Platelet-rich plasma (PRP)

PRP Injections in Glastonbury, CT: Measured Platelet-Rich Plasma

High-concentration PRP, prepared specifically for you, from the physician who performed the first PRP treatments in southern New England in 2007.

Medicine is not one-size-fits-all. Neither is your PRP. A high-volume blood draw, double-spin preparation, and laboratory platelet counting create a PRP customized to your age, injury, diagnosis, and baseline platelet count. Measured before processing. Measured again after. Dose calculated before injection. Measured. Every time. No guessing.

Platelet dose measured and matched to your conditionprecision Ultrasound-guidanceresearch / evidence-based

Written and clinically reviewed by

Paul D. Tortland, DO, FAOASM, CAQSM, RMSK

Dr. Paul Tortland, DO is a non-surgical orthopedic & sports medicine physician specializing in regenerative orthopedics and surgical alternative treatment. He is dual board-certified in Sports Medicine & Osteopathic Manipulative Medicine (OMM) and Regenerative Medicine, Fellowship-trained in Sports Medicine. He became the first physician in the world to earn board certification in Regenerative Medicine in 2015. Diplomate, American Board of Regenerative Medicine (ABRM), 2015. Registered in Musculoskeletal Ultrasound (RMSK).

Last clinically reviewed

October 2026

Quick answer

Platelet-rich plasma (PRP) is a concentrated dose of a patient's own platelets and growth factors, drawn from their blood and injected under live ultrasound guidance into an injured tendon, ligament, or joint. Evidence is strongest for mild to moderate knee osteoarthritis, where randomized trials show PRP outperforming hyaluronic acid and saline, and for certain tendon conditions; results vary by diagnosis and preparation method. This practice custom-formulates PRP in an on-site lab, measuring platelet concentration before and after processing to a therapeutic target rather than relying on a one-size-fits-all bedside kit.

What PRP is Conditions treated The procedure Candidacy PRP vs alternatives FAQ

Definition: platelet-rich-plasma (PRP)

What PRP therapy is and how it is customized

And why not all PRP is prepared the same way.

Platelet-Rich Plasma (PRP) concentrates your own platelets to help injured or arthritic tissue heal: best for mild-to-moderate osteoarthritis, partial tears, back and neck pain, and tendinopathy. Not all PRP is the same: platelet concentration, total dose, and cellular composition vary by clinic, and most patients never learn what they actually received.

Dr. Tortland measures your baseline platelet count, sets the dose and the leukocyte profile for the tissue being treated, and measures the final preparation again before injection. Arthritis and tendon or ligament injuries are prepared differently: leukocyte-poor PRP for arthritic joints, leukocyte-rich PRP for tendons, and a platelet dose matched to the structure. In one documented bilateral knee case, 40.272 billion platelets were delivered in total, 20.136 billion per knee.

Time in office

About 75-90 minutes

Anesthesia

Local only: no sedation

Typical course

1 to 2 injections and / or annually to keep arthritis at bay

Return to work

Usually next day

First results

Weeks 4 to 10, depending on the area treated

Guidance

Live ultrasound or x-ray, always

Source material

Your own blood

Insurance

Not covered; but HSA / FSA applicable

Indications

Conditions PRP treats

Knee osteoarthritis & meniscus injuriesHip osteoarthritis / bursitis / ImpingementShoulder osteoarthritisRotator cuff tears & tendonopathySports Injuries - tendon / ligament Chronic Low Back & SI joint PainNeck / Cervical PainHypermobility & Joint Instability

Patellar tendinopathyPlantar fasciitisGluteal tendinopathyHamstring injuryPartial ligament tearsThumb and hand arthritis

Step by step

The PRP procedure, step by step

High-concentration PRP, a customized platelet count, and precise ultrasound guidance.

Diagnostic ultrasound first

At your initial evaluation, the joint or tendon is examined on live ultrasound so the treatment target is confirmed, not assumed. Treatment itself is typically scheduled as a separate visit.

Blood draw: high volume

Dr. Tortland draws 60 to 250+ mL of blood, depending on the target: chosen for the condition being treated, the patient's age, and platelet count. More starting blood means more platelets available to concentrate and measure. Most general PRP kits only require 20-60 mL of blood drawn, which is NOT acceptable for Dr. Tortland's standards.

Centrifugation: double spin

Your blood is spun in office with a double-spin protocol to separate and concentrate the platelet fraction. Preparation takes 30-40 minutes while you wait in the room.

