CONSERVATIVE CARE · EVIDENCE-BASED · FRANKLIN, TN
PRP Injections for Joint Pain
in Franklin, TN
Platelet-Rich Plasma for Hip & Knee Arthritis · An Option Before Joint Replacement · Dr. Cory Calendine, MD
Platelet-rich plasma (PRP) injections use a concentrated sample of a patient’s own blood platelets to deliver growth factors directly into an arthritic or injured joint, with the goal of reducing inflammation and pain. At the Bone and Joint Institute of Tennessee in Franklin, TN, PRP injections are offered for selected patients with mild to moderate hip and knee osteoarthritis who want to delay joint replacement. The evidence for PRP is still developing, and it does not regrow cartilage or reverse joint damage, so Dr. Cory Calendine reviews candidacy, current evidence, and realistic expectations at each consultation. For some patients PRP provides meaningful relief for months or longer; for others it does not, which is why honest candidate selection matters more than the treatment itself.
OPTIONS FIRST
Every Nonsurgical Option Considered
Before Surgery
700+
HIP & KNEE PROCEDURES/YEAR
When Surgery Is Right
FELLOWSHIP TRAINED
Anderson Orthopaedic research Institute
Hip and Knee Specialist
UNDERSTANDING PLATELET-RICH PLASMA
What Are PRP Injections for Joint Pain?
Blood is made of a liquid called plasma plus three solid components: red blood cells, white blood cells, and platelets. Platelets are best known for helping blood clot, but they also carry hundreds of proteins called growth factors that signal the body’s healing response. PRP injections concentrate those platelets, typically to about 5 to 10 times the level found in normal blood, and place them where the body needs help.
Making PRP is straightforward. A small sample of the patient’s blood is drawn in the office, spun in a centrifuge to separate and concentrate the platelets, and then injected into the affected joint. The injection is usually done with ultrasound guidance so the platelet-rich plasma reaches the exact target. Because PRP comes from the patient’s own blood, there is no risk of an allergic or rejection reaction to the material itself.
In an arthritic hip or knee, PRP works mainly as an anti-inflammatory agent. It appears to calm the joint inflammation that drives pain and stiffness, and some laboratory research suggests it may slow certain aspects of cartilage breakdown. What PRP does not do is regrow cartilage or reverse the structural changes of advanced arthritis. Cartilage has almost no blood supply of its own, which limits how much any injected treatment can rebuild it. For that reason, PRP is best understood as a way to manage symptoms and possibly delay surgery, not as a cure for arthritis.
| What is PRP? | A concentrate of the patient's own platelets, about 5 to 10 times normal, rich in growth factors. |
|---|---|
| How is it made? | A small blood draw is spun in a centrifuge to separate and concentrate the platelets. |
| How is it given? | Usually a single injection into the affected joint, most often with ultrasound guidance, in the office. |
| What is it for? | Reducing joint inflammation and pain; most studied for knee osteoarthritis and certain tendon problems. |
| What it does not do | It does not regrow cartilage or reverse structural joint damage. |
| When results appear | Gradual improvement over about 6 weeks to 3 months; relief, when it occurs, often lasts around a year. |
AN HONEST LOOK AT THE RESEARCH
What the Evidence Says About PRP for Joint Pain
Where PRP Has the Strongest Support
PRP is the most widely used and most studied of the orthobiologic treatments, and the research picture is clearest in two areas. The first is tendon conditions such as tennis elbow and chronic patellar tendonitis, where PRP has shown the most consistent benefit. The second, and the reason most patients ask about it, is knee osteoarthritis. In 2026, the American Academy of Physical Medicine and Rehabilitation published a guidance statement recommending PRP for people with mild to moderate knee osteoarthritis who still have symptoms after standard care such as weight management, physical therapy, and pain relievers. Several clinical studies have reported meaningful short-term pain reduction after PRP for knee arthritis, with the clearest results in earlier-stage disease and in more active patients.
Where the Evidence Is Still Developing
The honest counterweight matters. PRP for hip arthritis is less studied than the knee, and the overall body of evidence is still developing rather than settled. PRP preparations also vary from clinic to clinic, which makes results hard to compare directly and helps explain why studies do not always agree. Most importantly, PRP does not repair or regrow cartilage, so it will not reverse advanced, bone-on-bone arthritis. It is not a replacement for the foundational conservative treatments, weight management and exercise chief among them, and it works best alongside them rather than instead of them. Some patients get real relief from PRP and some do not, and there is not yet a reliable way to predict in advance who will respond. Dr. Calendine’s approach is to talk through this evidence plainly at consultation so the decision is made with clear expectations.
THE PROCEDURE, START TO FINISH
What to Expect from a PRP Injection
The Procedure, Step by Step
A PRP injection is an in-office procedure that usually takes under an hour. Blood is drawn from a vein in the arm, much like a routine lab draw. That sample is placed in a centrifuge and spun for several minutes to separate and concentrate the platelets. The skin over the joint is numbed, and the platelet-rich plasma is injected into the hip or knee, most often under ultrasound guidance to confirm accurate placement. Excess fluid is sometimes removed from a swollen knee before the injection. Some treatment protocols use a single injection; others use a short series of injections spaced a few weeks apart, and that plan is decided based on the joint and the individual case.
