Patients often arrive having heard of PRP, stem cells, or microfat injections without a clear sense of how they differ or what the evidence actually supports. Here is how I explain the three orthobiologic treatments we use most.
Platelet-rich plasma (PRP) is made from a small sample of your own blood. The sample is spun in a centrifuge to concentrate the platelets — the cells that carry growth factors involved in healing — and that concentrate is injected into the injured tissue. The idea is straightforward: deliver a stronger biologic signal to tissue that is struggling to heal on its own. PRP has the most human research of any orthobiologic, particularly for tendon problems like tennis elbow and for early to moderate knee arthritis.
Bone marrow aspirate concentrate (BMAC) comes from bone marrow, usually drawn from the back of the pelvis. Marrow contains not just platelets but also the signaling cells that help coordinate repair. We tend to consider BMAC for problems where a more robust biologic response is warranted — certain cartilage, bone, or more stubborn tendon conditions.
Microfragmented adipose tissue (mFAT) uses a small amount of your own fat, typically from the abdomen or flank, which is processed to concentrate its natural cushioning and signaling properties and then injected into the joint or tissue. It has become a useful option for joint pain and early arthritis, particularly when cushioning and inflammation control are the goals.
All three share two important traits: they come from your own body, and they are intended to support your own repair process rather than replace it. They are not magic, and they are not right for everyone or every condition. The honest version of this conversation — what these treatments can and cannot do for your specific problem — is exactly what a consultation is for.
If you are weighing an orthobiologic treatment, bring your imaging and your questions. We will look at both together.