Why do you need ultrasound to do shoulder, knee and elbow injections . I have been doing joint injection for 25 years with excellent results. Isn’t the use of US use to increase the billable? In NJ most insurance will not pay for the use of US I can understand its use for tendons and ligaments only
I wonder if PRP could really heal a meniscus tear?. After 1 injection i felt much better and can go back to light running now. The doctor who gave me PRP said that 1 injection would be sufficient to fix my issue but now i`m starting to experience pain again. Some orthopaedics told me that PRP is not an option for a meniscus tear, as it would be too serious to be healed by PRP and must get operated. 😵💫😵💫
I had prp injection 6 months ago for tennis elbow and can say it made my pain has gone away and now have better use of my arm. Now its not 100% better but i say I'm 80 percent better know.
Prp saved my life!! Not exaggerating. Osteoarthritis, Tietze’s Syndrome, shoulder bursitis, muscle tears, shoulder impingement, herniated disc- three injections, feel like I have a new lease on life
@@gerrie6498 thank you, starting to feel that way again. If you are struggling with similar conditions, I hope you can and will access PRP care. Took years of saving, but totally worth it, and I’d do it again, can’t recommend enough, for anyone reading (do make sure they are a doctor/licensed/ anesthesiologist/use ultrasound, and follow diet/supplement requirements to boost efficacy). Best wishes!
@@heretolearnCA i trust God for a miracle . I wish you prosperity. Here in South Africa there are doctors who is doing it. Considering prosedure in 2 months time. Recently had local anaesthetic and cortizone injected. Today is 3 rd day. See how it will goes. God bless you. In fact the doctor is ½ hour away. I’m willing to give it a go. I also started cannabis drops yesterday. If all else fails then shall I go for PRP. I had 4 back surgeries in 3 years time and from there ongoing complications. Through the wounds of Jesus Christ we are healed under His Mighty name. I have scans. Thank God all blood results are fine.
@@gerrie6498 awesome!! Start prepping now. Get more collagen II/ bone broth in your diet, more dark leafy greens - anything that will enrich your blood and give the PRP its best chance of working. Prioritize sleep, if you can. Cut sugar and sat fats. Have more fish oil and curcumin, all the way up until about three or two weeks before AND after your PRP appt. Efficacy depends on the person (and make sure your dr uses ultrasound and gives you lidocaine for trigger points). It won’t feel good haha and you’ll need a recovery day or two after, but Ice, maybe heat pad (ask your dr about the injection site), Tylenol, and the optimism that suffering some discomfort for a day or two means you might get mobility and function back can all help :)
Fantastic video Jeff. SO happy you are educating the public. Clearly stated, evidence based Dose, guidance, patient selection all matter. I have been doing I/O now since 2015 with excellent success for severe cases of O/A. (Sanchez, Hernigou, Zhang,DiMatteo, Kon, Kattapatiya, Varshney, etc). Say no to repetitive cortisone injections!
This is an extremely-informative video, delivered clearly and in a well-thought-out and well-organized format. I do not get any sense that Dr. Peng is trying to "seel" anything, but rather to fully-inform people who may be exploring this form of therapy. Thank you!
The most complete review of PRP use I have seen and heard. You have answered questions on use and indications that and contraindications to its use that i had.From your presentation it shows the deep investigation and research on this topic, you have done .It takes a lot of time to do all this research and analyse.Good Job.
Would like to thank you for your job. A Young doctor, you have now inspired me. I'm 22, from Brazil, made an exam for medicine last Sunday. I'm finishing my PT graduation and fell in love with medicine. I intend to use regenerative medicine knowledgment for getting even better results in my PT sessions.
PRP works. And not just for joint issues. I suffered for 19 years with lichen sclerosis & drs couldn’t find healing. Until one suggested PRP. I can’t speak highly enough of this treatment & the relief and healing to my body. I can live my life without all the issues I previously had pain free. It’s definitely worth giving it a try. The injection site pain at the treatment time is worth it. I never had any pain after the treatment nor any inflammation.
Wow. Just watched your video and I do believe you are credible because you cover a lot of information that seems in line with the brief information I have looked up on the misinformation web. My issue is my hip and it seems there is even less information on that area. Lots of knees and I think the regenerative therapies seem to have centered around that. My chronic problem has been for 20 years and was holding out that advancements would allow me to avoid becoming a cyborg with hip replacement. I have spoken with University of Penn in Philadelphia about evaluation for PRP being a potential therapy for myself. Really appreciate your video. Being retired LEO and not a doctor, as you clearly state many many factors can effect outcome however it is disappointing that insurance companies would not at least give a provisional approval or some assistance with the costs. Godspeed doctor!
Came across your video by accident. Wish I had known about this some years ago when I had 2 cortisone shots at 2 different times. Your video was not only informative but understandable. It's a shame that health insurance don't cover it. I guess it's better to completely fall apart so you'll eventually have to get more invasive procedures. The health industry is so contradictory. They need more doctors like you. Thank you for sharing your knowledge.
