What are orthobiologics, and how is a PRP injection different from a steroid shot?

An orthobiologic is a treatment made from your own tissue and placed back into a damaged joint or tendon. The goal is repair. A steroid shot has a different job. It shuts down the alarm for a while, and it does nothing to the worn fibers that set the alarm off.

That difference matters most to people who have already had three or four cortisone shots in the same knee. Each one tends to last a little less than the one before. The tissue under the shot keeps wearing, because nothing in the syringe was aimed at it.

Which three orthobiologics do we use?

• Platelet-rich plasma (PRP). We draw blood from your arm, spin it, and keep the layer packed with platelets. Platelets carry the growth signals that call in repair cells. PRP is the workhorse for tendons and for early to middle knee arthritis.
• Bone marrow concentrate (BMAC). A small amount of marrow is drawn from the back of the hip bone under local numbing, then concentrated. It carries repair cells along with the signals. We reach for it in a joint further along, or in bone that is swollen under the cartilage.
• Microfragmented fat. A few spoonfuls of fat from the belly or flank are washed and broken into tiny clusters. Those clusters cushion the joint and keep releasing signals for weeks. In a review of six randomized trials, fat and PRP gave similar relief in knee arthritis over a year.

Which one fits depends on the tissue, how far it has worn, and your own health. We pick at the exam, not over the phone.

Where does the injection actually go?

There are three targets, and the scan decides which one is yours.

• Into the joint. For a worn knee, hip or shoulder, the dose goes into the joint space, where it calms the lining and bathes the cartilage.
• Into the tendon. For tennis elbow, a rotator cuff or a kneecap tendon, the needle goes into the frayed part of the tendon itself, watched on ultrasound the whole way.
• Under the cartilage. In some worn knees the bone just beneath the cartilage is bruised and swollen on MRI. Treating that bone, called a subchondral injection, reaches pain that a joint shot alone can miss.

Conditions we treat with orthobiologics

Each page below covers one problem in depth, written for people who live on the Illinois side. Start with the one that sounds like you.

Knee

• Knee pain: worn cartilage, the fat pad that acts like a gland, and where PRP fits.
• Patellar tendonitis: the tendon below the kneecap that rest alone does not fix.
• Godfrey, Illinois: what bone-on-bone means and which knee nerve can be tested.

Hip

• Hip pain: sorting a hip problem from a back problem before anything is injected.
• Hip bursitis: usually a tendon on the side of the hip, treated as one.

Shoulder and elbow

• Rotator cuff tendinitis: for the shoulder that comes back after the cortisone fades.
• Shoulder pain: which shoulder problem is most likely at your age, and where PRP fits.
• Tennis elbow: outer elbow pain from tools, keyboards and lifting.
• Golfer’s elbow: inner elbow pain that weakens your grip.

Foot

• Plantar fasciitis: the heel pain of the first step out of bed.

Spine

• Facet joint pain: the small joints of the spine, and where our back guide lives.
• Columbia, Illinois: a sacroiliac joint workup and the options that follow it.

Crash and work injuries

• After a car accident: Illinois crash rules and how orthobiologic care is written into the record.
• Injured at work: choosing your own doctor under Illinois workers’ comp.
• For attorneys: how PRP and other orthobiologics are documented for a case.

Before your visit

• Image-guided joint injections: why the needle is watched on a screen every time.
• About Dr. Padda: his training, including regenerative medicine in interventional pain.

Pick your guide

Each guide is a short email series from our regenerative team, matched to one part of the body. Choose the one that fits, and the form is on that page.

• Knee, hip arthritis or joint wear: the form on this page, or the knee guide on knee pain.
• Shoulder, elbow, hip tendon or heel: the tendon guide.
• Low back and spine joints: the back guide.
• Hurt in a crash: the accident guide.

Who is a good candidate for PRP injections?

The best fit is someone with mild to moderate wear who has already tried therapy, weight-bearing changes or a cortisone shot, and is not ready for surgery. A European panel of knee experts reached the same view. They rated PRP as appropriate after other care has failed, and not as the first thing tried or in the most worn knees.

Your body sets the ceiling. High blood sugar stiffens collagen and slows how fast a tendon rebuilds. Poor sleep from a rotating shift at the refinery or the warehouse raises the body’s inflammation all day. Smoking chokes the small vessels a tendon depends on. So we check your blood work and ask about sleep and work before we inject anything, because a repair signal sent into an inflamed body gets a weaker answer.

Some knees are past this. When the joint has collapsed or the leg has bowed, we say so plainly. That knee may do better with a nerve treatment such as a genicular nerve block, or with a surgical opinion. You will hear which group you are in at the first visit.

What is the visit like for someone driving over from Illinois?

Orthobiologic procedures are done at 4477 Woodson Rd in St. Louis, off I-70 at Woodson Road. Most people from Edwardsville, Collinsville or Belleville spend more time on the bridge than in the room.

You stay awake. We numb the skin with local anesthetic and use ultrasound to guide the needle. There is no sedation, so most people drive themselves home. Expect the area to ache for about 48 hours as the platelets set off a short burst of healing inflammation. Skip anti-inflammatory pills like ibuprofen for that stretch, since they blunt the very signal we just placed.

Most people feel the change build over six to twelve weeks. The number of injections follows what your tissue needs. Some do well with one, and others need a second, which we decide together at follow-up.

Why do dose and rehab decide the result?

Not all PRP is the same product. A fast spin can leave barely more platelets than plain blood. In a review of 18 randomized trials, high-platelet PRP gave real pain relief that lasted a year in knee arthritis, while the weak version did not beat a placebo shot on pain. So we prepare a concentrated dose and confirm where it lands.

Then the tissue has to be loaded. A new collagen fiber lines up along the force it feels, so the right exercise teaches it which way to grow. Your plan builds week by week from gentle loading toward the climb, the lift or the swing your life demands. The injection opens the window. The rehab, the sleep and the blood sugar decide what fills it.

Frequently asked questions

Are PRP injections covered by insurance in Illinois?

Most plans, including Medicare, do not pay for PRP. That is a funding decision by the plan, not a ruling on whether it works. HSA and FSA funds can generally be used. Under workers’ comp, the carrier’s review decides.

How long do PRP injections last?

In knee arthritis, the stronger trials show relief that holds for about a year, and many people go longer. The result lasts longest when the rehab and the metabolic work continue after the shot.

Does a PRP injection hurt?

The skin is numbed first, so most people feel pressure more than pain. The joint or tendon aches for about two days afterward.

What is the difference between PRP and stem cells?

PRP carries growth signals from your platelets. Bone marrow concentrate and microfragmented fat also carry living repair cells. We use whichever matches the tissue and how worn it is.

Can I drive home after a PRP injection?

Yes, in most cases. There is no sedation, so you can drive yourself back across the river the same day.

Do I need an MRI before PRP?

Not always. Ultrasound in the room shows most tendon and joint problems. We order an MRI when we suspect bone swelling under the cartilage or a tear that would change the plan.