High platelet count & customization

Your baseline platelet count is measured on a Beckman Coulter DxH 500 cell counter, and the PRP is custom-prepared with the Exo Advantage system, tailored to your injury, age, and baseline count. The preparation is targeted to a high platelet concentration relative to baseline, then measured again to verify what was actually produced, not assumed from the process alone.

MSK ultrasound-guided injection

The area is numbed with local anesthetic both locally AND inside the joint to ensure as painless a procedure as possible, then the needle is advanced under live MSK ultrasound and / or fluoroscopic guidance into the exact structure(s) at fault. You can watch the screen as it happens.

Customized Recovery Protocol

You leave with a written Recovery schedule tailored to your specific treatment plan, with potential for EMTT & ESWT and / or Physical Therapy to accelerate recovery time. Expect two to five days of initial soreness: that inflammatory response is the treatment working. No anti-inflammatories for two weeks.

Follow-up and re-evaluate

Follow-up within 6 weeks to 3 months with repeat ultrasound and / or an updated MRI to compare tissue appearance and patient symptom progression against baseline and decide whether a second PRP procedure adds value.

the proof - Why this matters to you

Why measuring PRP dose and concentration matters

You don't know what you don't measure.

Lab hematology report showing a platelet count of 5,034,000 per microliter used to calculate the 40.272 billion platelet PRP dose

From a recent bilateral knee PRP treatment: 240 cc blood → 8 cc PRP (4 cc/knee), measured at 5,034,000 platelets/µL, 40.272 billion total, 20+ billion per knee. Bedside counters typically under-count, so the true number was likely higher.

Concentration counts. Starting platelet counts vary widely, so two patients who get "the same PRP" can end up with very different numbers of actual platelets. Dr. Tortland measures your count before and after processing on an in-lab Beckman Coulter cell counter, so he knows what was actually produced, not what a standard kit was expected to deliver. Published trials point the same way: studies with positive results delivered higher platelet doses than studies without. In one recent bilateral knee treatment, 40.272 billion platelets were delivered in total, over 20 billion to each knee. The goal is the right concentration and total dose for your tissue, measured every time.

What is platelet concentration? How densely packed the platelets are in the PRP. What is platelet dose? How many platelets are actually delivered: platelet dose equals platelet concentration times PRP volume. They're not the same number, and only one tells you what you actually received. Think of it like coffee: a strong shot packs more flavor per ounce, but a bigger mug can still deliver more caffeine overall. Dr. Tortland measures both, every time, so nothing is assumed.

Evidence

Research on PRP platelet count and dose

AAPM&R guidance, April 2026

AAPM&R's April 2026 guidance statement on PRP for knee osteoarthritis gives five evidence based recommendations and 11 consensus best practices on patient selection, platelet dose, preparation, technique, safety and informed consent. It supports considering PRP for mild to moderate knee osteoarthritis that persists despite conservative care.

Platelet dose: customized, not maximized

Concentration counts, and the right number depends on the tissue. A 2025 PM&R meta-analysis of 32 trials found PRP beat hyaluronic acid or saline at every dose studied, with 5 to 10 billion total platelets giving the largest functional gain. A 2024 review found that trials with positive results delivered higher doses than trials without (about 5.5 vs 2.3 billion platelets), and a 2025 meta-analysis found high concentration PRP gave clinically meaningful pain relief through 12 months while low concentration did not. Dr. Tortland measures concentration and total dose and sets both for the condition, rather than accepting whatever a standard kit yields.

Technique

A 2023 hematology study found double-spin centrifugation yields significantly higher platelet counts, with less red- and white-cell contamination, than a single spin: consistent with why it's used here.

Leukocyte Content

The preparation is matched to the tissue. For arthritic joints Dr. Tortland uses leukocyte-poor PRP, which scored better on IKDC outcomes in one meta-analysis (Belk 2021), although a 2026 review found the evidence too limited to say whether leukocytes change joint outcomes. For tendons he uses leukocyte-rich PRP, which gave the strongest results in a meta-analysis of 18 randomized tendinopathy trials (Fitzpatrick 2017). Ligament and spine preparations are tailored to the structure treated, and trials have not settled the best choice.

Full citations for every study on this page are listed under References & Further Reading below.

