Is all PRP the same quality?

PRP concentration depends on the centrifugation protocol, the collection system used, the patient's own baseline platelet count, and draw technique. Commercial bedside kits typically reach only about 2 to 7 times a patient's baseline platelet count, while a custom-formulated preparation can be targeted to roughly 12 to 15 times baseline or higher, tailored to the patient and the tissue being treated. The only way to know what was actually injected is to measure it with a real hematology analyzer, not to estimate it or assume a kit produces a consistent result.

PRP is not a standardized pharmaceutical, so there is no mandated platelet count and no requirement that a clinic verify what it produced before injecting it. Two patients receiving "PRP" at two different clinics — or the same clinic on different days — can receive preparations that differ dramatically in platelet concentration and activation state.

Every PRP preparation in my practice is verified before injection. That isn't standard industry practice — it should be, but it isn't. A low-concentration preparation that doesn't perform as hoped isn't evidence that PRP doesn't work; it may simply be evidence the preparation was never optimized in the first place.