Thank you so much for this extensive information on PRP! I have only just found about it from my new Dr after suffering for years in pain. I'm ready for the procedure!
THANK YOU! I will find out the analysis of an MRI on my knee this week - watching many of your videos has made me feel well prepared to make a decision and put my mind at ease.
I'm about to have PRP done for SI joint arthritis and SI joint tendon tears. This has been very helpful background for me, as I consider undertaking this. Thanks for your work sharing this objective and detailed consideration of PRP. Well done!
Wow, what a through coverage of PRP. I’m on week 4 of laser combined with PRP and already feeling better after 1out of 3 injections. This is the most extensive explanation of PRP that I’ve found. Thanks.
Having this done in Achilles and two small tendons in right ankle in a few weeks. I'm very nervous because I have a history of blood clots and will have to bridge my blood thinner so I am really grateful for your well explained series of stages for this procedure. Fingers crossed this helps me feel relief after 8 months of doctor visits, PT, infrared light therapy and nothing has helped.😢
@@zyou8er Hey! I am just hitting 2 months post injection. My injection was VERY painful haha, my shoulder felt worse than before injections close to about the 2 month mark. How they did the injection (they poked around the tear as well to stimulate more growth) caused a lot of pain, but this was suppose to happen. I have been noticing a lot of improvement in just the last weekish, been doing PT for 3-4 weeks and just started doing very very light weightlifting in gym about a week ago. I think I will have a better idea in about another 1-2 weeks, but so far things are looking very promising. I think the pain can very from person to person, but I pretty much couldn’t use my right arm for a week (couldn’t even sleep for the first 4-5 days due to extreme pain), and had very very limited range of motion with my arm for another 1-2 months. I’ve heard from a lot of people that it wasn’t too painful for them, but honestly it was the most painful thing I’ve done in my life hahahaha so who knows. I will definitely update you, remind me in a couple weeks if I forget! I really think things are looking good, and I’m excited to see where I am in a few more weeks.
if you study the speed applied and the slow down proccess, you can separate the middle layer and make leukocyte-free PRP, and once activated, you obtain an acellular liqui-to-gel sccafold, rich in proteins, anti-inflammatory and very active
Thank you SO very much dr for all these great tips I have red in my right shoulder and I would like to know if you can help with this procedure many thanks
I am doing this protocol. It works. A thousand less Advil. Go back every 9 months and work on strengthening. H acid works for me too. Lubricant helps significantly. Do one then other. It’s helped me.
I had a PRP injection for tennis elbow - it was very painful and hurt for 3 weeks - and 7 months later - still not much improvement :( But I don’t think I was told not to take Ibuprofen after the injection
Thank you for this excellent and comprehensive video. I could not find the link to the compilation of studies you showed at about 1:07. can you post that again?
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
Great presentation. I've had 4 significant surgical procedures on one knee over the last 20 years after losing a large chunk of cartilage playing football. This is the best treatment I've found for osteoarthritis in my bad knee. PRP has allowed me to return to a healthy lifestyle and exercise vigorously for the last five years. I'm hoping to delay the need for full knee replacement as long as possible. What's your opinion on healing peptides like BPC 157 and TB 4?
Thank you for such an in-depth discussion of PRP. I’m seeing a physician tomorrow to discuss PRP for my ongoing knee issues following a meniscus tear arthroscopy. Pain has been ongoing for almost 2 years and I have tried dextrose injections 3 times over the last three months and there has not been significant change. At this point, I really wish I had not had the surgery and tried PRP first. Anyway, now I know what questions to ask to make my decision. I’m 76 and had little to no arthritis in either knee 2 years ago. I’m beginning to feel old and arthritic now.😢
I have a shoulder labral tear and a cyst on spinoglenoid notch and measures approximately 1.5 X 1.4 x 1.3 Cm. I was given a cortisone shot for pain and it has relived 95% of the pain, but the cyst is definitely pressing up on my nerve cashing severe pain when i didn't have cortisone. Doc suggested shoulder surgery but i cant do that RIGHT now. I'm seeking to try Ultrasound-guided cyst aspiration... then we can talk surgery but i'm cannot do surgery right now. I'd like to try PRP before full fledged surgery.
Dear Dr. Peng, Thank you for the information! I have shoulder arthritis and a torn meniscus in my right knee which also has mild arthritis. MD said that “we can replace the shoulder “ when the pain gets bad enough. No other options were given. The knee is back to 90% by resting and lighter exercise. Another MD offered PRP for the knee and shoulder. I feel like I might try it after hearing your information. QUESTION: Do peptides have a place to augment PRP? Specifically TB 500 and BPC157. Also, any information on Pentosan polysulfate for use with or alternating with PRP for knee/shoulder arthritis? Thank you again!
Great tutorial on PRP. I'm going forward with PRP injection into Rt hip. The hope is to delay hip replacement. My limiting factor is currently taking low dose prednisone to counteract polymyalgia rheumatica. Thx for understandable PRP documentation.
