that's good to know, I hurt my knee cycling on Zwift....got a MRI and it was determined I have wear and tear in the articular cartilage area (above kneecap) and will have to schedule to get a shot....haven't had one since 2021 and it worked well for my other issue. Tore ACL in 2006 as well as Meniscus, knee has since started to give me problems in 2021 which would be inclusive to Degenerative Cartilage.
@@gtbike8142 Once a year, two time injections. The second is applied 15 days after the first one. That works good for me. I'm 45 years old, cyclist and I workout a lot! I'm fine, no pain, no serious injuries in knees. The treatment really works!
I had a cortisone injection one week ago for increasing knee pain I've had for over a 6-month period. Thankfully I got the immediate pain relief, but have been researching osteoarthritis and PRP injections and am so glad I found you here. My dog (pitbull/boxer) recently recovered from CCL (knee) surgery on both knees. She has a genetic condition with weakened CCLs and had surgery twice on one knee, (the first surgery failed) and once on her other knee. Last week her vet brought up the subject of PRP injections which was very new to me. She is fully healed from her surgeries which has been a very expensive and time-consuming road for my dog and me. I learned alot from the veterinarian about PRP (in my book he is a top veterinary surgeon) and am now also looking at PRP for my own knee. Your video is very helpful and I look forward to watching more of them. Your presentations are easy to understand and follow for this 68-year-old grandmother. Thank you.
Hi Dr. Peng, I am 57 year old active male I have work in a factory for 35 years and still working there I tore my left knee medial meniscus due to dengeration last year and the MRI revele that I have osteoarthritis too done a lot of PT to strengthen my quad muscles plus all other muscles on around knee. In December 2022 I had the gel injection shot in left knee which is the hyronic acid shot knee feels better not as much pain as before but I still have continued symptoms in the knee unfortunately I still have that physical job for 3 more years till I retire. I seen your PRP video I wish my insurance would acknowledged this treatment very hopeful for the future to do this treatment so I don't have to get a knee replacement...Keep up the good info and work Thank You John S
great blog. I had PRP and bone stem cell injections in my hip. I have great results and after a year I have been improved walking and less pain. I will continue with my treatments!
To those that are on the fence, get the injection. I'm 41 and am in need of a knee replacement but I'm too young. I've had 2 PRP injections on two separate occasions. I'm not saying it's magic but I have almost no pain. Gotta love medicine.
I just got my first one today and I have very high hopes!!! My knee feels very tight, but I am sure that will change in a few days! I k we both knees replaced and I do not want them! I do not do steroids at all!!
@@jackie-k ya my knee was tight as well. It went away after a couple days. I found it took a few weeks until I started to really feel an improvement. It was one of those things where my knee hurt and then I realized it didn't hurt anymore. It sneaks up on you so don't expect instant magic but it was pretty darn close. If you don't mind, let me know how it goes. I'm wondering if it works as well for others as it did for me.
@@mrglass3617 Thanks for sharing that! I am excited and have very high hopes. If it works along with my diet and exercise, I will pay out of pocket for the right knee. VA paid for my left knee, but right knee is shot and it was the one injured with a torn meniscus. I will keep the notification I got in my email and come back and give an update for sure!!
I got PRP injections through the VA it was an instant success the pain was gone after 1 week I got the PRP in both knees. I went from a wheelchair to walking miles
After getting the first 2 of 3 PRP injections at the VA the VA has decided to refuse all veterans this very beneficial procedure without reasoning 😭😭🥵🤬
Thank you Dr. Peng for all of your fantastic videos. I am 50 years old and am starting to deal with a degenerative meniscus tear (actually two - one on the medial and one on the lateral side, though the biggest challenge is on the lateral side). While I say degenerative, the truth is that they are likely the result of a soccer-induced ACL tear (and subsequent reconstruction) that took place in 1996. With the latest onset of pain, I did a deep dive into my options with a variety of renowned orthopedic surgeons (in the US, UK, and CH - I live in Geneva, CH) and while there was zero consensus among these experts, I think the best option is ultimately a partial knee replacement. That said, I am inclined to postpone as long as possible and have decided to do PRP injections. I have been managing the pain and swelling with fitness therapy (I love that you call this out - I know that I can't stop or I am f$#ked), NSAIDs, and ice so far. So finally my question: you recommend to have the PRP injection and then have a break from sports before restarting. I am moving into cycling season and would prefer not to break for too long. After the injection, how long should I wait before restarting cycling. Do you have a suggested program for the restart to sport after the injection? Thanks very much for your input! Also happy to have any other suggestions that you may have!
Also, I have never heard a more detailed and understandable description of what is actually happening in my knee. Thanks again for being here for us. Hugs
I have osteoarthritis in my hip and my doctor suggested this as well. Insurance doesn't cover it and this video is making me consider found this instead of cortisone ❤🎉
Just had my second PRP injection , started 4 weeks ago definitely feels better , pain free just walking around the house will try longer walks shortly but fingers crossed hopefully improvement will carry on !
I’ve been researching this forever and this was the most helpful and concise video I’ve found! I’m a 31 year old athlete and veteran and have late stage 3. It’s been horrible, but I’m staying optimistic!
Bro, look for the "knees over toes guy", just try to watch as many his videos you can... Then research on Collagen supplements, Vitamin C (cartilage precursor) and Magnesium (citrate) ..., internet has put to our disposal cases, information and testimonies, just try it all, good luck, you will find a solution.
I underwent PRP injections for both knees. This along with daily use of a single daily dose of meloxicam has made a huge improvement with my knee pain, joint mobility, knee weakness and some grinding I was experiencing in my left knee. I am now one month in.
My knees are still feeling good. I haven't tried playing tennis yet. I also still take meloxicam daily. Pain remains greatly reduced since receiving the PRP injections. Note: my doctor did not use an ultrasound guided needle as Dr. Peng mentions in his video.
Thanks Dr Peng for this vid. Have osteoarthritis in the knee n tried cortisone n HA shots; NSAIDs; knee braces, etc that help with the pain n stiffness to some extent. Intrigued by PRP if it's more effective n longer term than the other alternatives. Kudos for ur analysis n advice on the subject matter. Anticipating more on pain management, osteoarthritis, etc. Peace
Hey Doc, the information that you are providing is very educational...... it enables me to have a conversation with a provider the same way a person who became knowledgeable about cars with a mechanic.
Dr. Peng, thank you for this incredible information. Physicians like yourself are invaluable to society. I had a recurring patella injury in my teens and early 20s. I’m now 39 and was feeling dull pain, light stiffness and swelling, and light instability in my patella. Before the results of my MRI came in and without speaking to me about my pain level and/or risks, the orthopedic that I went to see stuck me with a cortisone injection about a month ago. I only learned about the toxic effects afterwards. I have to let this go because there is no point in crying over spilt milk. My MRI shows extensive loss of cartilage under my patella (grade 3 and 4). I love what you said about PRP possibly creating a neutral environment to help delay the progression of arthritis. Two questions and, of course I know you won’t be able to give me absolute answers - 1. In terms of cortisone injections being toxic to cartilage, does the research show that even one can cause significant damage? And 2. Because of the growth factors and healing capabilities, will PRP help to negate the toxic effects of the cortisone injections. Dr. Peng, thank you again for what you do. You are helping so many by sharing this information. I know it sounds crazy but I live in Florida and thinking of coming to California for a PRP injection from you (as I’ve read that, with PRP, process and technique matter a lot!)
Thanks so much for your kind words! My hope is to get the word out on new treatments such as PRP. There are lots of providers who do ultrasound guided PRP injections in Florida, so please do your due diligence and search! Yes, there are studies which suggest a few cortisone injections can cause damage, albeit the risk is low. ua-cam.com/video/qO6-xvWl4o4/v-deo.html No PRP cannot "undo" the effects of cortisone. I would not fret over the fact that you got a cortisone shot in your knee. Focus on what you can change and affect going forward!
Thank you so much for this video. I am seeking PRP therapy and of course insurance won't cover it because they classify it as an "investigational treatment". However, I am tired of limited range of motion, pain, and my knee intermittently giving out.
I couldn't walk 100 yards last summer, pain all the time. I had this procedure in August, three shots over three weeks. I am a high school teacher. This worked for me! It really worked! Last summer I could barely walk for the pain. It WORKED for me! Please try it, if you're in pain.
