Clear, evidence-informed answers from Dr. Paul Tortland on PRP, orthobiologics, regenerative medicine, sports injuries, and non-surgical orthopedic care.
What You Need To Know
● PRP uses concentrated platelets from your own blood to reduce inflammation and pain in mild to moderate joint arthritis and chronic tendon injuries.
● Relief commonly lasts 6 to 12 months in patients who respond, though results vary and repeat treatment is common.
● PRP does not regrow cartilage or reverse arthritis — it manages symptoms rather than curing the underlying condition.
● Most insurance plans do not cover PRP; typical out-of-pocket cost runs several hundred to a few thousand dollars per injection.
● The best candidates have early to moderate joint damage and want to delay or avoid surgery — an evaluation with imaging is the right first step.
PRP stands for platelet-rich plasma — a concentration of platelets drawn from your own blood, then re-injected into an injured joint or tendon. Platelets carry growth factors that help signal the body's natural healing and reduce inflammation. The visit itself is simple: a blood draw, a few minutes in a centrifuge, and an ultrasound-guided injection, usually done in under an hour.
Yes, for many patients with mild to moderate knee arthritis. Research suggests a majority of well-selected patients get meaningful pain relief that can last 6 to 12 months — often longer than a typical cortisone shot. PRP works best when there's still joint space left on X-ray; results are far less reliable in advanced, bone-on-bone arthritis. If your knee is hurting and you're hoping to put off a replacement, an X-ray and exam are the fastest way to know whether you're a good candidate.
Sometimes, for a limited stretch of time. PRP is not a cure — it doesn't regrow cartilage or reverse arthritis — but for patients throughout Connecticut and New England, it can meaningfully delay surgery when joint damage is early to moderate and the patient is still active and motivated. If a knee or shoulder is already bone-on-bone and disrupting sleep, PRP is usually a detour rather than a solution, and that's worth an honest conversation before starting a series of injections.
Non-surgical options include PRP, other orthobiologic injections, physical therapy, activity and weight modification, and in some cases bracing. The right combination depends on how much joint space and alignment remain, what's already been tried, and personal goals. An orthopedic evaluation with updated imaging is the right first step before deciding.
Cortisone often works faster, with relief in the first 4 to 6 weeks, but tends to fade sooner. PRP typically takes longer to build effect but can outlast cortisone, often pulling ahead around the 3 to 6 month mark. Cortisone is also generally covered by insurance, while PRP usually is not.
Both are orthobiologic treatments that use the body's own cells, but they're not interchangeable. PRP concentrates platelets from a blood draw; stem cell therapy typically uses cells harvested from bone marrow or fat tissue. Which is appropriate depends on the condition, its severity, and individual goals — worth a direct conversation with your physician rather than assuming one is simply a stronger version of the other.
PRP is commonly used for partial-thickness rotator cuff tears and chronic tendon injuries that haven't responded to rest, physical therapy, or other conservative care. It's generally better suited to tendon and soft-tissue injuries than to full-thickness tears, where surgical repair may still be the more reliable option.
The best candidates have mild to moderate joint or tendon damage, have already tried conservative measures like physical therapy, and want to delay or avoid surgery. Candidacy depends on imaging, prior treatment history, and goals — an in-person evaluation at the Glastonbury, Connecticut office is the only way to know for sure.
No — there's no strong evidence that PRP regrows cartilage in an arthritic joint. What research does support is that PRP can reduce inflammation, ease pain, and improve function. Claims that PRP "rebuilds" cartilage go beyond what current evidence shows, and it's worth being skeptical of any provider who promises otherwise.
Mild soreness, stiffness, or swelling at the injection site for one to three days is normal — that's part of the intended inflammatory response. Most people resume normal activity within a day or two. Relief typically builds gradually over several weeks rather than immediately. Severe pain, spreading redness, fever, or drainage isn't normal and should prompt a same-day call to the office.
Most clinics use pre-packaged commercial "bedside kits" — simple tabletop centrifuges that produce a generic, one-size-fits-all PRP. These automated kits yield inconsistent platelet concentrations and offer no control over cellular composition. Dr. Tortland processes blood in a dedicated on-site laboratory at the New England Stem Cell Institute, allowing the team to tailor concentration, filter out unwanted cellular debris, and precisely control white blood cell ratios based on the specific joint or tendon condition being treated.
White blood cells (leukocytes) play a major role in tissue healing, but they can cause harmful inflammation if used in the wrong place. Leukocyte-poor PRP filters out inflammatory white blood cells, making it well suited for joint cartilage and osteoarthritis — knee, hip, or shoulder arthritis — where minimizing joint swelling matters most. Leukocyte-rich PRP retains specific white blood cells to kickstart a targeted inflammatory response, which is often needed for chronic tendon and ligament injuries such as rotator cuff tears, tennis elbow, or Achilles tendinopathy. The exact ratio is formulated to the specific injury.
Most PRP clinics never count platelets — they simply inject whatever comes out of the centrifuge. Clinical research suggests therapeutic healing generally requires a specific dosage, often cited as 6x to 10x or higher baseline blood concentration. Cellular samples are evaluated under a microscope to verify dosage before treatment, confirming the platelet count meets the therapeutic density needed to stimulate real biological healing.
Even high-quality PRP can fail if it isn't delivered to the exact site of tissue damage. "Blind" injections relying on physical landmarks alone can miss the intended target in a meaningful share of cases. High-resolution musculoskeletal ultrasound is used during every PRP procedure, allowing real-time visualization of the damaged tendon fibers or joint space so the PRP is placed precisely where it has the greatest chance of therapeutic benefit.
Cortisone injections provide short-term pain relief, but repeated steroid use is associated with weakened tendons and accelerated cartilage breakdown over time. Surgery carries downtime, structural risk, and permanent changes to joint mechanics. Custom-formulated PRP takes a different approach: it uses the body's own concentrated growth factors to support tissue repair and joint preservation, aiming for durable functional relief rather than a temporary fix — though it isn't the right answer for every patient or every stage of joint damage.
This page is written for patient education and does not constitute medical advice or establish a physician-patient relationship. Treatment decisions require an in-person examination. Orthobiologic procedures are not FDA-approved drug therapies; they are performed as autologous same-day procedures under the practice of medicine. Dr. Tortland reports no financial interest in the products or devices described on this page.
Schedule an evaluation with Dr. Tortland to get a straight answer about your specific situation — imaging, prior treatments, and goals all factor into the right next step.