@@chrissystar8897 I just had a shot on my left hip three weeks ago and I'm almost 80 percent pain free and if I don't get complete freedom of pain I'm definitely open to getting another prp I say it works I could tell the difference after one week just make sure to rest if you can it was hard for me because I'm the only one that cooks at home
Dr. Peng, this is a great and informative presentation. I’m a 85 yo male that has had problems with my (R) knee for over 25 years. I have had two surgeries on the knee in the 70’s and 80’s. I’ve been treated with “Rooster Cone” for approximately 20 years. The Rooster Cone treatment no longer works. I’m looking to try the PRP treatment. Could you kindly recommend a provider in my area. I reside in North Augusta, South Carolina. Thank you for your assistance.
@TheLadybria all good thanks. I think it's reduced the pain almost immediately but then the right hip felt left out & has started hurting. I think it's from walking not quite right when the other one was so sore. I'm getting the 2nd jab this Tuesday. Take care!
Working on Labrum hip tear and knee meniscus tear. Knee hasn't seen change yet. Hip injection next week. Giving a 50/50 effective rate from two different orthopedic doctors... Fingers crossed. Thank you for the information.
Very comprehensive review particularly with clinical efficacy on ultrasound guided versus landmark approaches. I do have a question regarding post PRP injection and red-light therapy as an added therapeutic tool 48 hours post injection. IS there added benefit or is it disruptive to the healing process?
So im scheduled for a partial meniscectomy surgery tomorrow, for large oblique tear medial posterior horn portion and they are doing a PRP injection post surgery, won't my surgical medications reduce the effectiveness?? Should I wait for a week to get PRP done? Thanks, I liked and subscribed and watched all your PRP vids !
Can you do PRP injections for a pars fracture/spondylolysis? My son is 15 years old and a competitive athlete and a pars fracture can be difficult to heal and the athletes we have spoken to either had to quit playing sports or were limited due to pain from their fracture not healing 100% even when included physical therapy. Almost all videos on UA-cam show PRP for joint, cartilage, tendons, ligaments and arthritis. The only videos i have seen online for PRP injections for bone fractures have been from some podiatrists for bones in the feet or hand physicians.
Excellent overview of the use of PRP especially for knee arthritis, which is my interest and which is a use that has been extensively researched. Dr Peng covers many essential points raised including how patients can prepare to maximize the benefit of a PRP injection, the volume of platelets that should be injected to optimize the outcome and post-injection care. The doctor also explains how and why PRP works to reduce pain and in some uses (but not unfortunately knee arthritis) rebuild tissue. With knee arthritis, sadly PRP cannot rebuild cartilege but is quickly effective at reducing pain and improving functionality that will allow more movement. As my physiotherapist says ‘motion is lotion’ and recommended exercise as the best way to delay slow further knee deterioration. ho Wonderfully informative video. Many thanks for sharing your experience and collected research Dr Peng.
Where is the link to your data base of Medical Literature (that you mention at 1h 7m in this video)? By the way, this is another truly excellent video. Thank you!
I was reccomended prp injection as one of the treatment options by a piodatrist I saw back in June 2024. I ruptured my ATFL in the spring of 2023 and did a MRI in July 2023 which indicated this. I even brought a the same MRI results to the same piodatrist. I think it was an orthopedic piodatrist.
can you comment on the probable success rate one can expect using PRP treatment for partial medial meniscus tear in the knee that occured 2 years ago in a traumatic twisitng of the joint? I have the MRI report available; mild arthritis is indicated but I generally experience no discomfort in the joint with excellent overall health, frequent activity such as stationary ERG rowing, cyclling, competitive Laser sailing, and walking. I do NOT run or participate in high impact knee activites and am 74 years old with a BMI of 27.6
Higher dose is better (probably around 60 cc blood draw for a knee) than low dose PRP. In general three injections *is probably* better than one. But that's a lot of $ for many people. This is why I use my current treatment algorithm discussed in the video
I'm going to have my first Sports Medicine appointment in a few weeks for left knee arthritis. The pain started over a year over and I was given a steroid injection which seemed to help for a couple of weeks but the pain came back much worse afterward. I felt pain while lying down, and also when sitting of course while walking. It was driving me NUTS. I kept calling the NM warmline every day just to talk to someone. Next, I saw an ortho doc who gave me HA shots on two occasions and the pain has decreased somewhat. After listening to your lectures I will really ask for PRP. What is the patient prep for PRP and does Aetna readily approve the cost of the procedure?
The video says no insurance will cover the cost of prp, and no patient prep is needed before. Of course, you would have to discuss with the doctor BEFORE the injection anyway
Hey I have osteoarthritis on the shoulder joint from when I had fallen from my bicycle, the orthopedic told me this when he looke dat the MRI of my shoulder, apparently I akso have a cyst formed on the shoulder. Can you point me to videos or articles where I can inform myslef about the effective dose for the shoulder or maybe tell me if you know it? The orthopedics doctor told me that can do PRP with hyaluronic acid and he said that should help treat the problem. Any thoughts on this?
