Can PRP Help With Knee Arthritis and Tendon Pain?

Yes, platelet-rich plasma therapy may reduce pain and inflammation while improving mobility and function in people with knee osteoarthritis or chronic tendon injuries. This treatment uses a concentrated sample of your own blood platelets. The platelets release growth factors that may stimulate the body’s natural healing process and improve the healing environment around the affected knee.

At Total Orthopedics and Sports Medicine, Dr. Charles Ruotolo, a member of the American College of Sports Medicine, uses ultrasound-guided PRP injections to deliver concentrated platelets accurately into the affected joint or tendon. After that, he closely monitors your progress and adjusts your treatment plan to improve strength, reduce stiffness or swelling, and restore long-term function. Call us at 855-321-6784 to schedule your consultation in Massapequa.

How Does PRP Treat Knee Arthritis and Tendon Injuries?

PRP treats knee arthritis and tendon injuries by concentrating platelets from your own blood and injecting them into the damaged area. These platelets release growth factors that may reduce inflammation, support tissue repair, and improve joint function. It also eases pain, especially in mild-to-moderate knee osteoarthritis and chronic tendon problems.

Here’s how PRP therapy helps treat the following chronic conditions:

Knee Arthritis

In case of knee arthritis, PRP alters the joint environment. Rather than simply reducing pain or acting as a lubricant, growth factors lower levels of inflammatory markers in synovial fluid. While it does not regrow cartilage, it can significantly improve joint function, provide lasting pain relief for 6 to 12 months, and may even slow disease progression.

In fact, a PubMed meta-analysis found that PRP improved knee function at 1, 3, 6, and 12 months, while pain relief was observed at 3 and 6 months. In addition, PRP can help alleviate knee arthritis pain when combined with hyaluronic acid.

Tendon Injuries

For tendon injuries (such as tennis elbow, jumper’s knee, or Achilles tendinitis), PRP acts as a turbocharger for slow-healing tissue. Tendons have a poor blood supply, making natural recovery difficult. Injecting PRP delivers a highly concentrated dose of growth factors directly to the injured site, stimulating the creation of new, healthy collagen fibers and helping the tissue rebuild properly. The NCBI study also found that PRP provides better long-term functional improvement and pain relief for lateral epicondylitis (tennis elbow).

How Do Doctors Perform PRP Treatment?

Dr. Charles Ruotolo, our knee specialist, first draws a small amount of blood (usually 20-60 mL) from your arm for PRP therapy. The blood is then centrifuged to isolate concentrated platelets from red blood cells and white blood cells. After numbing the area, he injects the plasma, packed with healing growth factors, directly into the joint space.

Before the procedure, our doctor may examine the knee, review the patient’s medical history, and determine whether PRP is appropriate. Additionally, while targeting platelet-rich plasma injections, Dr. Charles Ruotolo may use real-time ultrasound guidance to carefully insert a needle into the knee joint capsule or a specific injured tendon. If excess fluid is present in the joint, our doctor may drain it before administering the PRP.

How Many PRP Injections Doctors Recommend?

Dr. Charles Ruotolo commonly recommends one to three PRP injections for knee arthritis treatment, typically spaced one to several weeks apart. In contrast, for tendon pain, he often uses a single ultrasound-guided injection and a clinical reassessment. But the exact number of injections depends on the affected tendon or joint, symptom severity, imaging findings, and treatment response.

Some patients with mild-to-moderate osteoarthritis pain improve after one injection, while others require a series of two or three injections. NIH randomized controlled trials on patients with early OA also reported that multiple (3) PRP injections are useful in achieving better clinical results.

However, for tendon pain, our doctor assesses the patient’s pain, strength, and mobility after one injection. He may recommend two injections for conditions such as tennis elbow, Achilles, and other tendinopathies. In fact, PMC research found that two consecutive PRP injections for chronic patellar tendinopathy led to better outcomes than a single injection.

Besides that, the following factors may affect PRP treatment plans:

Duration of Symptoms

Recent injuries or symptoms may respond to a single injection because the affected tissue may retain greater healing potential. In contrast, long-term arthritis or chronic tendon damage may require a series of injections, rehabilitation, and closer follow-up to determine whether treatment is working.

Arthritis Severity

PRP generally shows more predictable results in mild-to-moderate knee osteoarthritis. In contrast, patients with advanced cartilage loss, severe joint deformity, or bone-on-bone arthritis may experience less improvement. They may also need additional treatments or joint replacement surgery.

