What is PRP?
PRP stands for Platelet-Rich Plasma. It is a concentration of platelets derived from your own blood. Platelets contain a variety of growth factors and signaling molecules involved in regulating inflammation, cell recruitment, and tissue repair. When delivered in a concentrated form to injured or degenerative tissue, these components promote a biological environment that supports tissue repair and regeneration.
What can I expect during the procedure?
During a 60–90 minute in-office procedure, a small amount of blood (typically 60–120 cc) is drawn from your arm. This blood is then processed in a centrifuge to produce a high concentration of platelets.
At North Texas Musculoskeletal Medicine, PRP preparation protocols are evidence-based and individualized. Each protocol is tailored to the patient and the specific condition being treated, allowing us to optimize platelet concentration and biologic composition to support the best possible outcomes.
Once prepared, this high concentration of PRP is injected directly into the damaged tissue using ultrasound or fluoroscopic guidance.
Learn more about PRP Therapy offered at our office.
PRP for Osteoarthritis, Cartilage, and Soft Tissue Injuries: How It Works
Scientific evidence supports the use of platelet-rich plasma (PRP) for certain joint conditions, osteoarthritis, cartilage changes, and tendon or meniscal injuries. PRP works by delivering concentrated platelets that release signaling molecules—such as platelet-derived growth factor (PDGF) and transforming growth factor-beta (TGF-β)—which may help stimulate the healing when used in appropriate clinical situations.
Key components of PRP and how they work:
- Concentrated platelets (typically 2-20 times baseline levels) – Trigger the release of healing and repair signals
- Growth factors (PDGF, TGF-β, VEGF, and others) – Support collagen production, cell regeneration, and new blood vessel formation
- White blood cells – Help balance local inflammation and early immune response
- Plasma – Acts as the delivery medium carrying biologic components to injured tissue
- Cell signaling molecules – coordinate tissue repair and remodeling process
Important clarifications:
PRP does not directly “regrow” tendons or cartilage. Instead, it may help create a biological environment that supports tissue healing and joint health over time. Results vary depending on the tissue involved, injury severity, joint location, and individual patient biology.
PRP is not a stem cell treatment. It does not contain stem cells or progenitor cells. PRP is classified by the FDA as a blood product when prepared from your own blood during the same clinical encounter with minimal manipulation.
What is BMAC?
BMAC stands for Bone Marrow Aspirate Concentrate and is commonly referred to as “Stem Cell Therapy.” It is a concentration obtained from your own bone marrow rich with mesenchymal stem cells, platelets, and key growth factors (PDGF, TGF-β,VEGF, IGF-1, FGF, BMPs, EGF).
These cells stimulate cell proliferation and extracellular matrix production, promote cartilage, tendon, and bone repair, enhance new blood vessel formation (angiogenesis), and support cell migration and tissue healing.
How BMAC is obtained:
During an office procedure performed under local anesthesia, a small amount of bone marrow is withdrawn (aspirated) from your pelvis (usually from the small bump on the back of the pelvic bone). The bone marrow is then processed in our laboratory to concentrate the cellular components customized for the individual patient. The concentrated product is then injected using ultrasound or fluoroscope into the area being treated.
What BMAC contains:
- Mesenchymal progenitor cells (sometimes called mesenchymal stem cells or MSCs) – These are cells with the potential to differentiate into bone, cartilage, or other connective tissues
- Platelets and growth factors (similar to PRP)
- Hematopoietic stem cells (blood-forming cells)
- White and red blood cells
- Bone marrow plasma
Is the procedure painful?
Although the procedure may sound invasive, most patients report minimal discomfort during the bone marrow harvest, often describing it as brief pressure or a short “zing.” This is minimized with the use of local anesthetic administered prior to the procedure.
For patients who anticipate increased discomfort or anxiety, Dr. Minotti may prescribe medication prior to the procedure when appropriate.
Mild to moderate soreness may be experienced for 24 to 72 hours following the procedure at the harvest site and/or injection site. If needed, post-procedure medication may be prescribed to help manage discomfort during recovery.
See how Stem Cell Therapy is offered at our office.
Is BMAC approved by the FDA?
Bone Marrow Aspirate Concentrate (BMAC) is not FDA-approved as a drug or biologic product. However, it may be legally offered under FDA regulation 21 CFR §1271 when it meets specific criteria, including that it is autologous (derived from the patient’s own body), minimally manipulated, and used for homologous purposes in a same-day procedure.
When prepared and administered in accordance with 21 CFR §1271, BMAC may be provided by qualified physicians as part of musculoskeletal care. At NTXMSK, BMAC procedures are performed in compliance with U.S. Food and Drug Administration standards and established clinical protocols.
