Watch a PRP Injection for Knee Arthritis Pain! (Ultrasound Guidance)

[@JeffreyPengMD]

Why is this PRP slightly red? Recent research reveals that high-density platelets are concentrated near the buffy coat and red blood cell (RBC) layer. Harvesting these high-density platelets can increase the overall platelet count by an additional 10%. Since the buffy coat is so close to the RBC layer, a negligible amount of RBCs may be included in the process. This small amount of RBCs can give the golden-yellow PRP sample a slight red tint. However, this tradeoff is considered acceptable for the added benefit of including an extra 5-10% of platelets.

[@uknasa007]

would you say PRP is better for arthritis in knee or stem cell therapy?

[@michaeldigman1761]

Had this procedure done on my hip 6 weeks ago. Incredible results.

[@JeffreyPengMD]

Great to hear!

[@lucasjay1000]

I’m jealous about the 8 cc of prp. No doctor near me does doses that large. I got a 4.5 cc injection and it did nothing. That kit looks awesome

[@peybak]

That was very cool to watch.

[@etherburner]

Thank you, Dr. Peng for this informative presentation. I am undergoing this procedure next week to treat my near-complete oblique radial tear of the medial meniscus at the posterior horn. I have heard great results from this procedure. I hope those results will apply to my left knee.

[@FredPantone294]

The only physician I could find in Las Vegas that uses 60cc's of blood prior to using the centrifuge, injects into one knee site, and uses guided imagery for all injections into the knee for osteoarthrosis charges $3,550.00 dollars for the procedure which includes $350.00 for the initial consultation. I found a clinic in Thailand where I can receive the same procedure for $250.00 USD. This may be one reason why Thailand leads the world in Medical Tourism.

[@lavocelle1176]

Dr Peng, I really appreciate these very informative videos. I’m considering getting PRP & am wondering if I do get this high dose would I need another injection soon after or will it last a year?

[@ScottSummerill]

Just had one done yesterday. It was a 15-20 minute procedure. Involved multiple injection sites. Right now my knee is sore and stiff. Guessing from the multiple injections and added fluid. All that said, what happens to the platelets once in the knee? How do they not washout and ended up elsewhere? I read that platelets only survive 3-4 days so what happens then? In another video you said the results become apparent after 4-6 weeks. Thank you for the info you have provided in all your previous videos. Very helpful.

[@umamaheshwari7047]

I was suggested replacement can i try PRP shot

[@sheepseven7588]

Hi what is the source of the prp ? The plasma

[@frankholehouse6370]

I wish you would do my knee

[@nawluck]

Do you do private pay?

[@JeffreyPengMD]

PRP is considered self pay in most places, hopefully that will change soon when insurances start to cover it!

[@nawluck]

@JeffreyPengMD Yes. I am asking if you do appts via private pay since I don't have Stanford Insurance

[@millyonair9225]

Doc, do you recommend this treatment for older people that have bone on bone knee OA? My mom's doctors are discouraging her from getting this, claiming she is too far gone to get any meaningful benefit. But we are desperate.

[@arnoldvb]

why is it color red?

[@zakaha]

Hi Dr Peng, I do perform PRP injections and under USGuidance, use Athrex angel system. Not quite sure why the injectate in your video is RED with RBCs which shouldn’t be the case if it is leukocyte poor PRP which is being used

[@JeffreyPengMD]

Why is this PRP slightly red? Recent research reveals that high-density platelets are concentrated near the buffy coat and red blood cell (RBC) layer. Harvesting these high-density platelets can increase the overall platelet count by an additional 10%. Since the buffy coat is so close to the RBC layer, a negligible amount of RBCs may be included in the process. This small amount of RBCs can give the golden-yellow PRP sample a slight red tint. However, this tradeoff is considered acceptable for the added benefit of including an extra 5-10% of platelets.

[@zakaha]

@ Thanks Dr Peng for your reply. So the method and kit used for centrifugation of the blood would decide whether one will/can take the buffy coat layer. As the ARTHREX Angel kit separates the samples into 3 different compartments. Using the double syringe one may be able to take the buffy coat layer. Would you be able to send me a link for the above paper.

[@maheshreddy6624]

I got PRP of same dosage twice to my both knees along with BMAC. But zero Result. The Doctor who did the procedure is from USA and he frequently visits India. What could be the reason for not giving pain relief Doctor?

[@jairivasmen]

Dr Peng, I have been following you for a long time. Would you be willing to try a true leucocyte-free, activated PRP, to compare the immediate anti-inflammatory effect and also long term due to the strong coagulationand the fibrin? That's how we do it in Europe

[@JeffreyPengMD]

I have not seen any convincing RCT evidence that activated PRP is necessary. PRP activates once it is injected into the target site. Platelet dosing seems to be by far the most important criteria in achieving successful outcomes. Harvesting more of the buffy coat layer gets the high density platelets increasing yields by up to 10% at the cost of including a tiny amount of RBCs. My guess is activation vs no activation pales in comparison to an additional 10% of platelets.

[@ScottSummerill]

Hmm ... you have me concerned. Why is your injection red in color and not yellow? As in the video primer? Like I said in my other comment, my PRP (actually it was SCP) was a very pale yellow.

[@thanosfisherman]

But why PRP so red?

[@JeffreyPengMD]

I explain in the second part of the video. Harvesting the buffy coat layer to get high density platelets increases platelet yield by up to 10%. Buffy coat layer has minimal RBCs, but even a tiny bit changes the color slightly red.

[@LittleFairy96]

Is this procedure meant to be painful? My mum went through it and she was in excruciating pain during the injection.

[@JohnFisher-ls6wb]

Yes very common

[@thanosfisherman]

Yes it hurts A lot

[@JeffreyPengMD]

As with everything in medicine, technique matters A LOT to minimize discomfort during the injection. When I do these procedures, most people are surprised by how little it hurts.

[@lucasjay1000]

I’m jealous about the 8 cc of prp. No doctor near me does doses that large. I got a 4.5 cc injection and it did nothing. That kit looks awesome.

[@JeffreyPengMD]

Got to search around! The dose really matters