Enhancing the body's innate ability to heal

North Texas Musculoskeletal Medicine

Regenerative Orthopedics Osteopathic Manipulation



FAQs

PLATELET RICH PLASMA (PRP) TREATMENT

What is the cost of PRP?

PRP cost varies according to the location and complexity of the injury. Cost generally ranges from $500 for a simple joint to $1200 for a more complex injection of the spine.

Is PRP covered by insurance?

The procedure is not covered by insurance. We try to mitigate your cost by billing your insurance for the initial office visit. We also keep our costs competitive with those of most larger regenerative medicine facilities in this country.

Is PRP a good value?

PRP is a long-term solution because it actually helps to heal the injury and source of the pain. Many current treatments to joint injury merely mask the pain by temporarily reducing inflammation with cortisone and NSAIDS. Because they are temporary, they usually require repeated treatments for an indefinite period.

What types of problems can be treated by PRP?

Joint cartilage damage (osteoarthritis, meniscal tears, labral tears); partial tears of tendons, muscles, or ligaments; and chronic bursitis.

Why PRP instead of cortisone?

Cortisone injections (also known as corticosteroid injections) and PRP injections are both very effective at reducing joint pain, but for very different reasons. They are essentially opposite ends of the pain-relief spectrum. Corticosteroid injections stop the inflammatory process. The problem is that if you have a small tear in the tissue that needs to heal, you have essentially stopped the healing process. In addition, the corticosteroids are well known for breaking up collagen bonds. Tendons are a large cable made of collagen. Corticosteroid injections can weaken the tendon and make it more likely to rupture or completely tear.

PRP injections work in the opposite way. PRP uses the growth factors present in your blood stream (eg, platelets) and concentrates them many times. These re-injected cells stimulate new blood flow, unlock the body's natural healing response, and directly stimulate healing of the injured tissue.

Can PRP prevent surgery?

If the tissue is completely torn, surgery is most likely required. However, most soft tissue injuries have portions intact, making PRP a preferred approach. The concentration of platelets in the PRP solution stimulates activation of the body’s existing stem cells to regenerate and strengthen tissue. Studies have even found that PRP used during surgery can result in repairs that are more sturdy and longer lasting.

What are the Potential Benefits of PRP Treatment?

Patients can see a significant improvement in symptoms. This may eliminate the need for more aggressive treatments, such as long-term medication use or surgery. PRP also allows for a more rapid return of function.

How many PRP treatments are required?

While responses to treatment vary, most people will require 2-4 sets of injections. Each set of treatments is spaced approximately 4-6 weeks apart. There is no limit to the number of treatments you can have, but we usually limit a course of treatment to 4 sets.

Is PRP right for me?

Tendon, ligament, and cartilage injury or degeneration due to osteoarthritis are generally improved through PRP therapy. The procedure is less aggressive and less expensive than surgery. PRP injections can heal tissue with minimal or no scarring and reduce further degeneration of the tissues. An initial evaluation with a doctor will determine if PRP therapy is right for you.

Are there any special instructions?

You are restricted from the use of non-steroidal anti-inflammatory drugs (NSAIDs) 1 week prior to the procedure and throughout the course of treatments. Initially, the procedure may cause some localized soreness and discomfort. Most patients only require extra-strength acetaminophen (eg, Tylenol) to help with the pain. Ice may be applied to the area as needed.

How soon can I go back to regular physical activities after PRP?

PRP therapy helps to regenerate soft tissue and accelerates healing, but any healing is not immediate. This therapy is stimulating the growth and repair of tissue which requires time and rehabilitation. The length of time is determined by the extent of the injury and your individual healing tendencies.

What body areas do you treat with PRP?

The soft tissue of any joint area can be treated including the knee, hip, shoulder, ankle, hand, foot, neck, and lower back.

What is PRP’s success rate? How many people respond? What is the cure rate?

Studies show that approximately 86% of the patients who responded said they were satisfied with their treatment and would do it again. Below are the results of a survey done by another facility for knee and hip patients with severe arthritis who had been told that they needed a joint replacement surgery:

  • 89% of knee patients reported more than 50% relief of symptoms and more than half of them had greater than 75% relief.
  • 75% of hip patients reported more than 50% relief and 88% of them reported more than 75% relief.

STEM CELL THERAPY

Is the procedure painful?

With the use of adipose or bone marrow stem cells, there is some discomfort during the harvesting.  This is reduced by local anesthetic given before the procedure. There is little pain during the administration of the stem cell mixture into the problem area. Discomfort may be felt for 24 to 72 hours after the procedure, but the doctor will prescribe medication to manage the pain.

