If you’re struggling with knee osteoarthritis (OA) and want to avoid risky cortisone injections or irreversible surgery, Platelet-Rich Plasma (PRP) therapy may be something you’ve heard about. But here’s something most people don’t know: not all PRP treatments are the same, and the results can vary a lot depending on how the PRP is prepared and exactly where it’s injected.

At The Patel Center for Functional Regeneration in Newport Beach, CA, Dr. Shounuck Patel offers cutting-edge regenerative treatments, including high-dose PRP, cell therapy, and prolotherapy. In this article, we’ll break down what the research shows – and what you need to know before getting PRP injections for knee pain.


What Is PRP?

Platelet-Rich Plasma (PRP) is made by drawing your blood, spinning it in a centrifuge to concentrate the platelets (the cells that help with healing), and then injecting that concentrated solution into your knee joint or surrounding tissues.

The goal is to use your body’s natural healing system to reduce inflammation, relieve pain, and promote long-term recovery of the joint. But for PRP to work well, the dose of platelets and the accuracy of the injection are extremely important.


Why High-Dose PRP Works Better

At this point, there is ample research in support of PRP in the treatment of knee OA, but studies have shown that higher doses of platelets lead to better results. This is especially important for patients with moderate to severe osteoarthritis.

Here’s what the research says:

  • Bensa et al. found that high PRP concentration with more than 1 billion platelets per milliliter helped significantly with pain and function compared to a placebo injection [1].
  • Boffa et al. found that higher platelet concentrations were linked to better outcomes and fewer treatment failures [2].
  • Hohmann supported using PRP with at least 5 billion total injected platelets, showing long-term benefits at 6 and 12 months [3].
  • Berrigan et al. showed that PRP with a total of 5.5 billion platelets improved outcomes at 6 and 12 months, while lower doses were less effective [4].
  • Bansal et al. reported that PRP with 10 billion platelets improved key scores measuring pain and joint function [5].

 

At our Newport Beach clinic, we carefully prepare PRP to deliver a high platelet dose – not just a standard shot. This is one of the reasons our patients often see stronger and longer-lasting improvements.


Precision Matters: Where the PRP Is Injected

Equally important to the platelet dose is where the PRP is placed. Using image-guided injections, we ensure that PRP reaches the exact tissues that need healing.


Intra-Articular PRP (Inside the Joint)

The most common approach is injecting PRP directly into the knee joint – called intra-articular PRP. This method has strong clinical support:

  • The American Society of Pain and Neuroscience recommends PRP over hyaluronic acid (gel injections) due to better safety and long-term results [6].
  • Filardo et al. (2021) conducted a large meta-analysis of randomized trials and found that intra-articular PRP injections significantly improved pain and function compared to other non-biologic options, making it one of the most studied and validated regenerative treatments [7].
  • Bennell et al. showed that leukocyte-poor PRP (PRP with fewer white blood cells) reduced pain and improved knee function better than placebo [8].
  • Hunter et al. also found that PRP performed better than hyaluronic acid for relieving pain over time [6].


Extra-Articular PRP (Around the Joint)

In more advanced cases, adding injections around the knee – into soft tissue structures like the ligaments and tendons – can improve outcomes even more.

  • Chen et al. found that combining intra-articular PRP with extra-articular soft tissue structures resulted in better pain relief and improved function compared to joint injections alone [9].

Intraosseous PRP: A Deeper Option

A more advanced treatment for more severe conditions involves injecting PRP directly into the bone just beneath the cartilage – called intraosseous PRP. This may sound more intense, but it is proving to be significantly helpful for patients with more advanced or persistent knee OA.

Recent studies have looked at this approach:

  • In a 2022 study, Barman et al. compared intra-articular PRP alone to a combination of intra-articular and intraosseous injections. While both groups improved, the intraosseous group did not show extra benefits at the 6-month mark [10].
  • In a 2023 study, the same research group found that the combined intra-articular + intraosseous PRP group had better results in reducing joint swelling and inflammation than PRP alone [11].
  • Hunter et al. also reported that patients receiving both types of injections had greater improvements in pain and function scores compared to joint-only injections [6].

While intraosseous PRP may not be necessary for everyone, it can offer substantial added benefit in certain cases, especially where there’s bone-related inflammation, more severe OA, or deep joint pain. At our clinic, we evaluate each patient’s imaging and symptoms before recommending this approach.


What About Dextrose Prolotherapy?

For some patients, dextrose prolotherapy is another non-surgical option. This treatment uses a sugar-water solution (usually hypertonic dextrose) to stimulate the body’s healing response in ligaments and tendons.

  • Chen et al. found that combining joint and soft tissue prolotherapy injections gave stronger pain relief than joint-only injections [12].
  • Sit et al. showed that prolotherapy helped patients improve their WOMAC scores (a standard measure of osteoarthritis symptoms) better than exercise alone [13].

Prolotherapy may be especially helpful for patients with more mild arthritis, loose or unstable joints, or when PRP is not an option.


Bottom Line: PRP Results Depend on the Right Dose, Technique, and Experience

PRP can be a powerful tool in treating knee osteoarthritis—but not all PRP is the same. Here’s what matters most:

  1. Platelet dosage – higher counts (ideally over 5 billion) lead to better results.
  2. Injection technique – image guidance and proper targeting inside, around, or under the joint is key.
  3. Provider experience – your doctor’s understanding of musculoskeletal anatomy, imaging, and regenerative therapy makes a major difference.

At The Patel Center for Functional Regeneration, we combine the latest scientific evidence with personalized treatment plans. Located in Newport Beach, Orange County, we serve patients from Los Angeles to all across Southern California who are seeking advanced, non-surgical solutions for knee pain.


Take the Next Step Toward Lasting Relief

If you’re ready to move beyond short-term fixes and explore regenerative medicine for knee osteoarthritis, let’s talk. Our clinic offers high-dose PRP, stem cell therapies, and prolotherapy – all tailored to your condition and delivered with precision.

Call us or schedule your consultation today at www.fxregencenter.com and discover how expert-guided PRP treatment can help you get back to a more active, pain-free life.