No guideline sets a safe number. The one randomized trial that tested four a year in the knee found more cartilage loss than saline and no better pain relief. A 2024 review found guidelines on how often, how long and how many lifetime corticosteroid injections are safe still lacking.
In the one placebo-controlled trial of PRP for ankle arthritis, 100 patients reported in JAMA, PRP did no better than saline at 26 weeks or at the 52-week follow-up. A 2026 review that searched to May 2025 found no randomized trial of stem cell injection in ankle arthritis.
Sports medicine for athletes over 50 in Boulder should start with a 90-minute evaluation that reads the tissue, not the birthday.
To find a PRP doctor who follows published research protocols, ask the clinic to walk you through its protocol step by step and name the paper behind each step: the platelet dose, the preparation, who places the needle and under what imaging, how a second injection is decided, the rehab and how results are followed.
You find out which regenerative and stem cell clinics track and publish outcomes by checking three things: what they measure, who reviews their research, and what they have published. A consensus conference of the American Academy of Orthopaedic Surgeons asked physicians offering biologic therapies to commit to high-quality patient registries.
Yes: get an orthopedic second opinion before knee, shoulder or hip surgery when the plan rests on imaging without a hands-on exam, when the diagnosis does not match what the joint is doing, or when the date was set in one short visit.
Orthobiologics are biologic injections, most often prepared from your own blood, bone marrow or fat, used for joint, tendon and ligament pain. They fall into two families: blood-based platelet-rich plasma (PRP), and tissue- or cell-based products such as bone marrow aspirate (BMA) and fat-derived microfragmented adipose tissue (MFAT).
Where shockwave fits after surgery, after breast cancer treatment and for a fully healed C-section scar, with the evidence graded for each situation and what we will not do. From Aneesh Garg, DO, CAQ.
There is no single number: in early to moderate knee arthritis, trials found two or three injections beat one at six to twelve months, while in one review most ultrasound-guided tendon trials used one injection, and reviews disagree on how much it helps. The better answer is the number that gets you back, and it depends on the tissue, the stage and the dose in each syringe.
PRP works for some conditions and not others, and the trials and reviews we read show which. The evidence is most favorable in knee arthritis, where an 18-trial meta-analysis found PRP better than placebo, though one large saline-controlled trial did not.
Talk with our team about whether you're a candidate. Care is directed by Aneesh Garg, DO, CAQ, here in Boulder.
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