Thanks for your comment. It's amazing the response people can get with PRP injections! May not work for everyone, especially those with more severe arthritis. But it seems like an excellent option for those with mild to moderate arthritis or for those who have tried cortisone injections with minimal to no sustainable relief!
Hi you are amazing. Explain so clear as I now understand more. Thank you However, I do have a few question did you came a cross or you know. Q. 1) Can PRR injection help me to improve factional movement which is to be able to seat on my HEELS ? Q -2) What is the name a part of my knee that preventing me to seat all the way down and seat on my heels? I try to find out trough pictures but I am not sure. Please help me - if there is anything I can improve as it is very important to me. Thanks
Incredibly informative and obviously well researched Dr. Peng! Kudos and thank you from one whom was considering full or partial knee replacement! Thank you again for such a well delivered, easily understandable explanation of a biological that I never even knew existed! BTW,....does Medicare w/supplemental cover this proceedure??
@@JeffreyPengMD Dr. Peng, I was wondering if you have knowledge of a procedure being "pushed" (heavily advertised here on TV in the NYC area), involving the injection into the knee of some type of synthetic cushioning (NOT a biological) to help alleviate pain! I am waiting for a brochure on this and apparently this procedure is accepted by most insurances and medicare. Is it possible to have a video on this in the near future? I am sure all who watch you would be greatly interested in your opinion. Thanks again for all your well presented information. All the more viable as there is obviously no agenda other than the dissemination of valuable information and knowledge!
@@ineedhoez . . .there is also shockwave therapy and laser therapy. these do the same as prp injections. All three 3 treatments provide immediate pain relief within the first 2 days of treatment as it works to heal the musckolotal condition wether injury or otherwise. Shockwave therapy and laser therapy both might be less costly than prp injections . .multiple shockwave therapy sessions might be cheaper and more effective than 1 or 2 prp injectons. Also all 3 prp injections, shockwave therapy and laser therapy are most effective when combined with one another or physical therpay or exercise especially low impact. Shockwave and laser are less invasive than prp injections.
Amazing explanation! I've been having knee problems for over a year and doctors say nothing is wrong.After hearing your information, i now understand that my cartilage is injured and inflamed and now i know how to proceed.
@@JeffreyPengMD I Had my second injection 12/15/2021. Can I go do another injection, even if I do not feel Pain in right leg? Or start with the left leg injection treatment ?
Can you please tell me how PRP injections work for osteo arthritis of the finger joints. My hands are in so much pain and I refuse to get my finger joints fused to where I can never bend my fingers again. There has to be something better then fusing my finger joints. I had 3 toes fused and its the worst thing I've ever done, never again. I pray you can give me some good news on this. Thank you Doctor Peng
Hi Dr Pang once again an excellent video. You are extremely well informed and I want to know whether stem cell treatment is able To treat arthritis and secondly, if it is better than prp injections.
Dr Pang I have just heard the video you had already made and which addressed my question regarding stem cells vs prp. You are brilliant. Your analysis of things is clear and logical and sincere - all at the same. Thank you. After hearing your video, I wanted to ask you whether stem Cells from a donor Umbilical cord more effective than the prp and stem cells at 70. Would it be possible to advise me what to go with?
Interesting... so damn Interesting. I have post traumatic injury induced arthritis. I was told that this would be an issue when I had the surgery. What I wasn't told was that I needed to be intentional about rehabilitation and protective strength training. To be fair, I probably wouldn't have complied anyways but at least I would have known. Flash forward 10 years and I am at a level 2 knee arthritis with bone spurs🤨🤨🤨 I want to start the injections. I want to stave off a knee replacement. My doctor says that if I do the PT and Strengthening, I can buy myself another 15 years before a joint replacement. Thank you for this content. This has been so illuminating. I can now be incredibly proactive about my knee health.
Dr Peng, you provide amazing details and information in your videos. Thank you for your valuable info to society. I take clopidogrel and aspirin for stents placed in coronary arteries two years ago. My cardiologist recommends taking these drugs for a lifetime. Does that mean PRP is not my option for knee OA?
Dear Doctor Peng: Or should I say, Maestro Peng!? I came upon your wonderful series of videos by quite accident while investigating the effectiveness of PRP in treating my bilateral OA, from which I have been suffering for more than 10 years. I have received injections of hyaluronic acid (Supartz 25mg) twice a year and fortunately am one of those for whom this treatment has been very effective. However, based on your explanations through a series of very clear and helpful UA-cam videos…you should be awarded an Oscar!…I am now considering Platelet Rich Plasma as a next step in my treatment journey. Two reservation: (1.) At 75 years of age, I suspect this procedure is less likely to be successful for me; after all, how “platelet-rich” could my plasma be? (2.) The orthopod with whom I have discussed this protocol…in whom I have a great deal of confidence and who has administered the infusion many times in order to treat arthritis in elbows, hips, shoulders, knees, etc., always guided by ultrasound, prefers to use L-PRP (Leukocyte + PRP), which as you know, contains white blood cells & low fibrin matrix, as opposed to the alternative, and I believe your favored choice, L-PRF (Leukocyte + PRF) which includes no white blood cells & a high fibrin matrix and is believed to be more effective, especially in the treatment of OA of the knees. When I suggested that though not very large or double blind, studies to date have demonstrated that the L-PRF (Leukocyte + PRF) was more effective, he disagreed and said one study of 700 patients concluded no statistically different results were measured. What to do? I think if I were able to show him the studies that you have reviewed (the more, the better!), he would be open to trying it regardless of how slim the advantage. At my age, anything that increases my chances of success is worth trying. I would appreciate you sending me links to the most reliable and prestigious studies you have seen. I think that would be an invaluable first step of this physician being converted to some new thinking on the PRP issue as a viable standard of care. Many thanks! Will
Thank you, well explained. My name is Pamela NaidooI am a South African 66 year old Indian lady. I am following you regularly. Please advise if there is a Orthopedic Dr here in Johannesburg , Gauteng. South Africa. whom I can visit.
Thank you for the info on the research and how PRP works. I'm scheduled to have PRP later in January in my rt knee and low back. I've been feeling a little apprehensive. Your video has helped me to know I am doing a likely helpful treatment. 🙂
@@thijs9395can I ask what it costs for the treatment, how many injections are needed? I got the knee gell which did mostly nothing. Injections every week for 5 weeks. Only to have to do it again in the next few months. Would like something that actually try’s to fix things
28 years young, professional basketball player out in France. PRP+HA is magic, helped regenerate the small defect in my articular cartilage. Anybody reading this don’t lose hope.
The process takes time, do not get discouraged, knee will be sensitive as the prp cells are attaching. Rehab will be key, building a strong foundation in quads, hamstrings will help elevate the impact and pain. I’m pretty much back to normal.
My doctor advised me to get knee surgery on my left knee 15 years ago and I didn’t listen to him. I had two treatments of plasma on my knee and on my face for melasma also. it worked great. I had it done in Colombia and I spent $500. I’m planning to go again.
Hi dr. I can prepare PRP and I inject it in face and scalp. but I really like to learn how I can inject it in knee. please teach knee injection. thank you very much.
I wanted to ask when I can expect visible results from PRP therapy on my knee. I'm 3 weeks in and I'm not seeing much improvement. Is there a specific amount of time after which I should see improvement or does it vary for each person? Thank you for giving me this information."
Thank you for your detailed video presentation, Dr. Peng. It shattered my thoughts about to get my 84 yrs old mama to get Prp injection when you mentioned that stroked p.t. is on aspirin and clopigrel will inhibit the effect of platelets. So will stem cell will help my mama bilateral knees osteoarthritis and osteoporosis? Thank you Dr. Peng.
You may find this helpful: ua-cam.com/video/fNw-o-NHKh4/v-deo.html Short answer is we don't know if anti-platelet agents will affect stem cells. Though animal studies given naproxen post stem cell injection showed significantly worse outcomes.
I partially tore my patella tendon and had to get a few sessions of prp injections. missed summer aau but was back by the time varsity started in the fall
Dr Peng, i have damaged cartilage on both of my knees. My orthopedist recommends either injection of HA + PRP or surgery repairing the damaged cartilage on both of my knees with hyalofast. Could you give me your thoughts about it.
