PRP & Regenerative Treatment in Bangalore

What PRP actually is, and how it is prepared

Platelet-rich plasma is made from your own blood. On the day of the procedure, a quantity of whole blood is drawn from a vein in your arm, exactly as it would be for a blood test — usually somewhere between 15 and 60 ml depending on how much concentrate is needed. That blood goes into a centrifuge, which spins it fast enough to separate it by density into three layers: red cells at the bottom, a thin buffy coat containing platelets and white cells in the middle, and plasma on top. The platelet-rich fraction is drawn off, sometimes spun a second time to concentrate it further, and injected into the target joint or around the target tendon.

The rationale is straightforward. Platelets are the body's first responders to tissue injury, and they carry granules packed with growth factors — PDGF, TGF-beta, VEGF, IGF and others — that signal cells to migrate, multiply and lay down new matrix. Concentrating those platelets and delivering them directly into a degenerate joint or a failing tendon is an attempt to restart a repair response that has stalled. Because the material comes from you, there is no risk of transfusion reaction or transmitted infection from a donor, which is one of the genuine attractions of the technique.

Why the preparation protocol matters more than the label

This is the part that is almost never explained, and it is the reason two patients can have “the same” treatment with entirely different results. PRP is not a drug with a fixed formulation. The final product depends on how much blood was drawn, the centrifuge speed and duration, whether one spin or two were used, the final volume injected, and critically whether white cells were included or excluded. Leucocyte-poor preparations are generally preferred inside an arthritic joint, because white cells contribute inflammatory mediators that can aggravate the synovium; leucocyte-rich preparations have been argued for in some tendon applications. Platelet concentration itself varies several-fold between commercial kits and between hand-spun protocols.

The practical consequence is that when a study reports a benefit, that finding applies to the specific preparation that study used. It does not automatically transfer to the syringe you are being offered. It is entirely reasonable to ask what system is being used, whether it is leucocyte-poor or leucocyte-rich, and what volume will be injected. A clinic that cannot answer those questions is not necessarily doing anything wrong, but it is not in a position to tell you what to expect either. This is also the honest reason why GFC exists at all: by activating the platelets and separating the released growth factors, it produces a more consistent preparation from one patient to the next, which is a real advantage even if the clinical superiority is not yet proven.

What the evidence genuinely shows, joint by joint

Knee osteoarthritis. This is where the largest body of evidence sits. Multiple randomised trials and meta-analyses show PRP improving pain and function compared with saline and, in many comparisons, compared with hyaluronic acid, with benefits typically sustained for six to twelve months. The effect is consistently larger in mild to moderate radiographic arthritis than in severe. Some high-quality trials have been negative, so the picture is not unanimous. If the knee is your problem, the fuller discussion lives on the non-surgical knee pain and knee pain pages.

Tennis and golfer's elbow. Chronic lateral and medial epicondylar tendinopathy is one of the better indications. Trials comparing PRP with corticosteroid consistently show steroid winning in the first six weeks and losing by six to twelve months, which fits what is understood about steroid weakening tendon over time. PRP is a reasonable option here after a genuine trial of eccentric loading has failed — the principles of which are set out in the guide to non-surgical tendinopathy care.

Shoulder. Rotator cuff tendinopathy and partial-thickness tears show modest, mixed results. PRP does not repair a full-thickness rotator cuff tear and should not be offered as an alternative to surgery when a repairable tear is the problem. Accuracy of placement matters more at the shoulder than almost anywhere else, which is covered in precision injection care for shoulder pain, alongside the broader shoulder pain assessment pathway.

Hip. The evidence for intra-articular PRP in hip osteoarthritis is thinner than for the knee and the results are more equivocal. Gluteal tendinopathy — the very common cause of pain on the outer hip that is often mislabelled “trochanteric bursitis” — responds better, and there is decent trial evidence favouring PRP over steroid at twelve months. The wider workup is on the hip pain page.

Foot and ankle. Plantar fasciitis and Achilles tendinopathy are both treated with PRP in practice. The evidence for plantar fasciitis is reasonable and favours PRP over steroid in the medium term; for mid-portion Achilles tendinopathy the trials are genuinely mixed, and a properly executed heavy slow resistance programme remains the treatment with the best track record. That distinction is worth reading in full on the foot and ankle pain page.

Bone-marrow concentrate. BMAC, routinely marketed as stem cell therapy, sits at the frontier rather than in the mainstream. Early results in selected patients are encouraging, the procedure is more invasive, the cost is substantially higher, and the trial evidence is not yet at the level that would justify recommending it ahead of simpler options. There is a fuller, plainer discussion in BMAC and stem cell therapy for knee pain.