Previous Therapies

Our doctor may consider whether the patient has already tried activity modification, pain medication, corticosteroid injections, or hyaluronic acid injections. A poor response to earlier treatments may support PRP treatment, but it may also indicate more advanced joint or tendon damage.

Activity Level

Athletes, manual workers, and highly active individuals place greater mechanical stress on the treated joint or tendon. In such cases, our doctor may combine a PRP treatment plan with temporary activity restrictions and a gradual return to sport or work.

Low Platelet Count

PRP relies on the concentration of platelets that release growth factors involved in tissue repair. When the platelet count is very low or platelet function is abnormal, a single PRP shot may contain an insufficient number of functional platelets and may provide less benefit.

Active Infection

An infection at the injection site or elsewhere in the body may increase the risk of introducing or spreading infection. Doctors usually treat or control the infection before considering an elective PRP injection.

Chronic Illnesses

Poorly controlled diabetes, serious liver disease, immune-system disorders, cancer, and other chronic conditions may impair tissue healing. It also alters platelet function, increasing infection and procedural risks. In such cases, our doctor may delay treatment or coordinate care with another specialist.

Anti-Inflammatory Medications

Drugs such as aspirin and certain nonsteroidal anti-inflammatory drugs may reduce platelet activation. Additionally, it may interfere with the early inflammatory response involved in tissue repair. Therefore, our doctor may review the exact drug, dosage, and medical history before recommending PRP treatment.

Who Is a Good Candidate for PRP Injections?

Patients having mild to moderate knee osteoarthritis or chronic tendon tears that didn’t respond to conservative treatments are considered good candidates for PRP Injections. This treatment is also suitable for candidates in good overall health who want a non-surgical alternative to manage persistent pain.

Moreover, for knee arthritis, PRP may be considered when persistent stiffness, swelling, or reduced mobility interferes with daily activities despite appropriate conservative care. In contrast, for tendon pain, our doctor may advise PRP when a properly diagnosed case of chronic tendinopathy or a partial tendon injury has responded poorly to a structured rehabilitation program.

In addition, Dr. Charles Ruotolo, our knee specialist, may recommend PRP before orthopedic surgery to improve overall healing, shorten recovery time, and reduce surgical risks. Since PRP involves isolating and injecting a patient’s own whole blood, it is generally not advised for the following patients:

Active Cancer

PRP contains concentrated platelets that release growth factors involved in tissue repair and blood-vessel formation. Because these biological signals could interact with tumor activity, PRP is avoided in patients with active cancer, particularly near a tumor site. In addition, cancer may affect platelet counts, immune function, and blood clotting.

Blood Disorders

Conditions involving low platelet counts, abnormal platelet function, anemia, blood cancers, or impaired clotting can reduce the quality and effectiveness of the prepared PRP. They may also increase the risk of bleeding, bruising, infection, or other complications during the blood draw and injection. However, not every blood disorder is an absolute contraindication. Therefore, doctors may review laboratory results and perform hematology, such as a complete blood count, platelet count, and hemoglobin measurement, to determine whether PRP treatment is appropriate.

Serious or Unstable Cardiovascular Disease

Patients with unstable heart disease, recent cardiovascular events, clotting problems, or poor circulation may face increased procedural risks. Anticoagulant or antiplatelet medicines may also affect bleeding and platelet activity. Therefore, PRP treatment is only performed after medical clearance. However, in such cases, patients must never stop prescribed blood-thinning medication without their doctor’s instructions.

Advanced or End-Stage Joint Degeneration

PRP is generally more effective for mild-to-moderate osteoarthritis. In advanced “bone-on-bone” arthritis, there may be too little healthy cartilage and joint structure remaining for PRP to provide lasting improvement. Moreover, PRP cannot rebuild extensively lost cartilage, correct severe deformity, or reverse damage to muscles and ligaments. Therefore, doctors may consider surgical assessment or joint replacement in such cases for long-lasting relief.

Besides that, according to NCBI research, PRP treatment should not be performed in patients with severe thrombocytopenia, platelet-function disorders, or hemodynamic instability. Researchers also found that PRP must be delayed or carefully evaluated in patients with severe anemia or those who utilize NSAIDs within 48 hours before the procedure.

Is PRP Better Than Steroid Injections?

