Procedures · Knee arthritis · Glastonbury, CT
Dr. Paul Tortland, DO, has offered PRP since 2007, bone marrow aspirate (BMA) since 2008 and microfragmented adipose tissue (MFAT) since 2009. Patients from across New England come to compare them for knee arthritis. The choice is made on live ultrasound of your knee and your imaging, before any treatment is recommended.
PRP usually fits mild to moderate knee arthritis, while bone marrow aspirate (BMA) or microfragmented adipose tissue (MFAT) are usually considered for moderate to advanced arthritis. All three use your own blood or tissue and are guided by live ultrasound. Dr. Tortland chooses after examining your knee and reviewing your imaging.
Time to benefit is the range Dr. Tortland sees in his practice. Your own response can differ.
| Consideration | PRP | Bone marrow aspirate (BMA) | Microfragmented adipose tissue (MFAT) |
|---|---|---|---|
| What is collected | A blood draw | Bone marrow from the pelvis | A small amount of fat |
| Best fit | Mild to moderate arthritis, partial meniscus or tendon problems | Moderate to advanced arthritis, cartilage lesions | Advanced degeneration, or when marrow yield is low |
| Time to benefit | About 4 to 12 weeks | About 3 to 6 months | About 3 to 6 months |
| Treatments | Set at your evaluation | Usually one, sometimes followed by PRP 4 to 6 weeks later | Usually one, sometimes followed by PRP 4 to 6 weeks later |
| Starting cost | Custom-concentrate, high-dose PRP (not just PRP) from $1,800 | Tailored to each patient's treatment protocol. Treatments are not cookie-cutter or one-size-fits-all. | Tailored to each patient's treatment protocol. Treatments are not cookie-cutter or one-size-fits-all. |
| Insurance | Not covered; HSA and FSA may apply | Not covered | Not covered |
Every new patient gets an unhurried evaluation, $500, with live musculoskeletal ultrasound in the same visit. Dr. Tortland looks at joint space, cartilage, the meniscus and the surrounding tendons, then explains which option fits and which do not. About 30 percent of his patients travel from outside Connecticut, from across New England and beyond.
If surgery is the better path, he says so directly. Read more about alternatives to knee replacement, PRP injections for knee arthritis and cellular orthobiologics.
Not automatically. Cells are usually reserved for moderate to advanced arthritis or for knees that did not respond fully to PRP. For earlier arthritis, PRP is often the first step. Dr. Tortland decides from your ultrasound and imaging, not from a fixed rule.
Most patients notice gradual improvement between 6 and 16 weeks. PRP usually shows benefit in about 4 to 12 weeks, and BMA or MFAT in about 3 to 6 months. Follow-up with repeat ultrasound happens within 6 weeks to 3 months.
Yes. For arthritis, the plan often adds a PRP injection 4 to 6 weeks after the cellular treatment to build on the result.
No. The office is out of network with all insurance plans and provides a superbill. HSA and FSA funds may apply.
Then Dr. Tortland will say so and refer you to a trusted orthopedic surgeon. A thorough non-surgical evaluation does not close off surgery as an option.
Keeling LE, Belk JW, Kraeutler MJ, et al. Bone Marrow Aspirate Concentrate for the Treatment of Knee Osteoarthritis: A Systematic Review. Am J Sports Med. 2022. PubMed PMID 34236913.
Dulic O, Rasovic P, Lalic I, et al. Bone Marrow Aspirate Concentrate versus Platelet Rich Plasma or Hyaluronic Acid for the Treatment of Knee Osteoarthritis. Medicina. 2021. DOI 10.3390/medicina57111193.
Belk JW, Kraeutler MJ, Houck DA, Goodrich JA, Dragoo JL, McCarty EC. Platelet-Rich Plasma Versus Hyaluronic Acid for Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Am J Sports Med. 2021;49(1):249-260.
Pintore A, Notarfrancesco D, Zara A, et al. Intra-articular injection of bone marrow aspirate concentrate or adipose-derived stem cells for knee osteoarthritis: a prospective comparative clinical trial. J Orthop Surg Res. 2023;18:350.
Candidacy is determined on ultrasound, not over the phone. Bring your imaging and get a straight answer about your joint in one visit.