What is Platelet Rich Plasma (PRP)?

Platelet rich plasma (PRP) is the injection of concentrated platelets and growth factors, collected from your blood during an in-office procedure, into an area of injury or arthritis. The growth factor concentrate signals local progenitor cells to replace the injured area with healthy tissue. PRP is considered to be more effective than dextrose prolotherapy and has gained popularity over the last decade through highly publicized testimonials from numerous professional athletes.

BOUNDLESS is a leading provider of PRP injections in San Diego.

What makes our PRP different?

Recent publications support our observation that most commercial PRP systems are inefficient and inconsistent at producing PRP of sufficient concentration and quality for optimum healing. At BOUNDLESS, we have optimized a process of producing highly concentrated, custom-made PRP in our in-house GMP-quality lab. We offer personalized PRP preparation options depending on your healing needs, from a “pure,” clear, and largely anti-inflammatory preparation, to a stem cell and macrophage-rich hand-made preparation when needed.

What does a typical treatment entail?

An office visit for a PRP treatment lasts about 90 minutes. Your blood is drawn and prepared in our in-house lab while you wait. The injured or arthritic area is then injected with the custom-made PRP mixture under ultrasound or fluoroscopic guidance. Each treatment may consist of one or several injections, guided by physical examination, prolotherapy traditions, and the latest research, to maximize the healing and stabilization of your tendon, ligament, or joint.

How many treatments treatments are needed?

Typically 1-3 rounds of treatments spaced 1 -3 months apart are needed for optimum results.



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Is all PRP the same?

No – there is a wide variety of PRP preparations and this accounts, in part, in the conflicting study results. There are a number of commercial systems that produce easy to produce, turn-key PRP of various quality – some produce a mixture high not just in platelets, but also in white and red cells (which looks red, or bloody and results in higher inflammation levels and pain) and others that produce a much clearer solution which is low in white and red cells, and, unfortunately, also in platelets. At Boundless we are unique in the community in offering PRP using several commercial systems as well as custom hand-made preparations produced in our lab, shown to surpass most commercial systems in platelet recovery and selection. This allows us to offer our patients personalized PRP options depending on their healing needs, from a “pure”, clear and largely antiinflammatory preparation, to a stem cell and macrophage-rich preparation when needed. We also offer platelet lysate, containing growth factors without platelets, for those cases where minimum inflammation is necessary, such as around nerves and in the epidural space.

What are the risks and side effects of PRP treatment?

The risks associated with PRP are extremely rare, typically limited to infections and needle-related injuries according to the literature. Since a portion of your own blood is used, the treatment is one of the most natural, without risks of allergy/adverse reaction common to injected medications, or risks of anesthesia and surgery. PRP is associated with a temporary, self-limited
pain flare, lasting typically a few days to 2 weeks, related to its mechanism of action, your own healing/inflammation system. The purer, less inflammatory PRP preparations are associated with a lower/shorter pain flare.

How does PRP compare with cortisone injections and surgery?

Cortisone injections have shown to provide temporary relief of pain and inflammation at the cost of tissue weakness and destruction if overused. They are appropriate in cases of severe, functionally limiting pain and inflammation and, if used sparingly and combined with physical therapy and strengthening, can result in overall benefit. PRP, however, results in direct healing and strengthening of tendons and ligaments and outperforms cortisone in long-term studies of tendinopathy (tennis elbow) and arthritis (knee arthritis studies). Surgery is, for many patients, a last resort due to the risks of surgery and anesthesia, recovery time, cost, and extent of intervention/irreversibility. While there are cases where surgery is necessary, PRP can frequently prevent or delay surgery in cases of partial tendon tears and tendinopathies, meniscal and labral tears, arthritic conditions, and soft tissue injuries. In choosing PRP, you are not burning your bridges – for those patients who do not improve with PRP, surgery remains an option.

How soon can I go back to my regular activities?

Typically gentle range of motion and normal daily activities are resumed the first day after PRP treatment as tolerated. As the initial pain flare/inflammation resolves, patients resume an exercise program designed to optimize their healing, frequently under the guidance of a physical therapist. Gradual return to sports is encouraged, keeping in mind that those activities that resulted in the initial injury, if restarted too quickly, will re-injure the area and result in failure of treatment. Patients are counseled in pacing and advised to avoid those activities that result in a pain flare of more than 2 points on a scale of 1-10.

Will my insurance cover PRP therapy?

As with other regenerative procedures, medicare and most insurance companies consider PRP to be experimental despite the thousands of studies in the literature today. Some companies have begun to reimburse the procedure, but these are currently in the minority. At Boundless, we collect for the procedure at the time of treatment, but, as a courtesy to our patients, do send the billing codes to the insurance. If the insurance company is one of the few that does reimburse the procedure, the patient’s money will be refunded.

PRP Research

Interested in learning more about PRP?