Why ultrasound guidance changes the accuracy

An injection that misses its target cannot work, however good the preparation. Studies of blind, landmark-guided injections have repeatedly found accuracy rates that surprise people: reliable for a large, easily palpated knee, considerably less so for the shoulder, hip, small tendons and bursae. Ultrasound puts the needle tip on the screen in real time, confirms the target, avoids the vessels and nerves nearby, and shows the injectate spreading where it was intended. For a hip joint or a gluteal tendon it is not a refinement, it is a requirement. The technique and its indications are set out on the ultrasound-guided orthopedic injections page.

Who is a poor candidate

Being told you are not suitable is a useful outcome of the consultation, not a failure of it. Regenerative injections are generally unsuitable or need careful reconsideration in the following situations:

• Advanced, bone-on-bone arthritis where the joint space has largely disappeared — the biology being targeted is no longer there, and the discussion should be about joint preservation surgery or replacement instead.
• Any active infection, whether in the joint itself or a skin infection over the injection site, and any current systemic illness with fever.
• Poorly controlled diabetes, where healing is impaired and infection risk is higher — sugars should be brought under control first rather than the injection simply being refused.
• Blood disorders affecting platelet number or function, significant anaemia, and active malignancy — all of which need specialist input before anything is considered.
• Patients on anticoagulants, and those taking regular anti-inflammatory tablets, which are usually stopped for a period around the injection because they blunt the very response being provoked. Recent corticosteroid injection into the same site is also a reason to wait.
• Anyone whose expectation is that the injection will replace weight management, activity modification and strengthening rather than support them.

What a session actually involves

Most people are more anxious about the procedure than it warrants. You attend for a normal outpatient appointment, well hydrated and having eaten. Blood is drawn from your arm and processed in the clinic while you wait — usually fifteen to thirty minutes in the centrifuge. The skin over the target is cleaned thoroughly and local anaesthetic is used. The injection itself, whether into a knee, a shoulder or around a tendon, takes a minute or two. Ultrasound is used where the target requires it. You rest briefly afterwards, and you go home the same morning. The whole visit typically runs to about an hour.

A bone-marrow harvest for BMAC is a different proposition: it is done as a day-care procedure with the marrow taken from the pelvis under anaesthesia, and the concentrate injected in the same sitting. That is planned in advance rather than done at a routine consultation.

Aftercare, and the flare that is normal in the first 48 hours

Expect the treated joint or tendon to be more sore, not less, for the first day or two. This post-injection flare is the expected consequence of deliberately provoking an inflammatory repair response, and it catches out patients who were not warned. Ice and paracetamol are used for it; anti-inflammatory tablets are avoided for roughly one to two weeks afterwards, because suppressing the inflammatory cascade is precisely the opposite of what the treatment is trying to achieve.

Relative rest for 48 hours, then a gradual return to normal walking and daily activity. Impact sport, heavy lifting and long runs are held back for around two to six weeks depending on the site. Rehabilitation is restarted deliberately, because the injection creates a window in which the tissue tolerates loading better, and that window is what actually produces the improvement. Meaningful benefit usually appears somewhere between three and six weeks and continues to build to around three months, which is when the treatment should be judged — not at two weeks, when many patients wrongly conclude it has failed. There is a week-by-week account in the guide to recovery after a regenerative injection.

Alongside load management and strengthening, not instead of it

No injection changes the mechanics of the limb it is put into. A quadriceps that has wasted stays wasted; a knee carrying excess body weight through a worn compartment still carries it; a tendon that failed because training volume doubled in a month will fail again if the volume doubles again. The injection reduces pain and, at best, nudges the tissue towards repair — the strength, the load management and the weight are what determine whether that gain holds. Patients who treat the injection as the whole treatment are the ones who come back at nine months no better than before. Where the underlying process is arthritis, the same conservative-first framework applies as on the arthritis treatment page.

What drives the cost

No figure is quoted on this page, because a number given before an examination is guesswork and tends to be wrong in both directions. What can be set out honestly is what the price actually depends on:

Exact pricing is confirmed after assessment, once it is clear what you need and how many sessions are realistic, and it is given to you before anything is booked. For indicative ranges and the eligibility criteria in plain terms, there is a dedicated write-up on PRP and GFC injection cost and eligibility in Bangalore. One thing to plan for: regenerative injections are usually not covered by health insurance in India and are treated as a self-pay procedure, because most insurers still classify them as investigational for orthopedic use. That is different from surgery, where cover is common — the insurance and cashless treatment page explains how that side works. Always confirm with your own insurer rather than assuming either way.