Information regarding unregulated “stem cells”:
Umbilical cord–derived or perinatal “stem cell” products (including those derived from umbilical cord blood, Wharton’s jelly, or placental tissue) are not FDA-approved for orthopedic or musculoskeletal injection and do not qualify for the same regulatory pathway as autologous BMAC. These products are considered allogeneic (donor-derived) and are generally regulated by the FDA as biologic drugs, requiring an approved Biologics License Application (BLA) or participation in an FDA-authorized clinical trial.
The FDA has issued multiple enforcement actions and public warnings stating that commercial umbilical cord and placental tissue products marketed as “stem cell therapy” for orthopedic conditions are not legally approved, regardless of whether the donor is related or unrelated.
At this time, NTXMSK does not offer umbilical or perinatal stem cell products, and limits regenerative procedures to autologous, FDA-compliant therapies such as BMAC and PRP.
How long until I feel relief?
PRP and BMAC work through biologic mechanisms at the cellular level that require time to influence tissue repair and remodeling. Unlike a cortisone injection, which may provide short-term symptomatic relief, regenerative orthopedic treatments typically demonstrate clinical effects over weeks to months. Response timelines vary based on diagnosis, tissue type, injury severity, and patient-specific factors. Early clinical changes may occur within several weeks, while functional improvement often develops over six to twelve weeks or longer. Clinical response is variable, and improvement is not guaranteed.
Patients are provided with post-procedure rehabilitation protocols and activity guidance to optimize outcomes. Specific restrictions and progression may be determined on an individual basis and reviewed with Dr. Minotti, with a scheduled follow-up assessment approximately 10 weeks after treatment.
Recovery Timeline
| Timeframe | PRP (Platelet-Rich Plasma) | BMAC (Bone Marrow Aspirate Concentrate) |
|---|---|---|
| Day 0 (Procedure Day) | Mild to moderate soreness or stiffness at the injection site | Soreness at both the bone marrow harvest site and injection site |
| Day 1 | Normal daily activities may be resumed; avoid strenuous or high-impact activity | Normal daily activities may be resumed; avoid strenuous or high-impact activity |
| Days 2–7 | Temporary inflammation may persist; light activity is encouraged | Soreness gradually improves; activity remains light |
| Weeks 2–4 | Early improvements in pain and function may begin | Early biologic repair phase; symptoms may fluctuate |
| Weeks 6–12 | Ongoing tissue repair and strengthening | Gradual improvement in function and stability |
| 3–6 Months | Peak clinical benefit for many conditions | Continued regenerative activity and remodeling |
| 6–12 Months | Benefits stabilize; maintenance strategies may be discussed | Maximal benefit often seen during this window |
What is the difference between PRP and BMAC—and which is better?
There is no single “better” option for everyone. The most appropriate treatment depends on the specific condition, severity of tissue damage, and individual patient factors.
PRP (Platelet-Rich Plasma) is derived from your own blood and primarily delivers a high concentration of platelets, which release growth factors and signaling proteins involved in inflammation modulation and tissue repair. PRP is commonly used for tendon injuries, mild to moderate joint degeneration, and ligament pathology.
BMAC (Bone Marrow Aspirate Concentrate) is obtained from your own bone marrow and contains a broader biological mixture, including mesenchymal progenitor cells, platelets, and growth factors. Because of its cellular component, BMAC is often considered for more advanced degenerative conditions, cartilage injury, or cases where prior treatments have not provided sufficient relief.
Each treatment has different biological mechanisms, cost considerations, and levels of supporting clinical evidence, which vary by diagnosis and tissue type. Current research does not demonstrate that one treatment is universally superior across all orthopedic conditions.
During your consultation, Dr. Minotti will review your imaging, clinical findings, and goals to determine whether PRP, BMAC, or another treatment approach is most appropriate for your specific condition.
What types of conditions can be treated?
PRP (Platelet-Rich Plasma) and BMAC (Bone Marrow Aspirate Concentrate) are particularly beneficial for musculoskeletal and orthopedic conditions where pain, dysfunction, or degeneration involves joints, tendons, ligaments, cartilage, or spine-related structures. Appropriateness depends on diagnosis, severity, and patient-specific factors. to torn or strained ligaments, tendons. It also helps to restore cartilage that has degenerated due to injury or osteoarthritis.
Why PRP instead of cortisone?
Cortisone injections can provide quick, short-term pain relief by suppressing inflammation, but they do not repair damaged tissue. By stopping the inflammatory process, corticosteroids may also interfere with healing, particularly when a small tendon or ligament tear is present. In addition, corticosteroids are known to break down collagen, the primary structural component of tendons and ligaments, which can weaken these tissues and increase the risk of further injury or rupture with repeated use.
