Treatments that use cells and proteins from your own body to help calm pain and support healing. Here's a straight look at what they are, what we know, and what we don't, with no hype and no pressure.
Your blood and bone marrow are full of natural ingredients your body already uses to fight inflammation and repair tissue, platelets, proteins, cells, and growth factors. Orthobiologics take a small sample from you, concentrate the helpful parts, and place them right where it hurts: a joint, tendon, or ligament.
Because these come from your own body, allergic reactions and rejection are very unlikely. They're used most often for arthritis and stubborn tendon or joint problems, usually after simpler treatments haven't given enough relief.
Each of these starts with a sample from your own body and concentrates a different set of healing ingredients. Which one makes sense depends on your diagnosis, how much inflammation is involved, and what we're trying to accomplish.
We draw some of your blood, usually 60 to 120 cc (for reference, a standard blood donation is around 350 cc), and spin it in a centrifuge to separate and concentrate the platelets. Platelets are best known for clotting, but they also carry a payload of growth factors and proteins (PDGF, TGF-beta, VEGF, alpha-2-macroglobulin, and others) that help recruit repair cells, protect cartilage, and signal tissue to heal. That concentrated plasma is then injected directly into the joint or tendon.
Dose matters. Current evidence points to roughly 8 to 10 billion platelets as the threshold for a full-strength treatment. The system we use, Xcell PRP, has been verified to reach that target in most patients, so you receive a genuinely therapeutic concentration rather than a diluted one.
Not all PRP is the same. Preparations also differ in whether white blood cells are included. Leukocyte-poor PRP is generally favored inside a joint like an arthritic knee, while leukocyte-rich PRP is sometimes chosen for stubborn tendon problems. We select and document the preparation to match your target, rather than using one recipe for everything.
Protein Concentrate is prepared alongside your PRP, from the same blood draw. When we spin your blood for PRP, plasma is left over. Rather than discard it, we run that excess plasma through an additional step that removes much of the water and concentrates its natural proteins into a thick gel. To be clear, this gel is made entirely from your own blood; it is not hyaluronic acid or any manufactured filler.
What gets concentrated are your blood's own anti-inflammatory proteins, including IL-1 receptor antagonist (IL-1Ra), a natural blocker of interleukin-1, one of the main "inflammation signals" that drives cartilage breakdown and pain in an arthritic joint. Pairing PRP, which delivers growth factors, with this protein gel, which delivers concentrated anti-inflammatory proteins, lets us both support the tissue and quiet the inflammatory cycle in a chronically irritated joint. The idea is less about "regrowing" tissue and more about calming a joint that has become inflamed.
For select conditions, we draw a small sample of bone marrow, usually from the back of the pelvis (the posterior iliac crest) with numbing medicine and sometimes light sedation, then concentrate it. The concentrate contains a mix of cells, platelets, and growth factors, including a small number of mesenchymal stromal cells that may support repair and modulate inflammation.
A word to clear up common misinformation: you will often see BMAC advertised elsewhere as a "stem cell" treatment. We want to be direct that we do not make that claim. While marrow concentrate does contain a small number of mesenchymal stromal cells, the number of true stem cells is low, and the science does not support marketing this as a stem-cell cure. We mention this only to counter the misleading way it is sometimes sold, so you have the accurate picture rather than the marketing version.
Used honestly, BMAC is a reasonable tool in the right setting, typically more advanced cartilage or bone problems, or as an add-on during surgery. Because harvesting marrow is more involved than a blood draw, we reserve it for the cases where it genuinely makes sense.
The strongest research is for PRP in knee osteoarthritis. In April 2026, the American Academy of Physical Medicine & Rehabilitation (AAPM&R) released a guidance statement saying PRP can be considered for people with mild-to-moderate knee arthritis who still hurt after trying conservative care like physical therapy, anti-inflammatories, and activity changes.
The same experts were honest that more high-quality studies are still needed to know exactly who benefits most and how best to prepare and dose PRP. Evidence for other uses and for the other products is earlier and still developing. We'll tell you where your specific situation falls, including when the honest answer is "this probably won't help you."
How these treatments apply depends on the joint. Here's a closer look at the areas we treat most.
The best-studied joint in orthobiologics. What PRP and cellular treatments can do for knee arthritis and tendon pain.
Learn morePRP and, increasingly, BMAC for hip arthritis and the tendon problems around the joint.
Learn morePRP for rotator cuff and tendon problems, with an honest read on the evidence.
Learn morePRP for stubborn tennis elbow, one of its best-studied uses.
Learn moreBiologics are one tool in a much bigger toolbox. We'll give you an honest assessment of whether they're likely to help you, and we're just as happy to recommend physical therapy, a simple injection, bracing, or, when it's genuinely the right call, surgery. You will never be sold something you don't need.
Orthobiologics sit in the middle of your options, after simple conservative care, and often before surgery is on the table. We guide you honestly along this path.
Activity changes, physical therapy, anti-inflammatories, and simple injections. Always the first line when it's reasonable.
PRP, Protein Concentrate, or BMAC for the right candidate, to calm pain and, at times, delay or avoid surgery.
When it is genuinely the best option, done with the same honesty, never as a default.
The honest answer depends on you. Here is the general picture, and we settle it together after we examine you and review your imaging.
On what to expect around the procedure itself, see preparing for your procedure and after your procedure.
These are promising tools, not miracle cures. Results vary from person to person, and the science is still growing. We won't overpromise.
Insurers consider orthobiologics investigational, so they're paid out of pocket. We'll always give you a clear price before anything is scheduled.
We only suggest biologics when they're a reasonable option for you. If we don't think they'll help, we'll say so, and point you to what will.
Because insurance doesn't cover orthobiologics, they're a cash-pay service. We'll give you a clear price and answer your questions before you decide, and there's never any pressure to proceed. If you have Medicare, we'll walk you through how that works before your visit.
Most people tolerate them well. We use numbing medicine, and any soreness afterward is usually mild and short-lived. PRP and Protein Concentrate involve a blood draw; BMAC also involves a small marrow sample, taken with numbing.
Biologics work gradually. It is common to feel a temporary flare for a few days, then a slow improvement over the following weeks, with benefit often building over two to three months. This is not an overnight fix.
It varies. For people who respond, relief from PRP in knee arthritis can last many months and sometimes longer. Some patients choose to repeat treatment over time.
Often a single injection, sometimes a short series. We will tell you what is reasonable for your situation rather than sell you a package.
Because these use your own blood or marrow, allergic reactions and rejection are very unlikely. As with any injection, there is a small risk of soreness, bruising, or, rarely, infection. We review this with you beforehand.
We generally ask you to hold anti-inflammatory medications such as ibuprofen or naproxen for a window before and after the injection, since they can blunt the effect. Tylenol is usually fine. You will get exact instructions.
No. Insurers consider orthobiologics investigational, so they are a cash-pay service. We give you a clear price up front, with no pressure to proceed.
Let's talk it through honestly. We'll evaluate your situation and give you a straight recommendation, whatever it is.
This page is for general education and is not medical advice. Orthobiologic treatments are not FDA-approved to cure or reverse any condition, results vary from person to person, and they are not right for everyone. Whether a treatment is appropriate for you is a decision we make together after an evaluation.
Wichman Orthopedics