I have golfers elbow (chronic, with 7mm tear; cannot play golf without high pain) I’m getting a surg referral, but considering a PRP injection. They’ll be way less downtime than a full repair. Guess it’ll depend on what the surgeon says.
Does PRP help with moderate hip osteoarthritis? If I am understanding correctly- is this only helpful for one year or can you continue to get them annually or will you eventually need replacement?
I am not a doctor, just a late 20-something who was told I would need a shoulder replacement AND SC Joint “replacement” essentially every 15 years for the rest of my life…..well, all those doctors who said PRP isn’t reliable were WRONG in my case, and 3 injections of PRP x $1K each (nice facility in SoCal out of pocket) completely changed my life after 2+ years of suffering. The doctor I see did mention another patient who got 3 injection for his hip and knee, who loved the results so much that he is now having his other knee done (apparently he’s a birdwatcher in his 60s, lots of crouching, so he had the second round of 3 as a precaution). I hope you find something that works for you, and hope PRP goes well if you pursue it! Best wishes!
Dear Dr. Peng, I got labral tear on my hip and would like to have PRP treatment, how can I make an appointment with you? Where your office is located.? Thank you!
Is there a recommendation for step count in the first days after a hip flexor/iliopsoas PRP injection? This would be on crutches and mostly around the house, but am trying to get an idea of just how light activity level should be; thanks anyone who has any experience or thoughts!
Can you please recommend a doctor and/or clinic that does the type and quality of PRP injections in the Seattle, Washington area? I’ve scoured the internet and reached out to several clinics with no success. If we lived closer to CA, I would come see you! My hip is killing me, but not bone on bone, so nothing the orthopedic doctor will do. I feel defeated…
What other questions do you have about PRP that wasn't covered in the video?
Can a patient use a topical lidocaine ointment on the area after injection to help with pain?
Why do you need ultrasound to do shoulder, knee and elbow injections . I have been doing joint injection for 25 years with excellent results. Isn’t the use of US use to increase the billable? In NJ most insurance will not pay for the use of US I can understand its use for tendons and ligaments only
I know your supposed to stop smoking tobacco for 4/6 weeks after injection but what about marajuana????????
I wonder if PRP could really heal a meniscus tear?. After 1 injection i felt much better and can go back to light running now. The doctor who gave me PRP said that 1 injection would be sufficient to fix my issue but now i`m starting to experience pain again. Some orthopaedics told me that PRP is not an option for a meniscus tear, as it would be too serious to be healed by PRP and must get operated. 😵💫😵💫
I'm going to try cupping it's basically the same thing
This doctor is extremely impressive. I wish he was my dr.!!
I had prp injection 6 months ago for tennis elbow and can say it made my pain has gone away and now have better use of my arm. Now its not 100% better but i say I'm 80 percent better know.
Prp saved my life!! Not exaggerating. Osteoarthritis, Tietze’s Syndrome, shoulder bursitis, muscle tears, shoulder impingement, herniated disc- three injections, feel like I have a new lease on life
You are blessed
@@gerrie6498 thank you, starting to feel that way again. If you are struggling with similar conditions, I hope you can and will access PRP care. Took years of saving, but totally worth it, and I’d do it again, can’t recommend enough, for anyone reading (do make sure they are a doctor/licensed/ anesthesiologist/use ultrasound, and follow diet/supplement requirements to boost efficacy). Best wishes!
@@heretolearnCA i trust God for a miracle . I wish you prosperity. Here in South Africa there are doctors who is doing it. Considering prosedure in 2 months time. Recently had local anaesthetic and cortizone injected. Today is 3 rd day. See how it will goes. God bless you. In fact the doctor is ½ hour away. I’m willing to give it a go. I also started cannabis drops yesterday. If all else fails then shall I go for PRP. I had 4 back surgeries in 3 years time and from there ongoing complications. Through the wounds of Jesus Christ we are healed under His Mighty name. I have scans. Thank God all blood results are fine.
@@heretolearnCA will let you know. Planning June/ July to go for PRP.
@@gerrie6498 awesome!! Start prepping now. Get more collagen II/ bone broth in your diet, more dark leafy greens - anything that will enrich your blood and give the PRP its best chance of working. Prioritize sleep, if you can. Cut sugar and sat fats. Have more fish oil and curcumin, all the way up until about three or two weeks before AND after your PRP appt. Efficacy depends on the person (and make sure your dr uses ultrasound and gives you lidocaine for trigger points). It won’t feel good haha and you’ll need a recovery day or two after, but Ice, maybe heat pad (ask your dr about the injection site), Tylenol, and the optimism that suffering some discomfort for a day or two means you might get mobility and function back can all help :)
I’m on week 2 post injection and it cured my bakers cyst behind my knee and has helped with mobility of my cartilage defect
How’s your knee ?