In Dr. Tortland's practice: measured, not marketed

12 to 15×

Average platelet concentration relative to baseline in the current High-Concentrate protocol

≈19×

The concentration measured in one documented case

40.272 billion

Total platelets delivered in that same 8 mL preparation, measured at 5,034,000 platelets per microliter

60 to 250+ mL

Blood volume range used, depending on treatment target and patient characteristics

DxH 500

The clinical hematology analyzer used to measure platelet counts, before and after processing

2-spin

The double-spin protocol used to separate and concentrate the platelet fraction

Why double-spin is only part of the story

A double-spin protocol concentrates platelets more precisely than a single spin. But the process alone doesn't guarantee a result: every preparation is measured and characterized before injection, not assumed from the method used.

Customization

PRP for arthritis versus tendon and ligament injuries

PRP is customized by tissue. Arthritic joints and tendons respond to different preparations, so Dr. Tortland sets the leukocyte content, volume and platelet dose for the structure being treated, then measures the result before injection.

Tissue treated

How the PRP is prepared

Platelet dose approach

What the evidence says

Arthritic joints: knee, hip, shoulder, ankle

Leukocyte-poor PRP in a larger volume, injected into the joint under ultrasound

Dose measured and set for the joint. Studies link outcomes to total platelets delivered and to platelet concentration

Higher concentration did better in a 2025 meta-analysis (Bensa). Leukocyte-poor scored better on IKDC in one meta-analysis (Belk), but a 2026 review found leukocyte effects unproven

Tendons: tennis elbow, Achilles, patellar, rotator cuff

Leukocyte-rich PRP placed into and around the damaged tendon under ultrasound

Smaller, concentrated dose aimed at the damaged segment. Dose studies in tendons are limited

A meta-analysis of 18 randomized trials found leukocyte-rich PRP gave the strongest results in tendinopathy (Fitzpatrick)

Ligaments and partial tears

Preparation chosen for the structure, after ultrasound confirms the tear is partial and not retracted

Dose matched to the size of the tissue treated

Fewer high quality trials. Clinical judgment guides the choice

Spine: facet, sacroiliac, epidural

Image guided placement, with volume and preparation chosen for the target

Dose matched to the target structure

Early evidence. A small epidural PRP pilot study improved pain through 12 months (Playfair)

Comparison

PRP compared with cortisone, gel injections, stem cells and surgery

PRP or cortisone? Cortisone can calm pain quickly, but relief usually fades within weeks to a few months, and repeated injections can weaken tendon and cartilage. PRP takes longer to work, typically 4 to 10 weeks depending on the area treated, and aims to improve the tissue itself. In patients who respond, benefit often lasts 6 to 12 months or longer, and arthritis may need a repeat treatment about once a year. When a joint or tendon is beyond repair, surgery is the right answer, and Dr. Tortland will tell you so.

Comparing PRP To

What it does

How Long It Lasts

Does It Help Long-Term?

OptionPRP vs. Cortisone Shots

→ What it doesCortisone shots calm inflammation and relieve pain quickly, often within days.

→ Duration of benefitCortisone relief typically lasts weeks to a few months.

→ Effect on tissueNo: cortisone doesn't repair tissue, and repeated shots can weaken tendon and cartilage over time.

OptionPRP vs. Gel Injections (Hyaluronic Acid)

→ What it doesGel injections (hyaluronic acid) add lubrication to the joint to ease friction and pain.

→ Duration of benefitGel injections typically help for a few months, though results vary by patient.

→ Effect on tissueNo: gel injections cushion the joint but don't repair damaged cartilage.

PRP: Platelet-Rich-Plasma injections

→ What it doesPRP uses your own concentrated platelets to stimulate the body's natural repair process.

→ Duration of benefitPRP's benefit typically builds over 4 to 10 weeks, depending on the area treated, and often lasts 6 to 12 months in patients who respond.

Yes: PRP is designed to improve the injured tissue itself, not just mask the pain. It also helps to keep arthritis at bay.

PRP vs. Cellular Orthobiologics (BMA/MFAT) stem cell treatments

→ What it doesCellular orthobiologics (bone marrow or fat-derived cells) deliver cells plus healing signals for a stronger biologic effect.

→ Duration of benefitBenefit often lasts longer than PRP alone, especially in more advanced or degenerated joints.

Yes, often more so than PRP alone: used when a joint needs a stronger regenerative signal: i.e. - severe arthritis and severe partial tendon / ligament tears.

OptionPRP vs. Surgery

→ What it doesSurgery physically repairs, removes, or replaces the damaged structure.

→ Duration of benefitSurgical results are long-term and often definitive when the diagnosis calls for it.

→ Effect on tissueYes, when surgery is truly the right answer. Dr. Tortland will tell you plainly if that's the case, with recovery time to weigh against it.

