The Full Answer
Not every patient responds to a first PRP treatment, and a lack of response doesn't automatically mean the next step is surgery. Depending on the diagnosis and how the patient responded (or didn't), options can include re-evaluating the diagnosis itself, moving to a cellular orthobiologic option like BMAC or MFAT, adding a complementary treatment such as shockwave therapy, or, when appropriate, discussing surgical options honestly.
What the Current Evidence Shows
Who May Benefit
When Surgery May Be More Appropriate
When a thorough, appropriately-dosed course of orthobiologic treatment hasn't produced meaningful improvement and imaging shows advanced structural damage, it's appropriate to have an honest conversation about surgical options.
Dr. Tortland's Perspective
A treatment that doesn't work as hoped is information, not a dead end — it prompts a re-look at the diagnosis and the plan, rather than simply repeating the same injection or defaulting straight to surgery.