Fantastic video Jeff. SO happy you are educating the public. Clearly stated, evidence based Dose, guidance, patient selection all matter. I have been doing I/O now since 2015 with excellent success for severe cases of O/A. (Sanchez, Hernigou, Zhang,DiMatteo, Kon, Kattapatiya, Varshney, etc). Say no to repetitive cortisone injections!
This information is invaluable and very well covered, thank you for putting this video together Dr. Peng!
Glad it was helpful!
This is an extremely-informative video, delivered clearly and in a well-thought-out and well-organized format. I do not get any sense that Dr. Peng is trying to "seel" anything, but rather to fully-inform people who may be exploring this form of therapy. Thank you!
The most complete review of PRP use I have seen and heard. You have answered questions on use and indications that and contraindications to its use that i had.From your presentation it shows the deep investigation and research on this topic, you have done .It takes a lot of time to do all this research and analyse.Good Job.
Would like to thank you for your job. A Young doctor, you have now inspired me. I'm 22, from Brazil, made an exam for medicine last Sunday. I'm finishing my PT graduation and fell in love with medicine. I intend to use regenerative medicine knowledgment for getting even better results in my PT sessions.
PRP works. And not just for joint issues. I suffered for 19 years with lichen sclerosis & drs couldn’t find healing. Until one suggested PRP. I can’t speak highly enough of this treatment & the relief and healing to my body. I can live my life without all the issues I previously had pain free. It’s definitely worth giving it a try. The injection site pain at the treatment time is worth it. I never had any pain after the treatment nor any inflammation.
How much does it cost you and how often do you get the shots?
I had a done today elbow and shoulder. Painful 😣. Hopefully 🙏🏽 works.
@@gabrielabarrera8061any update?
Just had my injection on Friday praying it works was really sore first two days
@@gabrielabarrera8061Update please 😅
very detailed, effective and educated yet simple enough for everyone to understand
Thank you for taking the time to provide this information. Very helpful & very thorough for us average mortals to understand. Great delivery also.
Wow. Just watched your video and I do believe you are credible because you cover a lot of information that seems in line with the brief information I have looked up on the misinformation web. My issue is my hip and it seems there is even less information on that area. Lots of knees and I think the regenerative therapies seem to have centered around that. My chronic problem has been for 20 years and was holding out that advancements would allow me to avoid becoming a cyborg with hip replacement. I have spoken with University of Penn in Philadelphia about evaluation for PRP being a potential therapy for myself. Really appreciate your video. Being retired LEO and not a doctor, as you clearly state many many factors can effect outcome however it is disappointing that insurance companies would not at least give a provisional approval or some assistance with the costs. Godspeed doctor!
Came across your video by accident. Wish I had known about this some years ago when I had 2 cortisone shots at 2 different times. Your video was not only informative but understandable. It's a shame that health insurance don't cover it. I guess it's better to completely fall apart so you'll eventually have to get more invasive procedures. The health industry is so contradictory. They need more doctors like you. Thank you for sharing your knowledge.
😊😊
Thank you so much for this extensive information on PRP! I have only just found about it from my new Dr after suffering for years in pain. I'm ready for the procedure!
This is fantastic information. Thanks very much doctor for your professional approach to these issues. It is much needed.
THANK YOU! I will find out the analysis of an MRI on my knee this week - watching many of your videos has made me feel well prepared to make a decision and put my mind at ease.
Amazing video! Thank you for the priceless info, Doctor🙏🏻
Finally more diverse treatment modalities are being studied and used with success. Thank you for so thoroughly covering this topic.
Thanks for the information Doc! God bless you 😇🙏🏻
I'm about to have PRP done for SI joint arthritis and SI joint tendon tears. This has been very helpful background for me, as I consider undertaking this. Thanks for your work sharing this objective and detailed consideration of PRP. Well done!
Great presentation for deep understanding for patients
Great video, so informative and professional. Thank you.
Fantastic in-depth talk 😊
Wow, what a through coverage of PRP. I’m on week 4 of laser combined with PRP and already feeling better after 1out of 3 injections. This is the most extensive explanation of PRP that I’ve found. Thanks.
This guy is 1000% right. PRP is a no brainer now.
Having this done in Achilles and two small tendons in right ankle in a few weeks. I'm very nervous because I have a history of blood clots and will have to bridge my blood thinner so I am really grateful for your well explained series of stages for this procedure. Fingers crossed this helps me feel relief after 8 months of doctor visits, PT, infrared light therapy and nothing has helped.😢
Did you have it done and have you seen any improvement? I have some similar ankle stuff going on …
@@sharonesther6159 unfortunately I haven't had it yet because the insurance wouldn't pay for it so I am saving money up to pay cash😕
Would also like to know how it went, I’m thinking of doing this possibly
Thanks
I am getting prp injections tomorrow morning for a partial 50% tear in the supraspinatus - your channel has been so helpful!
Best of luck!
Hi! Any updates? I’m in the same situation and considering PRP., any information would help. Thanks!