Candidacy

Who is and is not a candidate for PRP

PRP works best as an honest fit, not a guarantee: candidacy is judged on what live ultrasound actually shows, not hope or marketing claims.

See how we help you honestly weigh surgery vs. non-surgical care →

Good candidate

✓Mild to moderate osteoarthritis on imaging

✓Chronic tendinopathy that has failed rest and physical therapy

✓Partial, non-retracted tendon tears

✓Patients who want to avoid or delay joint replacement

✓

Wants a non-surgical option to support healing alongside a rehab program

✓

Overuse injuries or mild-to-moderate ligament sprains

✓

Realistic expectations and willing to follow the post-injection loading plan

Not a candidate

✓End-stage arthritis with significant deformity or bone loss

✓Fully retracted or complete tendon rupture

✓Active infection, local or systemic

✓Active blood cancers or platelet disorders

✓Cases where ultrasound shows a different, non-treatable cause

✓

Expecting a guaranteed outcome or full cartilage regrowth

✓

A condition where surgery is medically indicated and delaying it could cause harm

A patient's checklist

Questions to ask before choosing PRP

What was my baseline platelet count?
Do you measure the platelets, or rely on the kit's expected yield?
What was the final platelet concentration?
What was the total platelet dose delivered?
Was the preparation single-spin or double-spin?
What was the leukocyte content?
Why was this particular preparation chosen for my condition?
Was the injection performed under live ultrasound or fluoroscopic guidance?

If you don't know what was measured, you don't fully know what was injected.

Frequently asked questions

What are the most common questions about PRP therapy?

Does PRP actually work?

For appropriately selected patients, often yes, though results vary and PRP does not regrow cartilage. A 2025 meta-analysis of 18 randomized trials found clinically meaningful function gains and pain relief versus placebo in knee osteoarthritis, with the clearest benefit from higher platelet concentration (Bensa et al.). Several meta-analyses also favor PRP over hyaluronic acid (Belk 2021; Oeding 2024), but one large trial of a low concentration commercial product found no benefit over saline at 12 months (RESTORE, JAMA 2021). That spread is why dose, concentration and candidacy matter. PRP is far less effective for end stage arthritis or a fully retracted tendon tear.

Is all PRP the same?

No. PRP is a category, not a standardized product. Concentration, dose and leukocyte content vary by preparation, so one study's results do not transfer to another clinic's PRP. Most bedside kits concentrate platelets only 2 to 7 times baseline. Dr. Tortland measures your baseline platelet count on an in-lab cell counter before preparing anything, then custom-prepares your PRP and measures it again afterward, typically 12 to 15 times baseline, tailored to your injury and baseline count. He uses leukocyte-poor PRP for arthritic joints and leukocyte-rich PRP for tendons. The goal is not the highest number possible. It is knowing the number and matching it to the tissue.

How painful is a PRP injection?

It depends. Dr. Tortland numbs the joint or tendon space in addition to using local anesthetic, to keep discomfort as low as possible. Most patients still feel some pressure, and soreness for a few days afterward is normal.

How long does PRP take to work?

Most patients begin to notice improvement 4 to 10 weeks after PRP, depending on the area treated. Tendons and smaller structures tend to respond toward the earlier end, and large joints and the spine toward the later end. Results often keep building for up to a year. After each procedure, Dr. Tortland provides a week by week recovery protocol for the tissue treated.

How many PRP injections will I need?

Most patients need just one to two treatments, but it depends. A single injection often does the job for a tendon / ligament problem; arthritis is usually treated with a short series, then repeated yearly to keep arthritis at bay.

Is PRP covered by insurance?

Usually not. PRP cost starts at $1,800, and the exact price depends on your diagnosis and treatment plan. You will get the full cost in writing before anything is done. Your initial evaluation is $500 and includes a full exam and live ultrasound to assess options, PRP included.

How long will a PRP injection last?

It varies by injury. In patients who respond, relief often lasts 6 to 12 months or longer. For smaller partial tendon or ligament tears and tendonitis, one or two treatments may be enough. For arthritis, a repeat treatment about once a year is common. In one follow-up study of knee osteoarthritis patients, the median duration of improvement was 9 months (Filardo et al.).

Is PRP the same as stem cell therapy?

No. PRP concentrates your own platelets and growth factors, with very few whole cells. Cellular treatments (bone marrow- or fat-derived) deliver actual stem/stromal cells for a stronger effect. Dr. Tortland often starts with PRP and escalates to cellular treatment when needed (see the comparison table above).

Who performs the injection?

