In this video, we are going to talk about PRP, or platelet-rich plasma – what it is, why it might work, and what injuries PRP might be especially useful for – especially patellar tendinitis and patellar tendinopathy.

Please understand, in this video, I am not giving you medical advice. This is meant for general information and educational purposes only.

What is platelet-rich plasma?

PRP, also known as platelet-rich plasma, is a concentration of platelets that comes from your whole blood. It is centrifuged to obtain a ready-to-use product.

PRP works by releasing cytokines and growth factors, like platelet derived growth factor, platelet derived endothelial growth factor, transforming growth factor β1, insulin-like growth factor 1, fibroblast growth factor 2, and vascular endothelial growth factor A.

These growth factors enhance healing by stimulating cell proliferation, migration, and differentiation. They also modulate the immune system, inflammation, and angiogenesis, or the development of new blood vessels in the damaged tissue.

Nurse drawing patient's blood to make PRP

Biologic mediators in PRP and how they help healing

Those growth factors are essential for the three phases of healing of injured tendons and ligaments: inflammation, proliferation, and remodeling. In theory, PRP allows for the patient’s own blood to provide a high concentration of growth factors to promote healing in sites that have limited healing capacity due to blood supply. PRP can create a matrix that serves as scaffold for sustained release of growth factors that help bring in healing cells and new blood vessels that help deliver nutrients to improve healing.

What are patellar tendinitis and patellar tendinopathy?

Patellar tendinitis is a common source of pain in athletes of jumping sports, such as basketball and volleyball. It is an inflammation of the patella tendon, usually developing over time. The athlete complains of pain at the lower part of the patella where the tendon attaches. He also might feel pain at the insertion of the patella tendon into the tibia at the tibial tuberosity. It can be very painful to athletes who need explosive strength with jumping and pushing off. Therefore it can significantly limit an athlete’s ability to play at a high level. Treatment is almost always nonsurgical. Short-term rest from the offending activity can be helpful, although this is difficult in a high-level athlete during the season.

Patellar tendinosis, or patellar tendinopathy, is a disease process (tendinosis) or overuse injury in which an athlete develops a small area of degeneration within the patellar tendon. This condition can often be resolved with rest, activity modification, and physical therapy, but in a small percentage of athletes it requires more aggressive treatments.

Let’s see what recent scientific literature tells us about PRP for patellar tendinitis and patellar tendinopathy.

Patient putting on a knee brace for patellar tendinitis

PRP for patellar tendinitis

Two different studies showed PRP was better for  patellar tendinitis than either a slice injection (control) or dry needling at 1 year. PRP was also better than shockwave for patient-reported pain from patellar tendinitis.

Two other randomized control trials showed no difference between PRP and ESWT or dry needling at 2 or 3 months, but there was a significant difference and benefit to PRP at 6 months and 1 year. In the same way, PRP outperformed corticosteroids and ultrasound.

It’s important to understand that steroid injections into the patellar tendon can have very negative effects on healing and even future rupture of the tendon. PRP, on the other hand, does not have those negative effects but instead appears to help the tendon heal.

A 2017 study showed that PRP can be helpful as a first-line treatment for patellar tendinitis and may accelerate early recovery.

PRP for patellar patellar tendinopathy

Patellar tendinopathy, otherwise known as Jumper’s knee, is characterized by chronic pain in the patellar tendon as a result of overuse.

A review article in the Journal of Bone and Joint Surgery found that the current scientific research supports the use of PRP as treatment for chronic, degenerative tendinopathies such as lateral epicondylitis of the elbow or patellar tendinopathy.

One study looking at patients with patellar tendinopathy treated with PRP had significant improvement in pain and function. Over 80 percent of patients returned to their pre-symptom level of activity.

A 2019 study found that for patients with patellar tendinopathy, PRP showed the greatest functional improvement and pain reduction compared with other treatment options.

The number of PRP injections has also been shown to have an effect on the outcome of the treatment, with two injections found to improve outcomes significantly more than a singular injection.

Doctor injecting PRP for patellar tendinopathy

Caution with the research

There are many different methods of preparation, and different final products: PRP, leukocyte-rich PRP, platelet-rich fibrin, platelet gel, and more. All these platelet products have varying concentrations of blood cells, plasma, or fibrinogen. Therefore, they have different concentrations of growth factors and bioactive molecules, meaning they could have different efficacy for knee osteoarthritis.

The exact composition of PRP is not reported in many of the available studies. There are differences between leukocyte-rich and leukocyte-poor PRP and much more. Plus, humans have different numbers of platelets in our blood, so studies comparing PRP will lead to different results.

Plus, other than the leukocyte content, research studies differ in terms of volume of blood harvested, use of anticoagulant, number and speed of centrifugations, the final volume of PRP obtained, the overall number of platelets, their integrity and activation method, and more. All of these factors that could influence the properties of the final PRP product and how well it helps patients with osteoarthritis.

Is PRP covered by insurance?

Most insurance companies still consider PRP experimental and will no cover these treatments. And again, I’m not giving you medical advice. This information about platelet-rich plasma is intended for informational and educational purposes only.


Based on these recent studies, platelet-rich plasma offers a benefit that, although not significant at the early follow-ups (1 to 2 months), greatly exceeds the benefits over time, certainly by 6 months or longer, compared to cortisone shots and other non-surgical treatment options for patellar tendinitis. For patellar tendinopathy, PRP also appears to significantly reduce pain and improve knee function.

Links to studies in the comments

If you would like to read the studies I mentioned in the video, here are links to them:

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If you have a tendon or ligament injury and you want to see someone who truly knows about bone and joint injuries in athletes and active people, I’d be happy to help. I’m a double-board certified orthopedic surgeon and sports medicine specialist. I’d love to talk to you about all your options to recover from injury, not just surgery, cortisone shots, and physical therapy. Go to the Contact page to make an appointment to see me. The link to my website and the Contact information is in the description below this video.

I’m Dr. David Geier. Thank you for watching, and I look forward to helping you feel and perform Better Than Ever.