Yes, PRP is generally better for long-term healing and tissue repair. In contrast, steroid injections are beneficial for rapid, short-term pain relief. Steroids act quickly to suppress inflammation within 24 to 48 hours, but can weaken tissue over time. However, PRP uses the liquid portion of your blood and takes 2 to 6 weeks to show effects as the tissue repairs.

Additionally, steroid benefits typically fade after 3 to 6 months. On the other hand, PRP relief can last 6 to 12 months, or even up to two years. Repeated steroid use is also associated with cartilage damage and tendon weakening. However, PRP utilizes your body’s own growth factors and is considered safe for long-term joint health. In fact, a systematic review in PubMed reports that PRP showed significant improvement over corticosteroids at 1-year follow-up.

Another NCBI study reported that PRP treatment reported better results than corticosteroids for reducing pain and improving function in patients with knee osteoarthritis. Moreover, PRP injections can reduce the need for opioids and anti-inflammatories.

What Are the Side Effects of PRP Injections?

PRP injections may cause temporary pain, swelling, stiffness, bruising, or tenderness at the injection site. Symptoms often increase as healing inflammation begins, then improve within several days. Infection, bleeding, nerve injury, or tissue damage are also common during this time.

After a knee PRP injection, patients may temporarily experience increased joint discomfort, reduced flexibility, or difficulty walking. This post-injection flare generally occurs because PRP activates an inflammatory response inside the arthritic joint.

On the other hand, when PRP is injected into an injured tendon, such as the Achilles, patellar, rotator cuff, or elbow tendon, localized soreness may make stretching, lifting, or weight-bearing uncomfortable. In such cases, the intensity and duration of discomfort depend on the following factors:

Location and Type of Tendon

The location and function of the affected tendon can impact post-injection discomfort. Weight-bearing tendons, such as the Achilles or patellar tendon, may produce more noticeable soreness during walking, climbing stairs, or standing. In comparison, injections into the rotator cuff or elbow tendons may temporarily affect lifting, reaching, gripping, or arm movement.

Severity of the Tendon Injury

Patients with advanced tendinopathy, extensive tissue degeneration, or a partial tendon tear may experience longer-lasting discomfort than those with mild tendon irritation. Additionally, severely damaged tissue may generate a greater inflammatory response after PRP treatment. It may also require a longer period of activity modification and rehabilitation.

Injection Technique

The accuracy, depth, and number of needle passes used during the procedure can affect post-treatment soreness. Ultrasound guidance allows the doctor to place PRP precisely within or around the damaged tendon while avoiding nearby nerves and blood vessels. However, needling the abnormal tendon tissue may temporarily increase tenderness.

In addition to these symptoms, some patients may feel lightheaded during the blood draw used to prepare PRP. Therefore, eating beforehand and staying properly hydrated can help reduce this reaction. However, you should contact your doctor if you develop worsening pain, severe swelling, fever, or spreading redness. You must also seek immediate medical attention if you notice drainage, persistent numbness, unusual weakness, or an inability to move the treated knee or the tendon. These symptoms may indicate infection, nerve irritation, bleeding, or another complication.

Can You Walk After Platelet-Rich Plasma Injections?

Yes, most patients can walk after a PRP injection, especially after treatment for knee arthritis. However, walking should be limited to short, necessary distances for the first 24 to 72 hours. If pain, limping, or tendon treatment requires protection, your doctor may advise you to use crutches or a brace.

Moreover, tendon-specific PRP can be slightly more painful. During this time, the doctor may recommend light, non-strenuous walking to promote blood flow, but aggressive stretching or heavy loads should be avoided. But if walking causes severe or worsening pain, marked swelling, increasing redness, fever, numbness, or an inability to bear weight, contact your doctor immediately.

Consult Dr. Charles Ruotolo for Effective PRP Treatment in Massapequa!

If knee arthritis or chronic tendon pain is affecting your mobility, exercise, work, or everyday activities, you may be wondering whether PRP can provide lasting relief. You may also be uncertain about its effectiveness, recovery time, cost, and whether your condition is suitable for treatment.

At Total Orthopedics and Sports Medicine, Dr. Charles Ruotolo, our fellowship-trained orthopedist, provides PRP treatment based on your diagnosis, injury severity, medical history, and recovery goals. Instead of offering a one-size-fits-all injection, he evaluates the source of your knee or tendon pain and provides advanced PRP therapy for supporting tissue healing. Visit at 5500 Merrick Road, Massapequa, NY 11758, or contact us at 855-321-6784 to get expert care for your knees.

FAQs