PRP, or platelet-rich plasma, is a concentrated extract of the patient's own platelets and growth factors prepared from a small blood draw. Platelets contain growth factors that signal nearby cells to heal, produce collagen, and form new blood vessels. Concentrating those platelets at the site of an injury (a tendon, ligament, or joint) amplifies the body's natural healing response. PRP is autologous, meaning the cells come from the patient, not from a donor or a manufacturer.

How is PRP made and given?

A standard blood draw of about 10 to 15 mL is obtained from the patient's arm. The tube is placed in a centrifuge that separates the blood into layers, and the platelet-rich layer (the buffy coat) is drawn into a syringe. That concentrated material is then injected directly into the affected tendon, ligament, or joint, typically under ultrasound guidance. The entire procedure takes about 20 minutes.

Does PRP work, and for what?

The evidence is strongest for chronic tendinopathies (tennis elbow, golfer's elbow, rotator cuff tendinopathy, Achilles tendinopathy, patellar tendinopathy), ligament problems, and mild-to-moderate knee osteoarthritis. Results for ligament partial tears, basal joint arthritis, and TFCC tears are positive in many patients but variable in the literature. PRP is generally not effective for complete tendon ruptures, severe arthritis with bone-on-bone changes, or end-stage joint disease.

Are there side effects, and is PRP safe?

PRP is considered one of the safest modalities used in medicine because it uses the patient's own cells, which essentially eliminates the risk of allergic reaction or transmissible disease. The most common side effect is moderate soreness at the injection site for 24 to 72 hours after each injection, which is part of the controlled inflammatory response that drives healing. Patients are advised to avoid anti-inflammatory medications (ibuprofen, naproxen) for about a week after and even before each injection so the healing cascade is not blunted.

Can it be used in professional athletes?

The procedure is accepted by all major professional sports leagues and the International Olympic Committee.

PRP (Platelet-Rich Plasma) Injections, Steven J. Lee, MD

Platelet-rich plasma (PRP) is an autologous biologic treatment: the cells in the syringe come from the patient's own blood, not from a donor or a manufacturer. A small volume of blood is drawn, spun in a centrifuge to separate its components, and the platelet-rich layer is re-injected into the injury site under ultrasound guidance.

Most patients have moderate soreness at the injection site for 24 to 72 hours, sometimes longer. This is part of the biologic process: PRP triggers a controlled inflammatory response that drives healing. Patients are advised to avoid anti-inflammatory medications (NSAIDs like ibuprofen) for about a week after the injection so the healing cascade is not blunted.

The biological idea is straightforward. Platelets are not just for clotting; they also carry a dense load of growth factors that signal local cells to heal, build collagen, and form new blood vessels. Concentrating those platelets at the site of an injury is intended to amplify the body's natural healing response in tissues that are otherwise slow to recover.

What PRP is, and what it isn't

PRP is a regenerative injection: it uses the patient's own biologic material to stimulate healing. It is fundamentally different from a corticosteroid (cortisone) injection, which suppresses inflammation but does not promote tissue repair.

PRP is also distinct from stem cell or bone marrow aspirate concentrate (BMAC) treatments, which use different cell populations. The preparation method matters, the platelet concentration matters, and the indication matters.

How the procedure works

The entire procedure takes about 20 minutes. A standard blood draw of roughly 10 to 15 mL is obtained from the patient's arm. The tube is placed in a centrifuge, which separates the blood into layers by density: red cells at the bottom, plasma at the top, and a thin straw-colored layer of concentrated platelets in between (the buffy coat).

The platelet-rich layer is drawn into a syringe and injected directly into the injury site, sometimes under ultrasound guidance to ensure precise placement into the affected tendon, ligament, or joint. Cold spray and/or local anesthetic may be used at the skin to make this a surprisingly tolerable experience.

Conditions commonly treated

PRP helps to improve the healing for tendons, ligaments, cartilage, and bone, and is most often used for injuries that have not responded to a real trial of rest, physical therapy, and anti-inflammatories. Common indications include:

Lateral epicondylitis (tennis elbow)
Medial epicondylitis (golfer's elbow)
Rotator cuff partial tears and chronic tendinopathy
Biceps tendinitis and tendinopathy
UCL tears of the elbow or thumb
Thumb basal joint arthritis
TFCC tears and other wrist ligament injuries
Knee osteoarthritis, mild to moderate
Patellar tendinopathy (jumper's knee)
Achilles tendinopathy

While PRP can be used for those interested in accelerating the timeline for healing such as in athletes, it is generally used for cases where simpler measures have not delivered the expected result.