*Mild knee joint effusion is noted in tha tibiofemoral joint space *There is evidence of lateral meniscus showing meniscocapsular separation. *There is evidence of subtle T2 hyperintensities noted in the ACL. *Subchondral sclerosis noted in the medial tibial plateau. *There is mild tilt of the patella noted laterally with subtle chondral hyperintensities in the median ridge and the opposing trochlea of the femur. *Grade 1 signal in posterior horn and body of medial meniscus. Sir, left leg knee MRI report. Can PRP injection cure my problem?
I was gonna have a HA injection with my ortho doctor since the steroid injection he gave me only lasted 6 months. Then I asked him about PRP and he suggested it too. I also heard from someone who had PRP injections done to her plantar fasciitis that relieved her pain for 2 years now so I’m also thinking of doing it on my heel. I also went to a clinic that do stem cell but it will cost me $8500 for a series of 4-5 injections because they said the success rate is higher that way instead of just one. I do not want knee replacement and I still have 10 more years before retirement and with the kind of job that requires me to be on my feet 12 hours a day is killing me. The plantar fasciitis and osteoarthritis both on my right knee is debilitating. If PRP works just to buy me time before retirement that would be fantastic. If it doesn’t work then I’m going for the stem cell regeneration later on.
PRP and HA are both great options to treat knee arthritis if the injections are done ultrasound guided. With that said, head to head trials suggest PRP is superior, though HA can be covered by insurances. In my opinion, definitely worth the cost (though please shop around as costs vary widely) to preserve your knees! As far as plantar fasciitis goes, most studies suggest 1 PRP injection is often sufficient. You can always get more if symptoms return! ua-cam.com/video/wnfo3DuPK9I/v-deo.html
@@JeffreyPengMD I had HA injections that were not ultrasound guided. I too was thinking that would be the most logical approach. The 2 different PA's that administered the injections (series of 3 shots Supartz) claimed that the knee is encapsulated and ultrasound guiding is not needed. Just different thought processes or what? Thank you.
Update- it’s been 7 months since my PRP and so far so good. I feel my knee has cushion in between the 2 bones. I don’t have the “click” sound anymore and it’s comfortable going up the stairs now. I’ll do it again if the pain comes back. I think its how you use your knee in your day to day life.
Thanks, Dr. Peng - this was very informative! However, I have a question re my knee injury, which I've had for three years: does a PRP injection help not regenerate, but repair, soft tissue around the joint? I feel that the lack of soft tissue has led to all this nagging pain, as well as popping and clicking. The pain has significantly improved since day one, but it's still annoying.
Thanks for your comment. PRP has thus far not been shown to regenerate anything (though interestingly, it may have some reparative properties, still unknown). Decreased muscle strength is incredibly common in those who have arthritis. This is part of the reason why exercise therapy is so important!
THANK YOU FOR THE INFORMATION I WOULD LIKE TO KNOW IS IT COVER BY HEALTH INSURANCE AND IF NOT WHAT THE PRICE, AND ALL THE DETAIL OF THE PROCEDURE -HOW MUCH PLASMA U TAKE ,HOW LONG BETWEEN THE DRAWING OF THE BLOOD AND PUT IT BACK TO THE KNEE? AND WHERE ARE U LOCATED? THANK U
Thank for this excellent information. My mother who is 73 is undergoing PRP injections. What supplements can she take to boost the quality of the PRP that is drawn?
Would PRP/with possibly more injections help someone with osteoarthritis and pseudo gout along with a locked knee that can’t bend, help? Hx of knee surgery 1991, trimmed meniscus and acl repair along with femur condole shave…
I did plasma for my knees, I have a little roughness My weight is approximately 68 lbs. Do I need to walk lightly every day and do knee exercises? Is walking and exercises beneficial or harmful to the knee? Should I continue taking nutritional supplements for the knee? Please let me know and thank you
Thanks for good work.. I am 72 with mod oa and recent flare.. had a single prp 8 Bn leukocyte poor shot.. 5 weeks later don’t notice anything but did play tennis a few times .. should I do a repeat prp now or wait? Many thanks
MRI said I have a partial scapholunate ligament tear and a central triangular fibrocartilage fenestration or tear. Also a ganglion cyst. I’ve been in a cast on my wrist for about 6 weeks, 2 weeks left until I take it off and do another MRI. If it doesn’t heal, doctor said I need surgery. Do you think prp injections can heal these torn ligaments? I don’t want surgery. I only had pain when I bend my wrist hard so I don’t need prp for pain management. What would you do for your patients? Also very great and insightful video keep it up!!
Unfortunately, PRP injections have not been studied specifically for this indication. With that said, many sports medicine physicians use PRP injections to try to "augment" or "speed up" the healing of ulnar collateral ligament tears in the elbow. Theoretically, it would also make sense to treat scapholunate ligament tears or TFCC tears with PRP. To reiterate, this is not backed up by any clinical studies. Good luck with casting, many patients do well after that.
Hi Dr.Peng. Thanks for information. I have elbow and knees painted almost a year now, I got injections in my elbow for tendon and joint but I don’t see any better. I’m thinking PRP after watching your video and I know the insurance not cover unfortunately. Can you quote the costs for me plz. Thank you
It seems PRP is better than HA at each quarter follow-up thru a year post injection. One question for you : a 2021 meta-analysis by Aiyer, Rohit suggests the 2:1 ratio of positive studies and comes to a summary: Conclusion: We can only recommend PRP for patients with early-stage osteoarthritis (I or II) and who are aged below 65, based on our findings. Is this your view, given the constraints of meta-analytics, or as you seem to suggest, that there might be an optimal use for pre-symptomatic use of PRP or perhaps a bilateral use if the symptoms are unilateral but if both knees show joint-thinning or other clinical criteria indicating pre- or mild osteoarthritis. Have you seen any studies or your clinical impression? I am not asking for a consult...... 😃
Complicated question requires an indepth answer, that of which likely extends beyond a reply on youtube! I'll try my best to give a quick summary. It's clear cortisone injections have side effects and are toxic to joint cartilage. We should avoid those if possible, especially if you are young. And if you are "older," do you really want to put cortisone in your knee if it might make your osteoarthritis WORSE? There also aren't many other options. It's either cortisone, HA, or biologics such as PRP. And head to head trials clearly favor PRP. I have used PRP to treat patients of all ages and all degrees of osteoarthritis and have seen excellent results. Granted, best results are seen in those with mild to moderate osteoarthritis. But even patients with severe osteoarthritis have good outcomes and we are able to manage symptoms to prevent a joint replacement surgery. The ultimate goal is to PREVENT people from getting severe osteoarthritis in the first place. To that end, there is a big paradigm shift in how we treat osteoarthritis. Before it was "deal with it" and come see us when you are ready for a knee replacement. Now, it is let's treat it and manage it so that we can slow the progression and prevent it from getting worse. We should be managing osteoarthritis like any other chronic disorder (ie. diabetes, hypertension). We know the consequences of untreated diabetes and high blood pressure can be catastrophic to someone's health. Severe bone on bone osteoarthritis is the same way. Regular injections with biologics seem like an excellent way to manage this disorder.
@@JeffreyPengMD I think the importance of clinical insight only gained from treatment of a wide variety of patients of many ages and degrees of osteoarthritis is so evident in your reply. I am thankful that treatments to stop progression from very early onset are now being contemplated. I talked with a friend who is going to have to get treatment --- but he is near HSS, New York --- so i think from his feedback that they are going to be very proactive in his incipient unilateral osteoarthritis. While not preventative, it is at least early in the osteoarthritic progression and should be understood since it is a result of 50 years on the tennis court. Excellent overview and insightful summary [thumbs up!]. I appreciate the time taken. Yep - I've subscribed.
@@JeffreyPengMD I have severe bone on bone osteoarthritis. I’ve been getting HA and cortisone injections every 9 months. I’m really hoping prp is beneficial to me despite the severity of my osteoarthritis. HA has given me a lot of relief but my Orthopaedic surgeon feels confident that I’ll have even better pain relief with prp. I had my first prp injection today. My knee and the surrounding area is very stiff and quite sore….is this typical?
What’s the recommendation for time off after injection for patella tendinitis and quad (just above the outside of the knee) tendinitis for a hockey player?