@@zyou8er Hey! I am just hitting 2 months post injection. My injection was VERY painful haha, my shoulder felt worse than before injections close to about the 2 month mark. How they did the injection (they poked around the tear as well to stimulate more growth) caused a lot of pain, but this was suppose to happen. I have been noticing a lot of improvement in just the last weekish, been doing PT for 3-4 weeks and just started doing very very light weightlifting in gym about a week ago. I think I will have a better idea in about another 1-2 weeks, but so far things are looking very promising. I think the pain can very from person to person, but I pretty much couldn’t use my right arm for a week (couldn’t even sleep for the first 4-5 days due to extreme pain), and had very very limited range of motion with my arm for another 1-2 months. I’ve heard from a lot of people that it wasn’t too painful for them, but honestly it was the most painful thing I’ve done in my life hahahaha so who knows.
I will definitely update you, remind me in a couple weeks if I forget! I really think things are looking good, and I’m excited to see where I am in a few more weeks.
@wbae1340 Any update?
Update?
This was so thorough and helpful!
Great video
Wish u could teach my Dr
Your thoroughness is great.
if you study the speed applied and the slow down proccess, you can separate the middle layer and make leukocyte-free PRP, and once activated, you obtain an acellular liqui-to-gel sccafold, rich in proteins, anti-inflammatory and very active
Pretty amazing stuff!
Thank you SO very much dr for all these great tips I have red in my right shoulder and I would like to know if you can help with this procedure many thanks
I am doing this protocol. It works. A thousand less Advil. Go back every 9 months and work on strengthening. H acid works for me too. Lubricant helps significantly. Do one then other. It’s helped me.
I had a PRP injection for tennis elbow - it was very painful and hurt for 3 weeks - and 7 months later - still not much improvement :(
But I don’t think I was told not to take Ibuprofen after the injection
Thank you for this excellent and comprehensive video. I could not find the link to the compilation of studies you showed at about 1:07. can you post that again?
Thank you so much for these videos Dr Peng!❤
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
⁰0m
Good presentation with clarity.really commendablejob.covered all aspects of PRP treatment.❤
Thank you so much Doctor Jeff❤
Wonderful info. Thank you Doctor Peng.
Great presentation. I've had 4 significant surgical procedures on one knee over the last 20 years after losing a large chunk of cartilage playing football. This is the best treatment I've found for osteoarthritis in my bad knee. PRP has allowed me to return to a healthy lifestyle and exercise vigorously for the last five years. I'm hoping to delay the need for full knee replacement as long as possible. What's your opinion on healing peptides like BPC 157 and TB 4?
Thank you for such an in-depth discussion of PRP. I’m seeing a physician tomorrow to discuss PRP for my ongoing knee issues following a meniscus tear arthroscopy. Pain has been ongoing for almost 2 years and I have tried dextrose injections 3 times over the last three months and there has not been significant change. At this point, I really wish I had not had the surgery and tried PRP first. Anyway, now I know what questions to ask to make my decision. I’m 76 and had little to no arthritis in either knee 2 years ago. I’m beginning to feel old and arthritic now.😢
Good luck Leila! I'm 42 and my right knee makes the same sound of when you step on glass.
Good luck!!
What was the outcome?
I have a shoulder labral tear and a cyst on spinoglenoid notch and measures approximately 1.5 X 1.4 x 1.3 Cm. I was given a cortisone shot for pain and it has relived 95% of the pain, but the cyst is definitely pressing up on my nerve cashing severe pain when i didn't have cortisone. Doc suggested shoulder surgery but i cant do that RIGHT now. I'm seeking to try Ultrasound-guided cyst aspiration... then we can talk surgery but i'm cannot do surgery right now. I'd like to try PRP before full fledged surgery.
How about use as a spinal epidural PRP for peripheral neuropathy?
❤ thanks for that movie and comment section, I have no morę questions or doubts
Dear Dr. Peng, Thank you for the information! I have shoulder arthritis and a torn meniscus in my right knee which also has mild arthritis. MD said that “we can replace the shoulder “ when the pain gets bad enough. No other options were given. The knee is back to 90% by resting and lighter exercise. Another MD offered PRP for the knee and shoulder. I feel like I might try it after hearing your information. QUESTION: Do peptides have a place to augment PRP? Specifically TB 500 and BPC157. Also, any information on Pentosan polysulfate for use with or alternating with PRP for knee/shoulder arthritis? Thank you again!
Very informative and helpful insightful. Thank for creating this video.
Great tutorial on PRP. I'm going forward with PRP injection into Rt hip. The hope is to delay hip replacement. My limiting factor is currently taking low dose prednisone to counteract polymyalgia rheumatica. Thx for understandable PRP documentation.
I'm getting it as well on my right hip after 4 rounds of Shockwave therapy first. Let me know how it goes.
@@chadhorton5879 did having the PRP in right hip help? I ask as i am planning the same to try?.
