PRP and BMAC injections · St. Louis

Expert Orthobiologic
Evaluation

Orthobiologics are PRP, BMAC and Lipogems. They are your own platelets, marrow and fat, concentrated into a repair signal. Here each one is matched to the tissue and guided by imaging. That happens only after labs check the terrain and a diagnostic block proves the pain source.

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The evaluation also covers the case nobody advertises for: the PRP or “stem cell” treatment you already paid for that did not work. Most orthobiologic failures are not failures of biology. They are failures of terrain, dose, or placement — and all three can be found on review.

Why Orthobiologics Fail

Why do PRP and stem cell injections fail?

Orthobiologics became a menu item. They became a same-day shot sold without labs, without imaging, and without preparing the terrain. Sometimes there was no physician in the room. A repair signal sent into inflamed, insulin-resistant tissue is an order given to cells that cannot follow it. The patient decides “regenerative medicine doesn’t work.” The truth is narrower: that shot couldn’t work.

The Revision Evaluation

What if my PRP or stem cell treatment did not work?

i.What was injected? How it was made, how strong it was, and how many white cells it had. PRP is not one product, and most failures start here.

ii.Where did it go? Guided by imaging, or placed by guesswork? A perfect biologic in the wrong layer of tissue is an expensive placebo.

iii.What terrain did it land in? Metabolic markers at the time of treatment. Almost no one measured them, and they most often decide the outcome.

iv.Was the diagnosis right? Diagnostic blocks prove the real pain source. A flawless treatment of the wrong structure fails flawlessly.

The Procedures

Which orthobiologic procedures are offered?

The biologic is chosen last. First we prove the pain source. Then we map the tissue layer. Then we match the signal to it. That includes the layer most practices never treat: the bone beneath the joint.

i.Intra-articular & tendon PRP Leukocyte-poor for the joint space, leukocyte-rich for tendon. The type is matched to the tissue, and every needle is guided by imaging.

ii.Intraosseous / subchondral PRP For the joint that still hurts after a “perfect” injection. MRI bone-marrow lesions are swelling in the bone beneath a worn joint surface. They track closely with pain and with the joint getting worse. A shot into the joint space never reaches them. Under live X-ray, we send platelet concentrate through the hard outer bone. It goes into the bone beneath the joint. It is usually paired with a dose into the joint in the same visit. That way both parts of the failing joint get the repair signal.

iii.BMAC & Lipogems Grafts from marrow and fat, saved for tissue that has earned the strongest signal. The terrain must also be ready to answer it.

iv.Intradiscal orthobiologics Shots aimed at the disc, for disc pain proven by testing. Not trial-and-error shots into an unproven source.

Done Correctly

How should orthobiologic injections be done?

Labs check the terrain before treatment. A diagnostic block proves the pain source, so nothing is assumed. The type is matched to the tissue: leukocyte-rich for tendon, leukocyte-poor for joint. BMAC / Lipogems are saved for tissue that has earned the strongest signal. Every needle is guided by ultrasound or fluoroscopy (live X-ray). We stretch out the repair window with peptides, light therapy, and repeat lab tests. That is the difference between a shot and a protocol. The full set is laid out in Pillar I.

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Physician-led · Data-driven · The terrain must be addressed for procedural success

Common Questions

Frequently asked questions

What is an orthobiologic procedure?

An orthobiologic procedure places a concentrate from your own body into damaged tissue as a repair signal. At Regen.MD that means PRP from your platelets, BMAC from your bone marrow, or Lipogems from your fat. First, a diagnostic block proves the pain source. Labs check the terrain. Every needle is guided by ultrasound or fluoroscopy.

Do orthobiologics really work?

Whether they work depends heavily on how they are used. Most orthobiologic failures are not failures of biology. They are failures of terrain, dose or placement. A repair signal has little chance in three cases. One is inflamed, insulin-resistant tissue. Two is the wrong tissue layer. Three is a structure that was never the pain source. That is why labs, a diagnostic block and imaging come first here.

What is the difference between PRP, BMAC and Lipogems?

All three come from your own body. PRP is concentrated platelets from your blood. Leukocyte-poor PRP goes in the joint space, and leukocyte-rich PRP goes in tendon. BMAC is concentrated from bone marrow, and Lipogems from fat. BMAC and Lipogems are saved for tissue that needs the strongest signal. And they are used only after the terrain is ready to respond.

Why does image guidance matter for PRP and BMAC injections?

A biologic only helps if it lands in the right tissue. A shot placed by feel can put a perfect biologic in the wrong layer. That makes it an expensive placebo. At Regen.MD every needle is guided by ultrasound or fluoroscopy. Fluoroscopy also reaches the bone beneath a worn joint surface. A joint-space shot never touches that layer.

Expert OrthobiologicEvaluation