There are MANY different types of PRP, each with pros and cons. The most important variable seems to be platelet count and concentration. ua-cam.com/video/NPrNeyx6Bv8/v-deo.html
Omg ..the chain reaction of having bad cartilage was this bad...never knew Abt this...will see if I can ask my dad to get this...also doc do u hv any food recommendations for people above 75 years of age ?
Thanks for your question. PRP has been shown to be less effective for stage 4 (bone on bone) arthritis when compared to stage 1 or stage 2. However, it can still do a good job to help palliate symptoms.
I just had a total knee replacement on my right knee and my left knee needs it too, but it’s bone on bone only in the medial part and most of the middle worn down. Do you think I could benefit from a platelet rich plasma injection and stick it out another year because I don’t want another TKR right now, even though it hurts. Week 4 on my right knee now. Cortizone makes me gimpy, and it works to a degree, but not very well anymore. I had synvisc injections in both knees over a year ago and they didn’t do a thing.
What about having a PRP injection when you have a platelet disease like Essential Thrombocytosis? Ive had ET for years but i have severe knee pain arthritis
Hello Dr. I had a PRP injection today. The Dr. didn’t use an ultrasound or anything so see where he was injecting. Is that normal? He just injected and said he’s being doing it for a long time and that he’s a surgeon so he knows what he’s doing. Would like your opinion on this?
Thanks for your comment. In my opinion, you never want to "guess" where PRP is going, no matter how experienced you are. Others may disagree. There are a lot of things we used to do that has now changed with advances in technology. I'm a firm believer that ultrasound guided injections will become "standard of care" in the near future (if it hasn't already).
I have had two injections of cortisone in my shoulder (bursa) since April 2022 and at the end of July,2023 I’m due to receive another injection. Is PRP helpful for the pain and my reduced range of motion in my shoulder?
Dr Peng can you do a video on cutting edge biomedicine for knees? I have read that spider silk can be used for ligament replacement and that a new lab grown cartilage replacement can be transplanted onto bone and is better than the real thing.
Lots of exciting stuff happening in laboratories that I'm not up to date on! I focus more on clinical applications and what I can offer patients that come through my office
Dr Peng, thank for the video. i wish to know more how PRP help in knee arthritis. The growth factor in PRP is actually inhibiting the release of toxic enzymes so as to reduce inflammation or promote tissue regeneration in cartilage and collagen production ? This is the part confusing me.
Great question. The goal of PRP is to treat the micro-enviroment inside the knee. Try to think about it this way, the platelets and growth factors initiate anti-inflammatory cascades to help neutralize the inflammation caused by arthritis. By doing so, we help improve symptoms related to arthritis. Furthermore, by keeping the level of inflammation in the knee controlled at a very low level, we hopefully prevent arthritis from getting worse. There is no evidence (at least not yet) that anything is being regenerated with PRP. The hope is to improve symptoms and slow the progression of arthritis.
@@JeffreyPengMD Hi Dr, if this is the case, will you suggest combination treatment of PRP and HA on the same setting or on alternate session since both are to provide symptomatic relief ?
Another excellent question. Many docs do recommend this (combining PRP + HA) however the evidence is still mixed. journals.sagepub.com/doi/abs/10.1177/0363546521998010 This systematic review concluded "combination therapy with PRP + HA improves patient reported outcomes and is superior to HA alone but is not superior to PRP alone." If you are fortunate to have access to both, it seems worthwhile to try. However, I have seen excellent results with just PRP alone. This is also what the above systematic review concluded.
@@JeffreyPengMD Thank you Dr for your time to reply me. Appreciated. It seems that PRP is much superior than HA. I wonder if Dr has tried the combination, i am more curious the mechanism and how it is carried out.
The basic science mechanism of how HA and PRP interact is not fully understood so I cannot give you an exact answer. What we do know is that both HA and PRP work under different pathways to decrease pain and inflammation. Theoretically by addressing a problem (inflammation due to arthritis) from different approaches, we can try to obtain a better outcome. But it may be sufficient to just use one pathway (PRP) to achieve the same outcome. The true answer is yet to be determined.
I’m getting my first PRP injection for my SI joint. I’ve had many of the cortisone shot that didn’t seem to work so I’m going to give the PRP a shot and see if that works. What is your opinion?
Thank you for such an informative video. I have osteoarthritis in my knee. I will be getting my 1st PRP injection on the 1st of August , 2nd on the 8th and then 3rd on the 15th. I'll be traveling to Europe on the 24th and doing ALOT of walking. Would you recommend this or not ?
Thanks for your comment. Unfortunately I cannot give medical advice over the internet. Please discuss your situation with your trusted health care professional. Best of luck!
I’ve tried PRP last year and all of my pain is gone. I’m a mountain biker and the therapy brings me to life again 😀
that's good to know, I hurt my knee cycling on Zwift....got a MRI and it was determined I have wear and tear in the articular cartilage area (above kneecap) and will have to schedule to get a shot....haven't had one since 2021 and it worked well for my other issue. Tore ACL in 2006 as well as Meniscus, knee has since started to give me problems in 2021 which would be inclusive to Degenerative Cartilage.
How many treatments did you require.. just had my first today
How many treatments did you have to achieve that
@@gtbike8142 Once a year, two time injections. The second is applied 15 days after the first one. That works good for me. I'm 45 years old, cyclist and I workout a lot! I'm fine, no pain, no serious injuries in knees. The treatment really works!
I have done 2 PRP injections and haven’t had pain in over 1 year.
I had a cortisone injection one week ago for increasing knee pain I've had for over a 6-month period. Thankfully I got the immediate pain relief, but have been researching osteoarthritis and PRP injections and am so glad I found you here. My dog (pitbull/boxer) recently recovered from CCL (knee) surgery on both knees. She has a genetic condition with weakened CCLs and had surgery twice on one knee, (the first surgery failed) and once on her other knee. Last week her vet brought up the subject of PRP injections which was very new to me. She is fully healed from her surgeries which has been a very expensive and time-consuming road for my dog and me. I learned alot from the veterinarian about PRP (in my book he is a top veterinary surgeon) and am now also looking at PRP for my own knee. Your video is very helpful and I look forward to watching more of them. Your presentations are easy to understand and follow for this 68-year-old grandmother. Thank you.
Steroids only break down bone density along with skin and veins. It is a temp solution with too many long term problems!!
Hi Dr. Peng, I am 57 year old active male I have work in a factory for 35 years and still working there I tore my left knee medial meniscus due to dengeration last year and the MRI revele that I have osteoarthritis too done a lot of PT to strengthen my quad muscles plus all other muscles on around knee. In December 2022 I had the gel injection shot in left knee which is the hyronic acid shot knee feels better not as much pain as before but I still have continued symptoms in the knee unfortunately I still have that physical job for 3 more years till I retire. I seen your PRP video I wish my insurance would acknowledged this treatment very hopeful for the future to do this treatment so I don't have to get a knee replacement...Keep up the good info and work Thank You John S
Thanks for sharing!
great blog. I had PRP and bone stem cell injections in my hip. I have great results and after a year I have been improved walking and less pain. I will continue with my treatments!
To those that are on the fence, get the injection. I'm 41 and am in need of a knee replacement but I'm too young. I've had 2 PRP injections on two separate occasions. I'm not saying it's magic but I have almost no pain. Gotta love medicine.
Wow! Thanks for sharing
I just got my first one today and I have very high hopes!!! My knee feels very tight, but I am sure that will change in a few days! I k we both knees replaced and I do not want them! I do not do steroids at all!!
@@jackie-k ya my knee was tight as well. It went away after a couple days. I found it took a few weeks until I started to really feel an improvement. It was one of those things where my knee hurt and then I realized it didn't hurt anymore. It sneaks up on you so don't expect instant magic but it was pretty darn close. If you don't mind, let me know how it goes. I'm wondering if it works as well for others as it did for me.
@@mrglass3617 Thanks for sharing that! I am excited and have very high hopes. If it works along with my diet and exercise, I will pay out of pocket for the right knee. VA paid for my left knee, but right knee is shot and it was the one injured with a torn meniscus. I will keep the notification I got in my email and come back and give an update for sure!!
