Orthobiologics

Platelet-Rich Plasma (PRP)

PRP is created from a sample of your own blood. The blood is processed to concentrate platelets (and, depending on the system, certain white blood cells). Platelets release growth factors that can influence inflammation and healing.

PRP may be used:

• As an in-office injection into an injured tendon/ligament or arthritic joint
• At the time of surgery or sometimes after a surgical repair, depending on the procedure and goals

Because PRP is made from your own blood, it does not involve donor tissue and does not require additional sutures or meaningful changes to the surgical plan when used in the operating room.

Bone Marrow Aspirate Concentrate (BMAC)

BMAC is obtained by taking a small sample of bone marrow (commonly from the pelvis) and processing it to concentrate biologic components. Bone marrow contains cells and signaling molecules that can produce proteins and growth factors involved in tissue repair. Due to FDA regulations, BMAC is one of the few legal ways of obtaining stem cells in the United States.

BMAC is typically obtained in the operating room, usually while you are already under anesthesia, and can be applied or injected during certain procedures without materially changing recovery timelines in most cases.

Adipose (Fat-Derived) Tissue Products

Adipose tissue (fat) contains biologic components that may be helpful in certain orthopaedic conditions. In general, a small amount of tissue is collected (often from the abdomen/waist area), processed, and then delivered to the area being treated.

Not all adipose-derived products are the same, and availability/use can vary based on clinical scenario and regulatory considerations. The decision to consider adipose-based options should be individualized to your diagnosis and goals.

How much do the injections cost?

Orthobiologic injections are considered elective treatments and are exclusively cash-pay services. Cost depends on:

• The biologic used (PRP vs BMAC vs adipose-derived options)
• The number of joints/areas treated
• Whether treatment is performed in-office or in the operating room
• Processing methods and supplies required

Our office can provide transparent, itemized pricing before you decide to proceed, including options for treating one area versus multiple areas.

Why are orthobiologics not covered by insurance?

Many insurance plans categorize orthobiologic treatments as investigational or not medically necessary for certain diagnoses, largely because clinical evidence is still developing and coverage policies lag behind emerging research. Even when studies show symptom improvement for select conditions, coverage decisions can vary widely among insurers.

What can I expect after treatment (or after surgery if a biologic is used)?

Most patients do not feel immediate improvement. In many cases, changes occur gradually over several weeks, and it may take 1–2 months to appreciate meaningful symptom improvement. Your response depends on:

• What structure is being treated (joint cartilage vs tendon vs ligament)
• How long the issue has been present
• The severity of tissue damage
• Your overall health and rehab participation

When orthobiologics are used with surgery, they are intended to support healing—but they are not a substitute for a well-performed repair, appropriate rehab, and realistic expectations.

What are the risks?

Orthobiologic injections are generally low-risk, but no procedure is risk-free. Potential risks include:

• Temporary increase in pain/soreness
• Bleeding or bruising
• Infection (rare)
• Injury to nearby structures (rare, e.g., nerve irritation)

Because PRP and BMAC are derived from your own body, the risk of allergic reaction or rejection is very low.

Will orthobiologics increase post-procedure or post-operative pain?

It’s common to feel soreness for a few days at the treatment site. If a harvest is performed (e.g., bone marrow), you may also have short-term discomfort at the collection site. Significant or prolonged pain is uncommon, and we provide clear guidance on what is normal and when to call our office.

Will orthobiologics increase surgical time?

When orthobiologics are collected and prepared during surgery, the collection typically occurs at the beginning of the case and is processed while the primary procedure is underway. In most cases, this does not meaningfully extend surgical time.