PRP: Platelet Dose & Concentration
His ongoing PRP investigation emphasizes platelet dose—not simply injection volume—as an important variable when comparing PRP preparations and interpreting clinical studies.
Peer-Reviewed Research · Sports Medicine & Regenerative Medicine · Glastonbury, CT
Verified, PubMed-indexed and peer-reviewed publications from Dr. Paul Tortland's work in sports medicine, regenerative medicine, orthobiologics, and musculoskeletal ultrasound.
Yao-Wen Eliot Hu, Garry W.K. Ho, Paul D. Tortland · Current Sports Medicine Reports · 2021 · PMID 34099604 · DOI 10.1249/JSR.0000000000000848
Read on PubMed →Sean W. Mulvaney, MD; Paul Tortland, DO; Brian Shiple, DO; Kamisha Curtis, MPH · Endurance and Sports Medicine · 2018
Read the publication →Paul D. Tortland, DO; Daniel Kuebler, DO · Pilot study / technical white paper · 2020 · Bone marrow aspiration technique and progenitor-cell yield
Read the study →Darrell Rigel, Jim Clover, Paul D. Tortland, Michael R. Whitford · The Physician and Sportsmedicine · 1994 · PMID 29272967 · DOI 10.1080/00913847.1994.11947716
Read on PubMed →Dr. Tortland’s current clinical investigation examines platelet dose and concentration, PRP processing variables, bone-marrow aspiration technique, cellular yield, and ultrasound-guided procedural precision.
His ongoing PRP investigation emphasizes platelet dose—not simply injection volume—as an important variable when comparing PRP preparations and interpreting clinical studies.
He has documented an N=1 head-to-head comparison of Exo Advantage with another PRP system, controlling blood draw, processing conditions and technician, then measuring the resulting PRP by hemocytometry. This is clinical investigation, not a peer-reviewed clinical trial.
View the documented comparison →His Technique Matters work investigates how aspiration variables can influence progenitor-cell yield.
Read Technique Matters →His MSK ultrasound work connects diagnosis, anatomy and precise needle guidance with orthobiologic procedures. He has used MSK ultrasound clinically since 2008 and taught it since 2009.
Teaching & Speaking →Recognition: Dr. Tortland was the 2024 inaugural recipient of the Caplan Excellence Award, named in honor of Arnold Caplan, for his educational contributions to regenerative medicine.
Dr. Tortland’s scholarly work has focused on sports medicine, musculoskeletal ultrasound, orthobiologics, regenerative medicine, ultrasound-guided procedures, and techniques intended to make non-surgical musculoskeletal care more precise.
His work includes peer-reviewed articles, literature reviews, technical studies, and textbook chapters addressing regenerative medicine, orthobiologic procedures, nerve injections, sports medicine, and bone-marrow aspiration technique.
Dr. Tortland has also taught physicians in sports medicine, musculoskeletal ultrasound, and regenerative medicine, emphasizing anatomy, diagnosis, imaging, patient selection, procedural precision, and appropriate use of orthobiologic treatments.
View Credentials & Professional Experience →Musculoskeletal ultrasound is more than a way to guide a needle. It can help a physician evaluate anatomy and pathology in real time, select the appropriate target, and visualize needle placement during an injection. Dr. Tortland has used MSK ultrasound clinically since 2008 and has taught diagnostic and interventional MSK ultrasound to physicians since 2009, including approximately 8–10 courses each year.
The broader evidence supports the importance of image-guided technique: systematic reviews consistently find ultrasound-guided musculoskeletal injections to be more accurate than landmark- or blind-guided injections, although improvements in pain and function vary by joint, condition, and study. A 2024 umbrella review of 17 systematic reviews and meta-analyses found greater accuracy with ultrasound guidance, particularly for several common musculoskeletal injection sites.
Evidence: 2024 umbrella review of ultrasound- vs landmark-guided injections · 2021 systematic review of 12 Level I knee-injection studies · 2015 systematic review/meta-analysis of randomized trials.
For patients, the practical distinction is straightforward: a landmark-guided injection relies primarily on surface anatomy and palpation, while ultrasound guidance allows the physician to see relevant structures and the needle in real time. Ultrasound does not guarantee a better outcome for every condition, but greater procedural accuracy is an important advantage when precise targeting matters.
The medical literature generally finds that ultrasound guidance improves injection accuracy compared with landmark-guided or “blind” techniques, although improvements in pain and function vary by joint, condition, and procedure. These studies support the value of image guidance for precision without implying that ultrasound guarantees a better outcome in every patient.
A synthesis of 17 systematic reviews and meta-analyses found ultrasound-guided injections were generally more accurate than landmark-guided injections, particularly for the shoulder, with additional benefits varying by joint and outcome.
Read on PubMed →A Level I systematic review of 13 studies reported cumulative accuracy of 95.4% for ultrasound-guided knee injections/aspirations versus 82.0% with landmark guidance.
Read on PubMed →Across 12 randomized controlled trials, ultrasound-guided intra-articular and periarticular injections were more accurate than landmark-guided injections; short-term pain outcomes also favored ultrasound guidance, while longer-term differences were less certain.
Read on PubMed →A systematic review and meta-analysis found weighted mean accuracy of 100% for ultrasound-guided hip injections compared with 72% for landmark-guided injections.
Read on PubMed →A systematic review and meta-analysis found ultrasound guidance improved accuracy for several shoulder targets, including the AC joint, biceps tendon sheath, and glenohumeral joint, with clinical benefits varying by injection site.
Read on PubMed →A systematic review of nine studies involving 715 adults found ultrasound-guided knee arthrocentesis had higher accuracy, lower procedural pain, and greater aspiration volume than landmark-guided procedures.
Read on PubMed →Frequently Asked
The research and sources on this page are provided so patients and clinicians can evaluate the evidence behind these topics. If you'd like to discuss how this research may apply to your condition, schedule a consultation.