I got PRP injections through the VA it was an instant success the pain was gone after 1 week I got the PRP in both knees. I went from a wheelchair to walking miles
After getting the first 2 of 3 PRP injections at the VA the VA has decided to refuse all veterans this very beneficial procedure without reasoning 😭😭🥵🤬
Thank you Dr. Peng for all of your fantastic videos. I am 50 years old and am starting to deal with a degenerative meniscus tear (actually two - one on the medial and one on the lateral side, though the biggest challenge is on the lateral side). While I say degenerative, the truth is that they are likely the result of a soccer-induced ACL tear (and subsequent reconstruction) that took place in 1996. With the latest onset of pain, I did a deep dive into my options with a variety of renowned orthopedic surgeons (in the US, UK, and CH - I live in Geneva, CH) and while there was zero consensus among these experts, I think the best option is ultimately a partial knee replacement. That said, I am inclined to postpone as long as possible and have decided to do PRP injections. I have been managing the pain and swelling with fitness therapy (I love that you call this out - I know that I can't stop or I am f$#ked), NSAIDs, and ice so far. So finally my question: you recommend to have the PRP injection and then have a break from sports before restarting. I am moving into cycling season and would prefer not to break for too long. After the injection, how long should I wait before restarting cycling. Do you have a suggested program for the restart to sport after the injection? Thanks very much for your input! Also happy to have any other suggestions that you may have!
Also, I have never heard a more detailed and understandable description of what is actually happening in my knee. Thanks again for being here for us. Hugs
Thanks for your kind words!
I totally agree with you I have the same problems.
The cherry on the cake information starts at min 8. Dr. Peng, hats off to you Sir. Crystal clear information. Blessings.
Thanks!
P.R.P is a true blessing!! Very beneficial and I'm so grateful for it and my Dr. L treating me with it
Yes! We still have so much more to learn about it
I have osteoarthritis in my hip and my doctor suggested this as well. Insurance doesn't cover it and this video is making me consider found this instead of cortisone ❤🎉
🎉
Just had my second PRP injection , started 4 weeks ago definitely feels better , pain free just walking around the house will try longer walks shortly but fingers crossed hopefully improvement will carry on !
That’s awesome! Cardio and strengthening exercises are definitely important aspects of a multimodal treatment approach to arthritis!!
I’ve been researching this forever and this was the most helpful and concise video I’ve found! I’m a 31 year old athlete and veteran and have late stage 3. It’s been horrible, but I’m staying optimistic!
Awesome, glad you found it helpful!
Bro, look for the "knees over toes guy", just try to watch as many his videos you can...
Then research on Collagen supplements, Vitamin C (cartilage precursor) and Magnesium (citrate) ..., internet has put to our disposal cases, information and testimonies, just try it all, good luck, you will find a solution.
@@frannelk NOPE, the knee over toes dudes aren't really helpful or nuanced for late-stage arthritis. i wish people would STFU about them.
I underwent PRP injections for both knees. This along with daily use of a single daily dose of meloxicam has made a huge improvement with my knee pain, joint mobility, knee weakness and some grinding I was experiencing in my left knee. I am now one month in.
Hi, how are your knees doing? I'm just curious, as I just had my right knee injected 2 weeks ago.
My knees are still feeling good. I haven't tried playing tennis yet. I also still take meloxicam daily. Pain remains greatly reduced since receiving the PRP injections. Note: my doctor did not use an ultrasound guided needle as Dr. Peng mentions in his video.
thanks and that's good news. I hope I'm improved at the 4 week mark. @@joesarver824
What grade of knee arthritis did u have?
@@riccphoto near bone on bone right knee. Moderate arthritis left knee
Thanks Dr Peng for this vid. Have osteoarthritis in the knee n tried cortisone n HA shots; NSAIDs; knee braces, etc that help with the pain n stiffness to some extent. Intrigued by PRP if it's more effective n longer term than the other alternatives. Kudos for ur analysis n advice on the subject matter. Anticipating more on pain management, osteoarthritis, etc. Peace
Hey Doc, the information that you are providing is very educational...... it enables me to have a conversation with a provider the same way a person who became knowledgeable about cars with a mechanic.
That's great! I love reading comments like these
Dr. Peng, thank you for this incredible information. Physicians like yourself are invaluable to society. I had a recurring patella injury in my teens and early 20s. I’m now 39 and was feeling dull pain, light stiffness and swelling, and light instability in my patella. Before the results of my MRI came in and without speaking to me about my pain level and/or risks, the orthopedic that I went to see stuck me with a cortisone injection about a month ago. I only learned about the toxic effects afterwards. I have to let this go because there is no point in crying over spilt milk. My MRI shows extensive loss of cartilage under my patella (grade 3 and 4). I love what you said about PRP possibly creating a neutral environment to help delay the progression of arthritis. Two questions and, of course I know you won’t be able to give me absolute answers - 1. In terms of cortisone injections being toxic to cartilage, does the research show that even one can cause significant damage? And 2. Because of the growth factors and healing capabilities, will PRP help to negate the toxic effects of the cortisone injections. Dr. Peng, thank you again for what you do. You are helping so many by sharing this information. I know it sounds crazy but I live in Florida and thinking of coming to California for a PRP injection from you (as I’ve read that, with PRP, process and technique matter a lot!)
Thanks so much for your kind words! My hope is to get the word out on new treatments such as PRP. There are lots of providers who do ultrasound guided PRP injections in Florida, so please do your due diligence and search!
Yes, there are studies which suggest a few cortisone injections can cause damage, albeit the risk is low.
ua-cam.com/video/qO6-xvWl4o4/v-deo.html
No PRP cannot "undo" the effects of cortisone. I would not fret over the fact that you got a cortisone shot in your knee. Focus on what you can change and affect going forward!
Just read your bio and had a suspicion by your presentation style that ytou are quite the gifted professor! Again, many, many thanks!
You're welcome and thanks for the kind words!!
I had PRP injections for my shoulders recently and it seems to have helped.😊
Really well explained and simple to understand! Thanks!
Glad it was helpful! Thanks for your comment
Thank you so much for this wonderful presentation.
You're welcome! Thanks for your comment
Thank you so much for this video. I am seeking PRP therapy and of course insurance won't cover it because they classify it as an "investigational treatment". However, I am tired of limited range of motion, pain, and my knee intermittently giving out.
You're very welcome, glad you found it helpful
How much do prp injections cost out of pocket?
I couldn't walk 100 yards last summer, pain all the time. I had this procedure in August, three shots over three weeks.
I am a high school teacher. This worked for me! It really worked!
Last summer I could barely walk for the pain. It WORKED for me!
Please try it, if you're in pain.
Thanks for your comment. It's amazing the response people can get with PRP injections! May not work for everyone, especially those with more severe arthritis. But it seems like an excellent option for those with mild to moderate arthritis or for those who have tried cortisone injections with minimal to no sustainable relief!
@ltyr-mr2if how are you now
Hi you are amazing. Explain so clear as I now understand more. Thank you
However, I do have a few question did you came a cross or you know.
Q. 1) Can PRR injection help me to improve factional movement which is to be able to seat on my HEELS ?
Q -2) What is the name a part of my knee that preventing me to seat all the way down and seat on my heels?
I try to find out trough pictures but I am not sure.
Please help me - if there is anything I can improve as it is very important to me.
Thanks
Excellent explanation
Incredibly informative and obviously well researched Dr. Peng! Kudos and thank you from one whom was considering full or partial knee replacement! Thank you again for such a well delivered, easily understandable explanation of a biological that I never even knew existed! BTW,....does Medicare w/supplemental cover this proceedure??
Thanks for commenting! Unfortunately, at this time PRP is not covered by insurances, including medicare.
@@JeffreyPengMD Dr. Peng, I was wondering if you have knowledge of a procedure being "pushed" (heavily advertised here on TV in the NYC area), involving the injection into the knee of some type of synthetic cushioning (NOT a biological) to help alleviate pain! I am waiting for a brochure on this and apparently this procedure is accepted by most insurances and medicare.
Is it possible to have a video on this in the near future?
I am sure all who watch you would be greatly interested in your opinion.
Thanks again for all your well presented information. All the more viable as there is obviously no agenda other than the dissemination of valuable information and knowledge!
Thank you. Helpful and informative.
I can only imagine how hard big pharma is lobbying to keep insurance companies from providing coverage for PRP.
100%!
Yes, I will have to pay out if pocket. But they'll pay for artificial steroid injections though. Smh.
Exactly!!!!!
