritic joint pain
In an arthritic joint the cartilage thins and the joint lining becomes chronically irritated. PRP shifts that environment — damping the inflammatory signalling inside the joint and stimulating the cells that maintain cartilage and joint fluid. It does not grow you a new joint. In mild-to-moderate arthritis it can reduce pain and stiffness for considerably longer than a steroid does.
- —Knee osteoarthritis, mild to moderate
- —Hip and shoulder arthritis
- —Thumb base (CMC) and small-joint arthritis
- —Post-traumatic ankle arthritis
Chronic tendon problems
Tendon pain lasting more than three months is usually not “-itis” at all. On ultrasound the tendon looks thickened and disorganised, often with abnormal vessels growing into it. That tissue has a poor blood supply, which is precisely why it heals badly — and precisely why a concentrated dose of growth factors delivered into the lesion makes sense.
- —Tennis and golfer's elbow
- —Gluteal tendinopathy / lateral hip pain
- —Patellar and Achilles tendinopathy
- —Rotator cuff tendinopathy and partial tears
- —Plantar fasciopathy
Targets treated, by region
All ultrasound-guided- ·Glenohumeral joint OA
- ·Rotator cuff tendinopathy and partial tears
- ·Long head of biceps tendon
- ·Acromioclavicular joint
- ·Common extensor origin (tennis elbow)
- ·Common flexor origin (golfer's elbow)
- ·Distal biceps tendon
- ·Thumb base (first CMC) OA
- ·De Quervain's tenosynovitis
- ·Carpal tunnel syndrome
- ·Hip joint OA
- ·Gluteus medius and minimus tendons
- ·Proximal hamstring origin
- ·Adductor origin
- ·Sacroiliac joint
- ·Tibiofemoral and patellofemoral OA
- ·Patellar tendinopathy
- ·Quadriceps tendon
- ·Pes anserine and MCL
- ·Iliotibial band
- ·Ankle and subtalar joint OA
- ·Achilles tendon, mid-portion and insertional
- ·Plantar fascia
- ·Peroneal and tibialis posterior tendons
- ·First MTP joint
- ·Lumbar facet joints
- ·Interspinous and iliolumbar ligaments
- ·Small joints of the hand and foot
- ·Post-traumatic joint pain
Steroid injection or PRP?
Both are injections; they do close to opposite things. A steroid suppresses inflammation quickly and powerfully. PRP suppresses nothing — it asks the tissue to remodel. That single difference drives everything else: how fast you feel better, how long it lasts, and what happens to the tissue over time.
A hot, swollen joint that needs to settle before physical therapy, or a patient who needs relief this week for a specific event — a steroid is the faster, cheaper tool, and I will say so. The concern is repetition: repeated steroid injections into the same joint or around the same tendon are associated with cartilage and tendon deterioration.
Chronic problems; patients whose steroid shot wore off; mild-to-moderate arthritis in someone trying to postpone a replacement; tendinopathy that has already failed a loading programme. Relief builds slowly and tends to hold longer.
Every injection is placed under live ultrasound
Arthrex ACP and ACP Max
Not all PRP is the same product. I use the Arthrex double-syringe system in two forms and choose between them based on the tissue being treated — not as an upsell. Both are prepared from your own blood, in the room, in a single spin. Nothing is sent away and nothing is added.
Arthrex ACP
Leukocyte-poorThe classic double-syringe preparation. It yields a small volume of platelet concentrate deliberately low in white cells, which makes it gentler — less post-injection flare, less inflammatory kick. My default inside joints and for peritendinous work where I want to avoid a painful reaction.
- —Small final volume, prepared in a single spin
- —Low white-cell content — milder post-injection soreness
- —Best for: knee, hip and shoulder OA; milder tendinopathy
- —Usually a course of 2–3 sessions, 2–4 weeks apart
Arthrex ACP Max
ConcentratedA larger-draw version of the same system, producing a higher platelet dose and more usable volume from one sitting. Where the evidence points toward dose mattering — larger joints, tendon with real structural change, or a plan built around fewer visits — this is what I reach for. Also what I use when treating more than one site in the same appointment.
- —Larger volume and a substantially higher platelet dose
- —Enough volume to treat two sites in one visit
- —Best for: moderate OA; gluteal, Achilles and patellar tendinopathy
- —Often achievable in 1–2 sessions
Diagnostic ultrasound, the Arthrex preparation kit, ultrasound-guided injection and a follow-up review. No separate guidance or facility charge.
Decided at the consult, not sold in advance. Arthritic knees typically do best with a three-session ACP course; a single ACP Max session is often the right call for tendon.
PRP is not covered by most plans and is paid directly.
What recovery looks like
PRP is not a quick fix, and being honest about the first two weeks is the difference between a patient who sticks with it and one who decides it failed.
Common questions
Find out whether you're a candidate before you pay for anything.
The consult includes a full ultrasound assessment of the joint or tendon. If PRP is the wrong answer — because the arthritis is too advanced, the tear too large, or a loading programme hasn't been tried — you'll know before committing to treatment.