Recovery and Aftercare
It is normal to feel some soreness at the injection site for a few days, and that discomfort is generally milder than surgery. Because anti-inflammatory medications may blunt the healing response PRP is meant to trigger, patients are typically asked to avoid NSAIDs for a period before and after the injection; the exact window is given at the visit. Light activity is fine in the first week, with a gradual return to normal activity after that. Physical therapy is often recommended to build strength during the window of reduced pain, which can extend the benefit of the injection. Improvement is gradual, usually noticeable somewhere between 6 weeks and 3 months. When PRP works, relief commonly lasts around a year, sometimes longer and usually not less than six months.
Hyaluronic acid injections typically take longer to reach full effect than corticosteroid injections — most patients notice gradual improvement over several weeks. When effective, relief can last six months to a year or longer. Coverage by insurance varies by plan and diagnosis; confirm with your insurer before scheduling.
| Stage | What Happens | Timing |
|---|---|---|
| Before | Stop NSAIDs as directed; confirm candidacy at consultation. | Days to weeks before, as instructed |
| Day of | Blood draw, centrifuge, ultrasound-guided joint injection, in office. | About 45 to 60 minutes |
| First week | Mild soreness expected; light activity only. | 1 week |
| Results window | Gradual pain and function improvement. | 6 weeks to 3 months |
| Duration of relief | When effective, benefit is sustained. | Often around 1 year |
FINDING THE RIGHT FIT
Who Is a Good Candidate for PRP Injections?
Who May Benefit from PRP
PRP is most appropriate for patients with mild to moderate hip or knee osteoarthritis who still have persistent symptoms after trying standard conservative care, and who want to delay joint replacement rather than proceed with it now. Active patients tend to respond better than sedentary ones, which likely reflects the role that muscle strength and overall fitness play in joint health. PRP can also fit patients who no longer get enough relief from anti-inflammatories, physical therapy, or cortisone injections but are not yet candidates for, or not yet ready for, surgery. The common thread is early-to-moderate disease and a realistic goal: better symptom control, not a cure
Who Is Not a Good Candidate, and Better Options
PRP is not the right choice for everyone. Patients with severe, bone-on-bone arthritis or a significantly misaligned joint are unlikely to get lasting benefit, and joint replacement is usually the more effective path for them. PRP is also generally avoided in patients with an active infection, a bleeding disorder, or those taking blood thinners, and in certain blood conditions. For these patients, Dr. Calendine will explain which alternative, whether that is a different injection, a bracing or weight-management plan, or a surgical consultation, is a better use of time and money. The goal at consultation is not to sell an injection; it is to match the treatment to the joint.
COMPARING YOUR INJECTION OPTIONS
PRP, Cortisone, and Gel Injections Compared
PRP is one of three injection options commonly discussed for hip and knee arthritis, and they work in different ways. Cortisone (corticosteroid) injections deliver a powerful anti-inflammatory medication and work fastest, which makes them useful when swelling and inflammation are the main problem. Gel injections (hyaluronic acid, also called viscosupplementation) add lubricating fluid to a knee that has lost its natural joint lubrication. PRP uses the body’s own growth factors to reduce inflammation and, in some patients, to calm the arthritic process. One or more of these may be appropriate at different points in arthritis management, and they are not interchangeable.
| Cortisone (Corticosteroid) | Gel (Hyaluronic Acid) | PRP (Platelet-Rich Plasma) | |
|---|---|---|---|
| What it is | Anti-inflammatory steroid | Joint lubricant | Concentrated platelets and growth factors |
| Onset of relief | Days to 1 week | Gradual, several weeks | Gradual, 6 weeks to 3 months |
| Typical duration | Weeks to a few months | 6 to 12 months or more | Often around a year when effective |
| Best suited for | Prominent inflammation and swelling | Knee osteoarthritis, low joint lubrication | Mild to moderate arthritis, active patients delaying surgery |
| Insurance coverage | Usually covered | Often covered for the knee | Usually not covered, out of pocket |
WHAT TO KNOW BEFORE YOU DECIDE
Cost, Insurance, and Stem Cell Treatments
Cost and Insurance
One practical consideration with PRP is cost. Most insurance plans do not cover PRP injections for arthritis, so the treatment is generally provided as an out-of-pocket service. National pricing for PRP varies widely by practice and by joint. The current fee at the Bone and Joint Institute of Tennessee is confirmed at your consultation, and patients are encouraged to check their own insurance eligibility before scheduling, since a small number of plans provide partial reimbursement.
A Note on Stem Cell Treatments
Patients often ask about stem cell injections alongside PRP. Stem cell treatments for arthritis remain at an earlier stage of evidence than PRP. Studies to date have generally been small and lightly regulated, and there is not yet strong evidence that stem cell injections let patients reliably avoid surgery. The FDA currently discourages stem cell use outside of clinical trials or approved therapies. Dr. Calendine discusses stem cell options individually with patients who inquire, with the same honest framing applied to PRP: what the current evidence supports, what it does not, and whether it fits the specific joint.