What is the advantage of Stem Cell Therapy over PRP or Dextrose Prolotherapy?

Sometime local stem cells that are activated in the PRP process have become depleted, particularly in the case of chronic injury or osteoarthritis.  The demand has simply exceeded the supply for too long.  In this case, stem cells must be brought in from a different source.

What is the advantage of umbilical stem cells over those that are harvested?

Just as any cell in our body, stem cells age.  Umbilical stem cells are not only younger and healthier, they also are able to differentiate into a greater variety of cells.  The additional nutrients in the umbilical tissue aids in the healing process.

When will I notice improvement?

It depends on the patient, but typically within 1-2 weeks with continual improvement for months after treatment.

Why is PRP often used with Stem Cell Therapy?

PRP is rich in growth factors and proteins that accelerate and boost tissue healing and repair. PRP also attracts more stem cells to the site.

When can I return to normal activities?

You will experience soreness for a few days, but most people return to regular activity and work the next day. For people with jobs that require load-bearing activity (eg, heavy lifting), it is best to refrain from this type of activity or any strenuous exercise for a short period.

Is Stem Cell Therapy covered by insurance?

No, insurance does not cover this cellular therapy.  You will find our prices, however, favorable comparable with national standard. 

What is the cost of Stem Cell Therapy?

Stem Cell Therapy costs vary with type and location.  Umbilical Stem Cell Therapy ranges from $2300-$2700.  When combined with PRP, cost range from $2500- $2900 for the combined procedures.  Adipose or bone marrow Stem Cell Therapy ranges from $3200- $3800 with 50% off for second side.

DEXTROSE PROLOTHERAPY

What types of conditions can be treated with dextrose prolotherapy?

Dextrose prolotherapy is particularly beneficial for torn or strained ligaments and tendons as it tightens laxity in joints by stimulation of collagen production.  It is also helps to restore cartilage that has degenerated due to injury or osteoarthritis.  Although not as effective for some conditions as other forms of regenerative cellular treatments, such as PRP or Stem Cell Therapy, many conditions respond well, making dextrose prolotherapy a cost-effective choice.

Why prolotherapy instead of cortisone?

Cortisone injections (also known as corticosteroid injections) and prolotherapy injections are both very effective at reducing joint pain, but for very different reasons. They are essentially opposite ends of the pain-relief spectrum. Corticosteroid injections stop the inflammatory process. The problem is that if you have a small tear in the tissue that needs to heal, you have essentially stopped the healing process. In addition, the corticosteroids are well known for breaking up collagen bonds. Tendons are a large cable made of collagen. Corticosteroid injections can weaken the tendon and make it more likely to rupture or completely tear.

Is dextrose prolotherapy covered by insurance?

No, insurance does not cover dextrose prolotherapy. We try to mitigate costs, however, by billing for the office visit.

VISCOSUPPLEMENTATION

What types of conditions can be treated with viscosupplementation?

Osteoarthritis of the knee or other articular cartilage degeneration.

When will I notice improvement?

It depends on the patient, but many patients report feeling relief during the 3- to 5-week course of therapy. The greatest pain relief is usually experienced between 8-12 weeks after treatment.

When can I return to normal activities?

Avoiding strenuous activities (eg, active sports, heavy lifting) and standing for more than an hour at one time for 24-48 hours after the injection is often recommended. After the first 48 hours, you can return to normal activities.

Is viscosupplementation covered by insurance?

Yes, insurance covers this therapy for osteoarthritis and cartilage degeneration.

EXTRACORPOREAL SHOCK WAVE THERAPY

Q. What types of conditions can be treated?

A. ESWT is an effective and safe treatment for acute and chronic musculoskeletal pain, stress fracture, scar tissue.  ESWT enhances bone and tendon healing.

Q. Can everyone be treated with ESWT?

A. No. Patients with a pacemaker, pregnant, or who are current cancer patients are not suitable candidates for treatment.

Q. How many treatments are needed and how long does it take to notice results?

A. Speed of recovery depends on the nature of the condition being treated.  Most patients notice pain relief after 1-2 sessions.  Clinical studies report significant reduction in pain or elimination of pain in as many as 91% of patients.

Q. Are there side effects?

A. There are virtually no side effects.  Very few patients experience discomfort at the treated area for a couple of days. Patients can expect no down time and can continue with work and normal activities on the same day as treatment.