Who is a good candidate

The best candidates are patients with a chronic tendinopathy, partial-thickness tendon tear, ligament issues, or mild-to-moderate arthritis who have not improved with 6 to 12 weeks of standard non-surgical care (rest, activity modification, hand therapy, NSAIDs, sometimes a single corticosteroid injection).

PRP is less likely to help in cases of severe arthritis with bone-on-bone changes, complete tendon ruptures, or end-stage joint disease where the structural problem is beyond what biology can repair. Dr. Lee determines candidacy on a case-by-case basis, weighing the imaging, the patient's activity demands, and the realistic biologic potential of the tissue.

What to expect after the injection

The actual injection can sting depending on the type of PRP used and if measures are not taken to ameliorate them. Dr. Lee, among the first in NYC to use PRP for the upper extremity, uses techniques that make the injection well tolerated.

Clinical improvement is gradual, typically beginning at 4 to 6 weeks and continuing to develop for 3 to 6 months. PRP is not a same-day pain reliever; it is a regenerative treatment whose benefits accrue over time.

Series and protocol

PRP response appears to be dose-dependent for most indications. The standard protocol is a series of 3 injections spaced approximately one week apart. In selected cases (slow responders, more degenerative tissue), a 4th or occasionally 5th injection is added.

Hand or physical therapy continues throughout the injection series and beyond. PRP is one component of a broader treatment plan, not a standalone replacement for the rehabilitation work that gets the tissue strong and re-loaded.

Dr. Lee's approach

Dr. Lee was among the first surgeons in NYC to use PRP for upper-extremity injuries and performs more than 250 PRP procedures per year. That volume matters: it allows him to match the right concentration, the right injection technique, and the right post-injection protocol to each indication, rather than applying a one-size-fits-all approach.

His honest framing for patients: PRP works well for some indications and modestly for others, and the evidence base is strongest for chronic tendinopathies and mild-to-moderate knee osteoarthritis. He recommends it where the literature and his clinical experience support real benefit, and he is comfortable telling patients when surgery is the better path.

Recovery timeline

PRP is not a procedure with a fixed recovery timeline like surgery; it is a series of office visits with progressive clinical change.

Day of injection
Local soreness, often noticeable within the first hour. No NSAIDs for one week after the injection.
Days 1 to 3
Peak soreness at the injection site. Ice and acetaminophen are acceptable. Activity is limited to comfort.
Week 1 to series completion
Second and third injections at one-week intervals. Continued hand therapy or physical therapy alongside the series.
Weeks 4 to 6
Earliest improvement typically appears as reduced pain and improved function. Some patients feel changes earlier; some take longer.
3 to 6 months
Full clinical effect realized. The injury is reassessed and next steps decided: continue therapy, repeat series, or revisit surgical options.

What patients commonly misunderstand

Three common misconceptions about PRP.

'PRP is the same as a cortisone shot.' They are fundamentally different treatments. Cortisone suppresses inflammation and often provides fast but temporary pain relief; it does not heal tissue and can weaken collagen tissue. PRP triggers a controlled inflammatory response intended to stimulate healing and works on a slower, weeks-to-months timeline.
'One PRP injection should fix it.' PRP appears to be dose-dependent for most indications. The standard protocol is a series of 3 injections spaced one week apart. Expecting a single injection to deliver the result of a series is the most common reason patients walk away dissatisfied.
'PRP can fix anything.' PRP works best for chronic tendinopathies and mild-to-moderate arthritis. It is not a substitute for surgery in cases of complete tendon rupture, severe arthritis with bone loss, or end-stage joint disease. An honest evaluation about whether biology can solve the structural problem comes before recommending PRP.
'PRP is covered by my insurance.' Unfortunately, PRP is not currently covered by insurance and is an out of pocket expense.

This page is general educational content authored by Dr. Lee. It is not a substitute for individual medical advice. Every patient's case is different, book a consultation to discuss yours.

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PRP Injections: your own platelets, concentrated.