Dr. Tortland does, every time, and never a technician, physician assistant, or nurse. He personally performs every PRP injection under live musculoskeletal ultrasound or fluoroscopic (X-ray) guidance. He performed the first PRP treatments in southern New England in 2007 and became the first physician in the world to earn board certification in Regenerative Medicine in 2015.

Sources

Mulvaney SW, Tortland PD, Shiple B, Curtis K. Regenerative medicine options for chronic musculoskeletal conditions: a review of the literature. Endurance and Sports Medicine. 2018.

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.

Filardo G, Kon E, Buda R, Timoncini A, Di Martino A, Cenacchi A, Fornasari PM, Giannini S, Marcacci M. Platelet-rich plasma intra-articular knee injections for the treatment of degenerative cartilage lesions and osteoarthritis. Knee Surg Sports Traumatol Arthrosc. 2011;19(4):528-535.

Mishra A, Pavelko T. Treatment of chronic elbow tendinosis with buffered platelet-rich plasma: a controlled clinical trial with a mean 25.6-month follow-up. Am J Sports Med. 2006;34(11):1774-1778.

Oeding JF, Varady NH, Fearington FW, et al. Platelet-Rich Plasma Versus Alternative Injections for Osteoarthritis of the Knee: A Systematic Review and Statistical Fragility Index-Based Meta-analysis. Am J Sports Med. 2024;52(12):3147-3160.

Everts P, Onishi K, Jayaram P, Lana JF, Mautner K. Platelet-Rich Plasma: New Performance Understandings and Therapeutic Considerations in 2020. Int J Mol Sci. 2020;21(20):7794.

AAPM&R Orthobiologic Technical Expert Panel. AAPM&R guidance statement on platelet rich plasma for knee osteoarthritis. PM&R. 2026;18(Suppl 2):S20-S35.

Berrigan WA, Bailowitz Z, Park A, Reddy A, Liu R, Lansdown D. A Greater Platelet Dose May Yield Better Clinical Outcomes for Platelet-Rich Plasma in the Treatment of Knee Osteoarthritis: A Systematic Review. Arthroscopy. 2025;41(3):809-817.e2.

Hooper N, Shapiro S, Paidsetty V, Azarpey A, Jindal A, Mautner K, Easley K, Buford D, Sussman W, Jayaram P. Platelet-Rich Plasma Outcomes in Knee Osteoarthritis Are Associated With the Amount of Total Deliverable Platelets: A Systematic Review and Meta-analysis. PM R. 2025.

Saqlain N, Mazher N, Fateen T, Siddique A. Comparison of Single and Double Centrifugation Methods for Preparation of Platelet-Rich Plasma (PRP). Pak J Med Sci. 2023;39(3):634-637.

Fitzpatrick J, Bulsara M, Zheng MH. The effectiveness of platelet-rich plasma in the treatment of tendinopathy: a meta-analysis of randomized controlled clinical trials. Am J Sports Med. 2017;45(1):226-233.

Bensa A, Previtali D, Sangiorgio A, Boffa A, Salerno M, Filardo G. PRP injections for the treatment of knee osteoarthritis: the improvement is clinically significant and influenced by platelet concentration: a meta-analysis of randomized controlled trials. Am J Sports Med. 2025;53(3):745-754.

Martín-Vega M, Gómez-Carrión Á, Zaragoza-García I, Ortuño-Soriano I, Marcelino-Argemi A, Sanz-Wozniak P, Saludes-Llamas R, Sánchez-Gómez R. Leukocyte-rich versus leukocyte-poor platelet-rich plasma for osteoarthritis: a systematic review. Regen Ther. 2026;31:101078.

Bennell KL, Paterson KL, Metcalf BR, et al. Effect of intra-articular platelet-rich plasma vs placebo injection on pain and medial tibial cartilage volume in patients with knee osteoarthritis: the RESTORE randomized clinical trial. JAMA. 2021;326(20):2021-2030.

Unlu MC, Kivrak A, Kayaalp ME, Birsel O, Akgun I. Peritendinous injection of platelet-rich plasma to treat tendinopathy: a retrospective review. Acta Orthop Traumatol Turc. 2017;51(6):482-487.

Playfair D, Smith A, Burnham R. An evaluation of the effectiveness of platelet rich plasma epidural injections for low back pain suspected to be of disc origin: a pilot study with one-year follow-up. Interv Pain Med. 2024;3(2):100403.

Find out whether PRP fits your condition

Candidacy for PRP is determined on ultrasound, not over the phone. Bring your imaging and get an honest answer in one visit.

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