Insurance will catch up. They will see the cost of surgery vs injections. It will become the new conservative treatment
@@ineedhoez . . .there is also shockwave therapy and laser therapy. these do the same as prp injections. All three 3 treatments provide immediate pain relief within the first 2 days of treatment as it works to heal the musckolotal condition wether injury or otherwise.
Shockwave therapy and laser therapy both might be less costly than prp injections . .multiple shockwave therapy sessions might be cheaper and more effective than 1 or 2 prp injectons.
Also all 3 prp injections, shockwave therapy and laser therapy are most effective when combined with one another or physical therpay or exercise especially low impact.
Shockwave and laser are less invasive than prp injections.
Amazing explanation! I've been having knee problems for over a year and doctors say nothing is wrong.After hearing your information, i now understand that my cartilage is injured and inflamed and now i know how to proceed.
Glad you found it helpful!
you need an MRI
i have them done and i feel much better! you will need 2-3 injections to give best relief
That's awesome! Yes, it does seem 2 (maybe 3) injections is the sweet spot for most people
@@JeffreyPengMD I Had my second injection 12/15/2021. Can I go do another injection, even if I do not feel Pain in right leg?
Or start with the left leg injection treatment ?
Great video, very informative and helpful
Can you please tell me how PRP injections work for osteo arthritis of the finger joints. My hands are in so much pain and I refuse to get my finger joints fused to where I can never bend my fingers again. There has to be something better then fusing my finger joints. I had 3 toes fused and its the worst thing I've ever done, never again. I pray you can give me some good news on this. Thank you Doctor Peng
Hi Dr Pang once again an excellent video. You are extremely well informed and I want to know whether stem cell treatment is able
To treat arthritis and secondly, if it is better than prp injections.
You may find this helpful: ua-cam.com/video/JjkQvbM6rsw/v-deo.html
Dr Pang I have just heard the video you had already made and which addressed my question regarding stem cells vs prp. You are brilliant. Your analysis of things is clear and logical and sincere - all
at the same. Thank you. After hearing your video, I wanted to
ask you whether stem
Cells from a donor Umbilical cord more effective than the prp and stem cells at 70. Would it be possible to advise me what to go with?
Interesting... so damn Interesting. I have post traumatic injury induced arthritis. I was told that this would be an issue when I had the surgery.
What I wasn't told was that I needed to be intentional about rehabilitation and protective strength training. To be fair, I probably wouldn't have complied anyways but at least I would have known.
Flash forward 10 years and I am at a level 2 knee arthritis with bone spurs🤨🤨🤨
I want to start the injections. I want to stave off a knee replacement. My doctor says that if I do the PT and Strengthening, I can buy myself another 15 years before a joint replacement.
Thank you for this content. This has been so illuminating. I can now be incredibly proactive about my knee health.
Thanks for sharing!
Thanks for enlightening about the PRP injection. Could you let me know if it is available in Australia ?
Thanks
Jacob Idicula
Dr Peng, you provide amazing details and information in your videos. Thank you for your valuable info to society. I take clopidogrel and aspirin for stents placed in coronary arteries two years ago. My cardiologist recommends taking these drugs for a lifetime. Does that mean PRP is not my option for knee OA?
More explanation and illustration please. Thank you
You may find this helpful: ua-cam.com/video/dqdmq_gTy-M/v-deo.html
Dear Doctor Peng:
Or should I say, Maestro Peng!?
I came upon your wonderful series of videos by quite accident while investigating the effectiveness of PRP in treating my bilateral OA, from which I have been suffering for more than 10 years.
I have received injections of hyaluronic acid (Supartz 25mg) twice a year and fortunately am one of those for whom this treatment has been very effective.
However, based on your explanations through a series of very clear and helpful UA-cam videos…you should be awarded an Oscar!…I am now considering Platelet Rich Plasma as a next step in my treatment journey.
Two reservation:
(1.) At 75 years of age, I suspect this procedure is less likely to be successful for me; after all, how “platelet-rich” could my plasma be?
(2.) The orthopod with whom I have discussed this protocol…in whom I have a great deal of confidence and who has administered the infusion many times in order to treat arthritis in elbows, hips, shoulders, knees, etc., always guided by ultrasound, prefers to use L-PRP (Leukocyte + PRP), which as you know, contains white blood cells & low fibrin matrix, as opposed to the alternative, and I believe your favored choice, L-PRF (Leukocyte + PRF) which includes no white blood cells & a high fibrin matrix and is believed to be more effective, especially in the treatment of OA of the knees.
When I suggested that though not very large or double blind, studies to date have demonstrated that the L-PRF (Leukocyte + PRF) was more effective, he disagreed and said one study of 700 patients concluded no statistically different results were measured.
What to do?
I think if I were able to show him the studies that you have reviewed (the more, the better!), he would be open to trying it regardless of how slim the advantage.
At my age, anything that increases my chances of success is worth trying.
I would appreciate you sending me links to the most reliable and prestigious studies you have seen.
I think that would be an invaluable first step of this physician being converted to some new thinking on the PRP issue as a viable standard of care.
Many thanks!
Will
Thank you, well explained. My name is Pamela NaidooI am a South African 66 year old Indian lady. I am following you regularly.
Please advise if there is a Orthopedic Dr here in Johannesburg , Gauteng. South Africa. whom I can visit.
Really good explanation. Thank you very much. Now i know what to do
You are welcome! Thanks for commenting
Hello Dr, is PRP injection also gut for torn ACl and Meniskus?
Very positive video. Will PRP work for smaller joints like CMC joint in the thumb?
Thank you for the info on the research and how PRP works. I'm scheduled to have PRP later in January in my rt knee and low back. I've been feeling a little apprehensive. Your video has helped me to know I am doing a likely helpful treatment. 🙂
Good luck with your treatments!
How did it go?
How'd you go?
@@thijs9395can I ask what it costs for the treatment, how many injections are needed? I got the knee gell which did mostly nothing. Injections every week for 5 weeks. Only to have to do it again in the next few months. Would like something that actually try’s to fix things
I need knee, shoulder and back. How much do your treatment cost you and do you have help with insurance?
just got mine done thank you Dr. Peng 谢谢你， 我 更觉啊 非常好 我 六十一岁！
Thank you so very much for this very accurate video explaining P.R.P!!
You're welcome, thanks for commenting!
28 years young, professional basketball player out in France. PRP+HA is magic, helped regenerate the small defect in my articular cartilage. Anybody reading this don’t lose hope.
AMAZING! Thanks for sharing your experiences
thats great to know......have the same issue, some days I can cycle and some days I can't.....this requires the knee to bend at a 90 degree angle
The process takes time, do not get discouraged, knee will be sensitive as the prp cells are attaching. Rehab will be key, building a strong foundation in quads, hamstrings will help elevate the impact and pain. I’m pretty much back to normal.
Wish they had this when I was in Italy playing for corona basket! Thanks for the comment, gl out there on the court & NBA wishes for you!
Does this help in stage 4 osteoarthrities ?? Pls do reply...i am in lot of pain..only 29 years old
My doctor advised me to get knee surgery on my left knee 15 years ago and I didn’t listen to him. I had two treatments of plasma on my knee and on my face for melasma also. it worked great. I had it done in Colombia and I spent $500. I’m planning to go again.
Hi dr.
I can prepare PRP and I inject it in face and scalp. but I really like to learn how I can inject it in knee. please teach knee injection. thank you very much.
I wanted to ask when I can expect visible results from PRP therapy on my knee. I'm 3 weeks in and I'm not seeing much improvement. Is there a specific amount of time after which I should see improvement or does it vary for each person?
Thank you for giving me this information."
Detail information, thanks
Thank you for your detailed video presentation, Dr. Peng.
It shattered my thoughts about to get my 84 yrs old mama to get Prp injection when you mentioned that stroked p.t. is on aspirin and clopigrel will inhibit the effect of platelets.
So will stem cell will help my mama bilateral knees osteoarthritis and osteoporosis?
Thank you Dr. Peng.
You may find this helpful: ua-cam.com/video/fNw-o-NHKh4/v-deo.html
Short answer is we don't know if anti-platelet agents will affect stem cells. Though animal studies given naproxen post stem cell injection showed significantly worse outcomes.
I partially tore my patella tendon and had to get a few sessions of prp injections. missed summer aau but was back by the time varsity started in the fall
That's awesome! Patellar tendon tears are so difficult to treat. Glad to hear it worked out for you.
