PRP injections use platelets concentrated from your own blood to restart healing in a damaged tendon or arthritic joint. In St. Louis, we prepare PRP in an FDA-cleared system and place it under ultrasound or X-ray guidance in one office visit. It suits tendon pain and mild to moderate arthritis that therapy and cortisone did not fix.
Platelets are the repair workers of your body. When you cut your hand, they arrive first, plug the leak and broadcast the growth signals that call in new blood supply and rebuild tissue. A tendon that has hurt for a year, or a knee that grinds every morning, is a site where that crew quit showing up. PRP brings them back in concentrated form, right to the injured spot.
The detail most clinics skip is that PRP is a family of products. Platelet count, white cell content and where the needle lands all change the result.
We draw a tube of your blood, spin it in a centrifuge and separate the platelet-rich layer. That concentrate goes back into the injured tissue. Once there, platelets release growth factors that do three jobs: they calm the inflammatory chemistry that keeps a joint irritated, they signal local cells to lay down new collagen, and they draw in blood supply to tissue that has very little. In a joint, the main effect is a quieter, better-lubricated joint and less pain. In a tendon, it restarts a repair process that stalled.
Leukocytes are white blood cells. How much of them stays in the final product depends on how we spin and draw it.
For knee arthritis, a 2026 network meta-analysis of 21 trials found both types beat placebo and hyaluronic acid on function, with no clear winner between them. So the choice follows the tissue, and we make it for your tissue.
Yes. A 2025 meta-analysis of placebo-controlled knee trials found high-platelet PRP gave clinically meaningful pain relief at 3, 6 and 12 months, while low-platelet PRP failed to give a benefit patients could feel on pain scores. A weak mix is a waste of a visit. We use systems built to reach a high platelet concentration, and we adjust the volume to the size of the target: a small elbow tendon needs less than a knee joint.
Every injection is guided. A blind needle in a tendon is a guess. See why guidance matters.
Platelets carry the message. The tissue has to be able to hear it. Three things decide that. Insulin resistance and the chronic inflammation it drives blunt the response of cartilage and tendon cells to every growth signal. Sleep debt does the same, because collagen repair runs on the night shift. Load decides whether the new tissue survives: a heavy knee or a weak hip keeps crushing the repair before it matures. Behavior closes the loop. The patient who goes back to the same desk, the same diet and the same weekend overuse is asking the platelets to rebuild a wall while the wrecking ball is still swinging.
So we treat the terrain alongside the tissue: metabolic optimization, a written rehab plan and laser therapy when it helps. That work is 40 to 50 percent of the protocol.
PRP works when two things are done right, and most clinics skip both. The first is the platelet count actually delivered. A weak spin can leave barely more platelets than ordinary blood, and an injection placed by feel often lands beside the tendon or outside the joint instead of in it. We prepare a high platelet dose and place it under ultrasound or X-ray guidance, because the repair workers only count if enough of them reach the job.
The second is the collateral rehab. The platelets restart the repair; the muscles and movement around the joint or tendon decide how much load the healing tissue takes afterward. Your plan rebuilds the muscles that protect the area, restores the motion it lost, and corrects the movement pattern that wore it down, alongside the metabolic work that sets your healing budget. An injection without that rehab is a repair crew sent to a building that is still being knocked down. For one joint where this matters most, see hip arthritis treatment.
The procedure takes place at our office at 4477 Woodson Rd in St. Louis under local anesthetic. You are awake and most patients drive themselves home. Expect soreness for about 48 hours as the platelets do their job. Protect the area for the first few days and follow the rehab plan. Some people feel better in three weeks; others need a second or third treatment, decided by how the tissue responds. You can’t make a carrot grow faster than it grows, and tendon and cartilage are slow crops.
No. PRP is not billed to insurance. That is a payer budgeting decision. HSA and FSA funds are generally eligible.
Because the platelet dose, the placement and the rehab vary. A low-platelet preparation, an injection that misses the tendon or joint, or no strengthening plan afterward all weaken the result. We control all three: a high platelet dose, image-guided placement, and a rehab plan built for your joint or tendon.
We numb the skin and the path of the needle. Most people feel pressure, then soreness for about two days.
Ask us first. Anti-inflammatory drugs can blunt the platelet response, so we give you a plan for pain control that does not fight the treatment.
Cortisone shuts inflammation down fast and wears off. PRP works slower and aims at repair, so the benefit tends to build over weeks and last longer.
In advanced arthritis or bone damage below the joint, bone marrow concentrate or microfragmented fat may fit better. We decide at your evaluation.
There is no preset number. The count follows how your tissue responds.
If cortisone keeps wearing off and therapy has stalled, PRP may be the next step. See the full range of options on our orthobiologics in St. Louis page. Over 90% of our accepted case-study patients see significant improvement. These are practice-reported figures from our own population, not trial outcomes, and individual results vary. Request the free orthobiologics guide above, or call (314) 481-5000 to ask whether PRP fits your joint or tendon.
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