WHEN INJECTIONS ARE NO LONGER ENOUGH
When PRP and Conservative Care Have Run Their Course
Recognizing When Surgery Becomes the Right Conversation
Injections, including PRP, are tools for managing arthritis, not for stopping it. There is a point at which the joint damage is advanced enough, and the relief from injections has become limited enough, that joint replacement becomes the more appropriate next step. Reaching that point is not a failure. It is often what a trial of PRP and other conservative care is designed to clarify: whether the joint still responds, or whether it is time for a different plan. The signs are usually recognizable. Injections that once gave several months of relief now give only weeks. Pain limits the daily activities that matter to you despite treatment. Imaging shows significant joint-space narrowing or bone-on-bone changes that line up with your symptoms.
What That Conversation Looks Like with Dr. Calendine
When those signs align, the conversation shifts to joint replacement, and it is a different conversation from one raised prematurely. Dr. Calendine will review your imaging, your treatment history including any injections you have tried, and the current character of your pain and function. He will explain which procedure fits your joint, what the technique involves, what recovery looks like, and why he recommends it for your situation. There is no pressure to decide at the visit. It is an information appointment. The practice performs hip and knee replacement at the BJIT Ambulatory Surgery Center and Williamson Health in Franklin, TN, and most appropriate candidates return to unrestricted daily activities within six to twelve weeks of surgery.
FREQUENTLY ASKED QUESTIONS
Frequently Asked Questions, PRP Injections for Joint Pain
What are PRP injections and how do they work for joint pain?
PRP injections use a concentrated sample of your own blood platelets, prepared by spinning a small blood draw in a centrifuge, and inject those platelets into an arthritic hip or knee. Platelets carry growth factors that signal healing and help reduce inflammation. In an arthritic joint, PRP works mainly by calming the inflammation that drives pain and stiffness. It is usually given as an ultrasound-guided injection in the office. PRP does not regrow cartilage, so it is best understood as a way to manage symptoms and possibly delay surgery, not as a cure for arthritis.
Does PRP work for knee arthritis?
For many patients with mild to moderate knee osteoarthritis, PRP can reduce pain, and a 2026 guidance statement from the American Academy of Physical Medicine and Rehabilitation supports PRP for these patients when standard care has not given enough relief. Results are clearest in earlier-stage arthritis and in more active patients. The evidence is still developing rather than settled, PRP preparations vary between clinics, and some patients do not respond. PRP will not help advanced, bone-on-bone arthritis, and it does not replace weight management and exercise. Candidacy is discussed honestly at consultation.
How long do PRP injection results last?
When PRP works, improvement is gradual, usually noticeable between 6 weeks and 3 months after the injection. Relief commonly lasts around a year, sometimes longer, and usually not less than six months. Duration varies with arthritis severity, how consistently you stay active, and your individual response. Some patients repeat the treatment when benefit fades, and some do not respond at all, which is why realistic expectations are set before treatment.
How much do PRP injections cost, and does insurance cover them?
Most insurance plans do not cover PRP injections for arthritis, so PRP is generally an out-of-pocket service. Pricing varies by practice and by joint. The current fee at the Bone and Joint Institute of Tennessee is confirmed at your consultation. Because a small number of plans offer partial reimbursement, it is worth checking your own eligibility with your insurer before scheduling.
What is the difference between PRP, cortisone, and gel injections?
The three work differently. Cortisone (corticosteroid) injections deliver an anti-inflammatory steroid, work fastest at days to a week, and suit joints where swelling is prominent. Gel injections (hyaluronic acid) add lubricating fluid to a knee and take several weeks to reach full effect but can last six to twelve months or more. PRP uses your own growth factors to reduce inflammation, works gradually over 6 weeks to 3 months, and may last about a year when effective. One or more may be appropriate at different points in arthritis management, and the right choice depends on your joint.
Is PRP a substitute for knee or hip replacement?
No. PRP does not repair cartilage or reverse structural joint damage, so it cannot replace surgery for advanced arthritis. For appropriate patients with earlier-stage disease, PRP may help control symptoms and delay the need for replacement, but it is not a permanent alternative to it. When conservative care and injections no longer provide meaningful relief and imaging shows advanced arthritis, joint replacement becomes the more effective option. To discuss whether PRP or surgery fits your joint, call (615) 791-2630 or schedule a consultation with Dr. Calendine at the Bone and Joint Institute of Tennessee, 3000 Edward Curd Lane, Franklin, TN 37067.
FRANKLIN, TN · SERVING ALL OF MIDDLE TENNESSEE
Wondering If PRP Is Right for Your Joint?
Start with a Consultation.
Whether you are researching PRP injections, comparing your nonsurgical options, or evaluating whether surgery is the better path, the consultation at the Bone and Joint Institute of Tennessee, 3000 Edward Curd Lane, Franklin, TN 37067, is the starting point. Dr. Calendine will tell you honestly whether PRP fits your joint. No referral required.