Dr Peng, i have damaged cartilage on both of my knees. My orthopedist recommends either injection of HA + PRP or surgery repairing the damaged cartilage on both of my knees with hyalofast. Could you give me your thoughts about it.
Unfortunately I cannot give medical advice over the internet, but you might find this helpful. ua-cam.com/video/iK3zTFRTzsA/v-deo.html
*Mild knee joint effusion is noted in tha tibiofemoral joint space
*There is evidence of lateral meniscus showing meniscocapsular separation.
*There is evidence of subtle T2 hyperintensities noted in the ACL.
*Subchondral sclerosis noted in the medial tibial plateau.
*There is mild tilt of the patella noted laterally with subtle chondral hyperintensities in the median ridge and the opposing trochlea of the femur.
*Grade 1 signal in posterior horn and body of medial meniscus.
Sir, left leg knee MRI report. Can PRP injection cure my problem?
I was gonna have a HA injection with my ortho doctor since the steroid injection he gave me only lasted 6 months. Then I asked him about PRP and he suggested it too. I also heard from someone who had PRP injections done to her plantar fasciitis that relieved her pain for 2 years now so I’m also thinking of doing it on my heel. I also went to a clinic that do stem cell but it will cost me $8500 for a series of 4-5 injections because they said the success rate is higher that way instead of just one. I do not want knee replacement and I still have 10 more years before retirement and with the kind of job that requires me to be on my feet 12 hours a day is killing me. The plantar fasciitis and osteoarthritis both on my right knee is debilitating. If PRP works just to buy me time before retirement that would be fantastic. If it doesn’t work then I’m going for the stem cell regeneration later on.
PRP and HA are both great options to treat knee arthritis if the injections are done ultrasound guided. With that said, head to head trials suggest PRP is superior, though HA can be covered by insurances. In my opinion, definitely worth the cost (though please shop around as costs vary widely) to preserve your knees!
As far as plantar fasciitis goes, most studies suggest 1 PRP injection is often sufficient. You can always get more if symptoms return!
ua-cam.com/video/wnfo3DuPK9I/v-deo.html
Am I ask what clinic would use stem cells?
@@JeffreyPengMD I had HA injections that were not ultrasound guided. I too was thinking that would be the most logical approach. The 2 different PA's that administered the injections (series of 3 shots Supartz) claimed that the knee is encapsulated and ultrasound guiding is not needed.
Just different thought processes or what? Thank you.
Such big figures id go on holiday get the injection s and still have change .
Update- it’s been 7 months since my PRP and so far so good. I feel my knee has cushion in between the 2 bones. I don’t have the “click” sound anymore and it’s comfortable going up the stairs now. I’ll do it again if the pain comes back. I think its how you use your knee in your day to day life.
Thanks, Dr. Peng - this was very informative! However, I have a question re my knee injury, which I've had for three years: does a PRP injection help not regenerate, but repair, soft tissue around the joint? I feel that the lack of soft tissue has led to all this nagging pain, as well as popping and clicking. The pain has significantly improved since day one, but it's still annoying.
Thanks for your comment. PRP has thus far not been shown to regenerate anything (though interestingly, it may have some reparative properties, still unknown). Decreased muscle strength is incredibly common in those who have arthritis. This is part of the reason why exercise therapy is so important!
I have similar issues but with my ankle. Did you end up getting the prp injection?
@@Muna-ht3me did you get ?
THANK YOU FOR THE INFORMATION I WOULD LIKE TO KNOW IS IT COVER BY HEALTH INSURANCE AND IF NOT WHAT THE PRICE, AND ALL THE DETAIL OF THE PROCEDURE -HOW MUCH PLASMA U TAKE ,HOW LONG BETWEEN THE DRAWING OF THE BLOOD AND PUT IT BACK TO THE KNEE? AND WHERE ARE U LOCATED? THANK U
Do you have a recommendation of providers for this treatment in Houston TX area? Thanks much.
Thank for this excellent information.
My mother who is 73 is undergoing PRP injections. What supplements can she take to boost the quality of the PRP that is drawn?
ua-cam.com/play/PLrX971rgONtooFRotwN9sADDLwYWXMvoz.html
Would PRP/with possibly more injections help someone with osteoarthritis and pseudo gout along with a locked knee that can’t bend, help? Hx of knee surgery 1991, trimmed meniscus and acl repair along with femur condole shave…
PRP has only been studied for osteoarthritis. It has not been studied for pseudo gout.
Dr Peng , how many days after PRP knee injection can i put ice on it ? better not at all ?
have a good day
Best to discuss your situation with your healthcare provider. I like heat better than ice!
Awesome video. Thank you !
Glad you liked it! Thanks for your comment
I did plasma for my knees, I have a little roughness
My weight is approximately 68 lbs. Do I need to walk lightly every day and do knee exercises?
Is walking and exercises beneficial or harmful to the knee?
Should I continue taking nutritional supplements for the knee?
Please let me know and thank you
You have conviced me ,doctor. Thank you.❤❤❤
Do you have a center in Georgia or can you recommend a great facility for me to get the prp procedure in the north Georgia area? Thanks!
Thanks for good work.. I am 72 with mod oa and recent flare.. had a single prp 8 Bn leukocyte poor shot.. 5 weeks later don’t notice anything but did play tennis a few times .. should I do a repeat prp now or wait? Many thanks
Best to discuss with your docs!
Superb video. Thank you very much!
Glad you liked it!
What about knee tendenosis? Jumpers knee? Pain right below the patella on the bottom of it
As well as quad tendon pain
MRI said I have a partial scapholunate ligament tear and a central triangular fibrocartilage fenestration or tear. Also a ganglion cyst.
I’ve been in a cast on my wrist for about 6 weeks, 2 weeks left until I take it off and do another MRI.
If it doesn’t heal, doctor said I need surgery. Do you think prp injections can heal these torn ligaments? I don’t want surgery. I only had pain when I bend my wrist hard so I don’t need prp for pain management. What would you do for your patients?
Also very great and insightful video keep it up!!
Unfortunately, PRP injections have not been studied specifically for this indication. With that said, many sports medicine physicians use PRP injections to try to "augment" or "speed up" the healing of ulnar collateral ligament tears in the elbow. Theoretically, it would also make sense to treat scapholunate ligament tears or TFCC tears with PRP. To reiterate, this is not backed up by any clinical studies.
Good luck with casting, many patients do well after that.
@@JeffreyPengMD Thanks for the reply! Keep up the amazing work!
What about torn meniscus
Hi Dr.Peng. Thanks for information. I have elbow and knees painted almost a year now, I got injections in my elbow for tendon and joint but I don’t see any better. I’m thinking PRP after watching your video and I know the insurance not cover unfortunately. Can you quote the costs for me plz. Thank you
You may find this helpful: ua-cam.com/video/kAWgnEO4Qo4/v-deo.html
Hey, Dr., do you think getting prp treatment along with an unloading knee brace can be the magic ticket?
It seems PRP is better than HA at each quarter follow-up thru a year post injection. One question for you :
a 2021 meta-analysis by Aiyer, Rohit suggests the 2:1 ratio of positive studies and comes to a summary:
Conclusion: We can only recommend PRP for patients with early-stage osteoarthritis (I or II) and who are aged below 65, based on our findings.
Is this your view, given the constraints of meta-analytics, or as you seem to suggest, that there might be an optimal use for pre-symptomatic use of PRP or perhaps a bilateral use if the symptoms are unilateral but if both knees show joint-thinning or other clinical criteria indicating pre- or mild osteoarthritis.
Have you seen any studies or your clinical impression? I am not asking for a consult...... 😃
Complicated question requires an indepth answer, that of which likely extends beyond a reply on youtube! I'll try my best to give a quick summary.
It's clear cortisone injections have side effects and are toxic to joint cartilage. We should avoid those if possible, especially if you are young. And if you are "older," do you really want to put cortisone in your knee if it might make your osteoarthritis WORSE? There also aren't many other options. It's either cortisone, HA, or biologics such as PRP. And head to head trials clearly favor PRP.
I have used PRP to treat patients of all ages and all degrees of osteoarthritis and have seen excellent results. Granted, best results are seen in those with mild to moderate osteoarthritis. But even patients with severe osteoarthritis have good outcomes and we are able to manage symptoms to prevent a joint replacement surgery.