Still too soon to tell. Just started PT last week.@@chrissystar8897
@@chrissystar8897 I just had a shot on my left hip three weeks ago and I'm almost 80 percent pain free and if I don't get complete freedom of pain I'm definitely open to getting another prp I say it works I could tell the difference after one week just make sure to rest if you can it was hard for me because I'm the only one that cooks at home
@@chrissystar8897 I'm on 12 weeks since getting the PRP and I'm pain free waiting on to do my back and other hip
Amazing, simple.to the point and evidence based. Plz do share your thoughts of this Exosome plus prp therapy outcomes !
We also use Tylenol on neonates as a prostaglandin inhibitor to close PDA’s…
Thanks Dr. very informative
I had a guided 5cc prp injection for knee cartridge injury almost 4 weeks ago with no improvement at all.
How's the knee?
@@Optimistgus still no improvement from the PRP. I may do another injection soon.
Thank you Doctor for the great explanation!🙏
Dr. Peng, this is a great and informative presentation. I’m a 85 yo male that has had problems with my (R) knee for over 25 years. I have had two surgeries on the knee in the 70’s and 80’s. I’ve been treated with “Rooster Cone” for approximately 20 years. The Rooster Cone treatment no longer works. I’m looking to try the PRP treatment. Could you kindly recommend a provider in my area. I reside in North Augusta, South Carolina. Thank you for your assistance.
Nice explanation and broad information thank you
If you have knee swelling, baker cyst, should you get the excess fluids aspirated first before any (ha/prp/ stem cells ) injections ?
I had my first PRP injection in my hip yesterday. Didn't hurt & took about 30 minutes. Fingers crossed.
How is it working out?
@TheLadybria all good thanks. I think it's reduced the pain almost immediately but then the right hip felt left out & has started hurting. I think it's from walking not quite right when the other one was so sore. I'm getting the 2nd jab this Tuesday. Take care!
@@Cocoandindyhow are you doing
@sarahtamaly3587 still really good thanks. The 3rd injection worked a treat.
@@Cocoandindy I am looking forward for my neck and knee
Working on Labrum hip tear and knee meniscus tear. Knee hasn't seen change yet. Hip injection next week. Giving a 50/50 effective rate from two different orthopedic doctors... Fingers crossed. Thank you for the information.
Did the PRP help with the labrum tear?
What about patients with Ankylosing Spondylitis but don't take NSAIDS or steroids? I treat mine with Biologics.
If you think about it cupping is the same thing it draws your healing platelets to the area
Kind of...? Even if true, it can't reach deeper tissue targets
Very comprehensive review particularly with clinical efficacy on ultrasound guided versus landmark approaches. I do have a question regarding post PRP injection and red-light therapy as an added therapeutic tool 48 hours post injection. IS there added benefit or is it disruptive to the healing process?
So im scheduled for a partial meniscectomy surgery tomorrow, for large oblique tear medial posterior horn portion and they are doing a PRP injection post surgery, won't my surgical medications reduce the effectiveness?? Should I wait for a week to get PRP done? Thanks, I liked and subscribed and watched all your PRP vids !
Can you do PRP injections for a pars fracture/spondylolysis? My son is 15 years old and a competitive athlete and a pars fracture can be difficult to heal and the athletes we have spoken to either had to quit playing sports or were limited due to pain from their fracture not healing 100% even when included physical therapy. Almost all videos on UA-cam show PRP for joint, cartilage, tendons, ligaments and arthritis. The only videos i have seen online for PRP injections for bone fractures have been from some podiatrists for bones in the feet or hand physicians.
Best presentation on this topic.
It works and its a miracle. I had mua and prp on my rt shoulder. Thankful thankful
Thanks for the extremely detailed video. How can I get a copy of your review of data that appears at the end?
Had PRP on my both kness, i have moderate OA, and very active....after 3 months, nothing 😢
Nothing as in, no more pain, or nothing as in it had no effect?
Cortisone triamcinolone acetonide did so much damage it's been 4 years and I'm still suffering from it.
Great video! How about PRP for SLAP tear of the shoulder? Thank you!
I’m wondering the same thing.
Thank you very much for this information!
Excellent overview of the use of PRP especially for knee arthritis, which is my interest and which is a use that has been extensively researched.
Dr Peng covers many essential points raised including how patients can prepare to maximize the benefit of a PRP injection, the volume of platelets that should be injected to optimize the outcome and post-injection care.
The doctor also explains how and why PRP works to reduce pain and in some uses (but not unfortunately knee arthritis) rebuild tissue.
With knee arthritis, sadly PRP cannot rebuild cartilege but is quickly effective at reducing pain and improving functionality that will allow more movement.
As my physiotherapist says ‘motion is lotion’ and recommended exercise as the best way to delay slow further knee deterioration.
ho
Wonderfully informative video. Many thanks for sharing your experience and collected research Dr Peng.
Where is the link to your data base of Medical Literature (that you mention at 1h 7m in this video)? By the way, this is another truly excellent video. Thank you!
Dr. what is your posture about the use of Hyaluronic Acid for the knee after a meniscus surgery?