PRP, by contrast, is made from your own blood and delivers a concentrated supply of growth factors and signaling proteins that support the body’s natural healing response. While relief from PRP typically develops more gradually than with cortisone, it is intended to improve tissue quality, strength, and durability, offering the potential for longer-lasting benefit in appropriately selected patients.
Am I a good candidate for BMAC?
Whether someone may be considered a candidate depends on:
- The specific diagnosis (joint, tendon, ligament, or bone involvement)
- Severity of degeneration or injury
- Overall health and medical history
- Prior treatments and response
BMAC is not appropriate for everyone, and it should not be viewed as a guaranteed alternative to surgery. A thorough medical evaluation is required to determine if this investigational option may be appropriate for your situation.
Are PRP and BMAC safe?
Because PRP and BMAC are derived from a patient’s own peripheral blood and bone marrow, respectively, they are considered autologous (from yourself), which generally reduces the risk of immune reactions compared to treatments using donor tissue. Safety also depends on sterile technique and procedural expertise.
When prepared and administered according to established protocols, PRP and BMAC are generally regarded as low-risk interventions. Reported adverse events most commonly include transient post-procedural pain, localized swelling, bruising, or bleeding. Infection and reactions related to processing materials are rare. Although uncommon, serious complications have been described in the medical literature.
Does stem cell therapy work for osteoarthritis?
What the Research Shows: Research on mesenchymal cells for knee osteoarthritis is ongoing, with several studies showing favorable results:
Studies
Can PRP or BMAC delay the need for joint replacement surgery?
In appropriately selected patients, PRP (Platelet-Rich Plasma) and BMAC (Bone Marrow Aspirate Concentrate) may help reduce pain, improve joint function, and enhance joint stability, which can delay—or in some cases avoid—the need for joint replacement surgery.
These biologic treatments work by supporting the body’s natural repair processes, improving the biological environment within the joint, and addressing inflammation and tissue degeneration rather than simply masking symptoms. They are often most effective in mild to moderate osteoarthritis, focal cartilage injury, tendon or ligament degeneration, and early joint instability.
However, PRP and BMAC are not a replacement for joint replacement surgery in advanced, end-stage arthritis where there is severe cartilage loss or significant structural deformity. Outcomes depend on factors such as degree of degeneration, joint alignment, patient activity level, and overall health.
At your consultation, Dr. Minotti will review your imaging, clinical findings, and goals to determine whether PRP or BMAC is an appropriate option—and whether it may reasonably help delay surgery in your specific case.
How long does BMAC last?
There is no fixed duration. If improvement occurs, it may last months to years or even decades, but:
- Results vary significantly by condition, severity, and individual biology
Repeat procedures may or may not be helpful, and there is limited evidence to guide re-treatment decisions
How much do Regenerative Orthopedic procedures cost?
Dr. Minotti is a price leader in the DFW metroplex. Procedure costs may vary depending on the complexity of the case and the specific body region being treated.
Does insurance cover PRP and BMAC?
Regenerative Orthopedic treatments are considered investigational and are therefore not covered by traditional insurance plans. As a result, these services are self-pay.
Exception: Employees who have Regenexx employer-sponsored benefits may have coverage for certain procedures. Eligibility and coverage details vary by employer and plan and will be verified by our office.
All pricing and coverage details are reviewed during your consultation.
Ultrasound- and fluoroscopic-guided injections: why do they matter?
Bone Marrow Aspirate Concentrate (BMAC) and high-concentration PRP are performed using ultrasound and fluoroscopic guidance to support accurate delivery to the intended treatment area. Imaging guidance allows clinicians to precisely target injured tissue while minimizing risk to surrounding structures such as nerves and blood vessels and is widely regarded as a best practice for many orthopedic injections.
Are PRP and BMAC FDA-approved?
PRP (Platelet-Rich Plasma) and BMAC (Bone Marrow Aspirate Concentrate) are not FDA-approved treatments for any orthopedic condition, including arthritis, tendon or ligament injuries, or back pain.
These therapies are regulated by the FDA under 21 CFR Part 1271, which governs human cells, tissues, and cellular and tissue-based products (HCT/Ps). When PRP or BMAC is prepared from a patient’s own blood or bone marrow, processed with minimal manipulation, and administered during the same-day procedure for homologous use, they fall under the practice of medicine and do not require FDA premarket approval.
Our practice offers PRP and BMAC in accordance with current FDA regulations and evolving clinical research. Patients should understand that these therapies are considered investigational.
Disclaimer
This information is provided for educational purposes only and does not constitute medical advice. You should not rely on this information as a substitute for professional medical advice, diagnosis, or treatment.
Clinical outcomes vary significantly among patients, and results are not guaranteed. The decision to pursue these treatments should be made in consultation with a qualified healthcare provider after a comprehensive medical evaluation.