The ultimate goal is to PREVENT people from getting severe osteoarthritis in the first place. To that end, there is a big paradigm shift in how we treat osteoarthritis. Before it was "deal with it" and come see us when you are ready for a knee replacement. Now, it is let's treat it and manage it so that we can slow the progression and prevent it from getting worse. We should be managing osteoarthritis like any other chronic disorder (ie. diabetes, hypertension). We know the consequences of untreated diabetes and high blood pressure can be catastrophic to someone's health. Severe bone on bone osteoarthritis is the same way. Regular injections with biologics seem like an excellent way to manage this disorder.
@@JeffreyPengMD
I think the importance of clinical insight only gained from treatment of a wide variety of patients of many ages and degrees of osteoarthritis is so evident in your reply. I am thankful that treatments to stop progression from very early onset are now being contemplated. I talked with a friend who is going to have to get treatment --- but he is near HSS, New York --- so i think from his feedback that they are going to be very proactive in his incipient unilateral osteoarthritis. While not preventative, it is at least early in the osteoarthritic progression and should be understood since it is a result of 50 years on the tennis court.
Excellent overview and insightful summary [thumbs up!]. I appreciate the time taken. Yep - I've subscribed.
Thanks for the kind words!
@@JeffreyPengMD I have severe bone on bone osteoarthritis. I’ve been getting HA and cortisone injections every 9 months. I’m really hoping prp is beneficial to me despite the severity of my osteoarthritis. HA has given me a lot of relief but my Orthopaedic surgeon feels confident that I’ll have even better pain relief with prp. I had my first prp injection today. My knee and the surrounding area is very stiff and quite sore….is this typical?
@@stacielee1170 hi, have you noticed any improvements to your osteoarthritis symptoms since PRP injection?
What’s the recommendation for time off after injection for patella tendinitis and quad (just above the outside of the knee) tendinitis for a hockey player?
Hi Dr Peng, can I have PRP if I have lost cartilage and nearly bone on bone. Thanks for the videos
Yes, but it does not seem to work as well as those with mild arthritis
Excellent video. I'm new to PRP. Is there just one kind or are there multiple variations? If multiple, what are the pro and con of each Thankyou!
There are MANY different types of PRP, each with pros and cons. The most important variable seems to be platelet count and concentration. ua-cam.com/video/NPrNeyx6Bv8/v-deo.html
Omg ..the chain reaction of having bad cartilage was this bad...never knew Abt this...will see if I can ask my dad to get this...also doc do u hv any food recommendations for people above 75 years of age ?
Can you get PRP when you had partial knee replacement 18:years ago?
Dr. Peng, thanks for the informative video. Can PRP work if you are already bone on bone??
Thanks for your question. PRP has been shown to be less effective for stage 4 (bone on bone) arthritis when compared to stage 1 or stage 2. However, it can still do a good job to help palliate symptoms.
@@JeffreyPengMD thank you Dr.!!!
So, how do I know if it's right for me? What patient profile would you consider to be a poor candidate for this treatment?
Dr. Peng, can you have PRP injections after you’ve had series of Euflexxa gel?
Apart from blood thinners which you advised to avoid before and after PRP, can you also advise what other foods are good and bad for platelets count?
In general, more plant based foods and lean meats, less processed foods
I just had a total knee replacement on my right knee and my left knee needs it too, but it’s bone on bone only in the medial part and most of the middle worn down. Do you think I could benefit from a platelet rich plasma injection and stick it out another year because I don’t want another TKR right now, even though it hurts. Week 4 on my right knee now. Cortizone makes me gimpy, and it works to a degree, but not very well anymore. I had synvisc injections in both knees over a year ago and they didn’t do a thing.
Dr. Peng do you have information or experience with combining PRP and stem cells for knee pain and an MCL tear.
There is no evidence that combining PRP and stem cells is more effective than PRP alone.
Does PRP work for near bone on bone pain? Does it help to regenerate cartilage?
Please reply as soon as possible- Thank you Dr so much 😊
is PRP injection on the knee possible without ultrasound? is there landmarks?
How can I screen providers to be sure I get the best quality PRP?
What about having a PRP injection when you have a platelet disease like Essential Thrombocytosis? Ive had ET for years but i have severe knee pain arthritis
Hello Dr. I had a PRP injection today. The Dr. didn’t use an ultrasound or anything so see where he was injecting. Is that normal? He just injected and said he’s being doing it for a long time and that he’s a surgeon so he knows what he’s doing. Would like your opinion on this?
Thanks for your comment. In my opinion, you never want to "guess" where PRP is going, no matter how experienced you are. Others may disagree. There are a lot of things we used to do that has now changed with advances in technology. I'm a firm believer that ultrasound guided injections will become "standard of care" in the near future (if it hasn't already).
I have had two injections of cortisone in my shoulder (bursa) since April 2022 and at the end of July,2023 I’m due to receive another injection. Is PRP helpful for the pain and my reduced range of motion in my shoulder?
Dr Peng can you do a video on cutting edge biomedicine for knees? I have read that spider silk can be used for ligament replacement and that a new lab grown cartilage replacement can be transplanted onto bone and is better than the real thing.
Lots of exciting stuff happening in laboratories that I'm not up to date on! I focus more on clinical applications and what I can offer patients that come through my office
Dr. Jeff, can we gîte PRP while the knee has big effusion.
Hi, does PRP heal torn meniscus? How many sessions do I need to get a good outcome?
My question is the PRP plasma can fixed the herniated disc????
I wonder if lidocaine
infusions would help
your pain?
Dr Peng, thank for the video. i wish to know more how PRP help in knee arthritis. The growth factor in PRP is actually inhibiting the release of toxic enzymes so as to reduce inflammation or promote tissue regeneration in cartilage and collagen production ? This is the part confusing me.
Great question. The goal of PRP is to treat the micro-enviroment inside the knee.
Try to think about it this way, the platelets and growth factors initiate anti-inflammatory cascades to help neutralize the inflammation caused by arthritis. By doing so, we help improve symptoms related to arthritis.
Furthermore, by keeping the level of inflammation in the knee controlled at a very low level, we hopefully prevent arthritis from getting worse. There is no evidence (at least not yet) that anything is being regenerated with PRP. The hope is to improve symptoms and slow the progression of arthritis.
@@JeffreyPengMD Hi Dr, if this is the case, will you suggest combination treatment of PRP and HA on the same setting or on alternate session since both are to provide symptomatic relief ?
Another excellent question. Many docs do recommend this (combining PRP + HA) however the evidence is still mixed.
journals.sagepub.com/doi/abs/10.1177/0363546521998010
This systematic review concluded "combination therapy with PRP + HA improves patient reported outcomes and is superior to HA alone but is not superior to PRP alone."
If you are fortunate to have access to both, it seems worthwhile to try. However, I have seen excellent results with just PRP alone. This is also what the above systematic review concluded.
@@JeffreyPengMD Thank you Dr for your time to reply me. Appreciated. It seems that PRP is much superior than HA. I wonder if Dr has tried the combination, i am more curious the mechanism and how it is carried out.
The basic science mechanism of how HA and PRP interact is not fully understood so I cannot give you an exact answer. What we do know is that both HA and PRP work under different pathways to decrease pain and inflammation. Theoretically by addressing a problem (inflammation due to arthritis) from different approaches, we can try to obtain a better outcome. But it may be sufficient to just use one pathway (PRP) to achieve the same outcome. The true answer is yet to be determined.
I’m getting my first PRP injection for my SI joint. I’ve had many of the cortisone shot that didn’t seem to work so I’m going to give the PRP a shot and see if that works. What is your opinion?
Thanks for your comment. You may find this helpful: ua-cam.com/video/_YZAZ7Vt2As/v-deo.html
What about a MCL full thick tear ? Im getting this offer to me , im very skeptical that it would work.
Thank you for such an informative video. I have osteoarthritis in my knee. I will be getting my 1st PRP injection on the 1st of August , 2nd on the 8th and then 3rd on the 15th. I'll be traveling to Europe on the 24th and doing ALOT of walking. Would you recommend this or not ?
Thanks for your comment. Unfortunately I cannot give medical advice over the internet. Please discuss your situation with your trusted health care professional. Best of luck!
So how was your experience with PRP Injection. Did it helped in fixing your knee pain?