Amazing video thank you so much
I was reccomended prp injection as one of the treatment options by a piodatrist I saw back in June 2024. I ruptured my ATFL in the spring of 2023 and did a MRI in July 2023 which indicated this. I even brought a the same MRI results to the same piodatrist. I think it was an
orthopedic piodatrist.
in my case PRP works for my CCI cranio cervical instability. Amazing but difficult to treat. PRP costs too much unfortunatelly
What is high dose PRP injections for knee joints? Your evidence based advice is awesome!
can you comment on the probable success rate one can expect using PRP treatment for partial medial meniscus tear in the knee that occured 2 years ago in a traumatic twisitng of the joint? I have the MRI report available; mild arthritis is indicated but I generally experience no discomfort in the joint with excellent overall health, frequent activity such as stationary ERG rowing, cyclling, competitive Laser sailing, and walking. I do NOT run or participate in high impact knee activites and am 74 years old with a BMI of 27.6
Thank you for great information and could i ask about high dose and low dose of prp how much and the amount of injection in the knee thanks.
Higher dose is better (probably around 60 cc blood draw for a knee) than low dose PRP. In general three injections *is probably* better than one. But that's a lot of $ for many people. This is why I use my current treatment algorithm discussed in the video
Do you know any doctors in the Charlotte, North Carolina area who give the PRP injections?
Hello Dr Peng, thank you for all your videos about PRP. Does PRP help repair or stop the pain or both?
Could you please make a video on Enbrel injection?
Wow! Wow! Wow! I'm writing notes!
Does this work for bone on bone arthritis in the hip?
Potentially, yes
I'm going to have my first Sports Medicine appointment in a few weeks for left knee arthritis. The pain started over a year over and I was given a steroid injection which seemed to help for a couple of weeks but the pain came back much worse afterward. I felt pain while lying down, and also when sitting of course while walking. It was driving me NUTS. I kept calling the NM warmline every day just to talk to someone. Next, I saw an ortho doc who gave me HA shots on two occasions and the pain has decreased somewhat. After listening to your lectures I will really ask for PRP. What is the patient prep for PRP and does Aetna readily approve the cost of the procedure?
The video says no insurance will cover the cost of prp, and no patient prep is needed before. Of course, you would have to discuss with the doctor BEFORE the injection anyway
I used my hsa.
Hey I have osteoarthritis on the shoulder joint from when I had fallen from my bicycle, the orthopedic told me this when he looke dat the MRI of my shoulder, apparently I akso have a cyst formed on the shoulder. Can you point me to videos or articles where I can inform myslef about the effective dose for the shoulder or maybe tell me if you know it? The orthopedics doctor told me that can do PRP with hyaluronic acid and he said that should help treat the problem. Any thoughts on this?
I have golfers elbow (chronic, with 7mm tear; cannot play golf without high pain) I’m getting a surg referral, but considering a PRP injection. They’ll be way less downtime than a full repair. Guess it’ll depend on what the surgeon says.
Doctor Peng, what do you think about combing PRP with oral BPC-157, ipamorelin or MK-677 for meniscus tear? Thanks for this informative video!
Sounds like a good idea
Make sure you’re megadosing the relevant dietary materials too
Does PRP help with moderate hip osteoarthritis? If I am understanding correctly- is this only helpful for one year or can you continue to get them annually or will you eventually need replacement?
I am not a doctor, just a late 20-something who was told I would need a shoulder replacement AND SC Joint “replacement” essentially every 15 years for the rest of my life…..well, all those doctors who said PRP isn’t reliable were WRONG in my case, and 3 injections of PRP x $1K each (nice facility in SoCal out of pocket) completely changed my life after 2+ years of suffering. The doctor I see did mention another patient who got 3 injection for his hip and knee, who loved the results so much that he is now having his other knee done (apparently he’s a birdwatcher in his 60s, lots of crouching, so he had the second round of 3 as a precaution). I hope you find something that works for you, and hope PRP goes well if you pursue it! Best wishes!
Dear Dr. Peng, I got labral tear on my hip and would like to have PRP treatment, how can I make an appointment with you? Where your office is located.? Thank you!
Is there a recommendation for step count in the first days after a hip flexor/iliopsoas PRP injection? This would be on crutches and mostly around the house, but am trying to get an idea of just how light activity level should be; thanks anyone who has any experience or thoughts!
I am sorry to hear about the stem cell research falling short.
How long can PRP delay knee surgery? Months? Years?
how to tackle post PRP inflammatory reaction resulting in severe pain ?
Thanks for all the info on PRP. Do you advocate Boron and Omega 3 supplements for hip arthritis?
You seem really good doctor i can see when you grow up you the BEST
Very good scientific information.
Can you do that for the ankle
Terrific presentation
Can you please recommend a doctor and/or clinic that does the type and quality of PRP injections in the Seattle, Washington area? I’ve scoured the internet and reached out to several clinics with no success. If we lived closer to CA, I would come see you! My hip is killing me, but not bone on bone, so nothing the orthopedic doctor will do. I feel defeated…