PRP vs. Stem Cell Therapy: What’s the Difference and Which One Is Right for You?
By Emily Quigley, PA-C
Medically reviewed by Robert Rankin, MD — Board Certified, ABPM & Interventional Pain Management
[Publication Date] · Estimated read time: 6 min
The Most Common Question in Regenerative Medicine
When patients come to us interested in regenerative options for their knee, back, or joint pain, we almost always hear the same question within the first few minutes: “What’s the difference between PRP and stem cells — and which one should I get?”
It’s a great question, and the honest answer is: it depends on your condition, the severity of your tissue damage, and what the evidence says for your specific situation. Here’s how Dr. Rankin walks his own patients through both options.
Platelet-Rich Plasma (PRP): Your Body’s First Responders
PRP starts with a simple blood draw — the same process as routine lab work. We process that blood in a centrifuge to separate and concentrate the platelets. The resulting preparation contains 5 to 10 times the normal concentration of platelets found in whole blood.
Why does that matter? Because platelets aren’t just involved in clotting — they’re loaded with growth factors and signaling proteins that play a central role in tissue repair. When you injure a tendon or ligament, your body rushes platelets to the area as part of its natural healing response. PRP essentially supercharges that response by delivering a concentrated dose directly to the damaged tissue.
PRP is best supported by evidence for: knee osteoarthritis, chronic tendon injuries (such as patellar tendinopathy and tennis elbow), rotator cuff tendinopathy, and certain types of spinal disc pain.
The procedure is done in-office, takes under an hour start to finish, and uses your own blood — so there’s no risk of rejection or allergic reaction to the biological component.
Bone Marrow Aspirate Concentrate (BMAC): A More Advanced Biological Option
BMAC — sometimes referred to broadly as “stem cell therapy” in patient-facing materials — involves drawing a small amount of bone marrow, typically from the back of the pelvis. That marrow is then concentrated and processed to yield a preparation rich in mesenchymal stem cells, growth factors, and anti-inflammatory proteins.
Stem cells have the capacity to differentiate into various tissue types — including cartilage, bone, and tendon — which is why they’ve generated significant interest in regenerative orthopedics. The research is still evolving, but outcomes data from high-volume Regenexx network practices, including published registries, show meaningful results for appropriately selected patients.
BMAC tends to be most appropriate for: more advanced joint degeneration (moderate-to-severe arthritis), conditions where cartilage regeneration is a goal, patients who haven’t responded adequately to PRP, and larger structural injuries.
BMAC is a more involved procedure than PRP and carries a higher cost. It’s not the right first step for everyone — and Dr. Rankin won’t recommend it if the clinical indication doesn’t support it.
How Dr. Rankin Decides Which Option to Recommend
There’s no universal answer to the PRP vs. BMAC question. The decision is individualized based on several factors Dr. Rankin evaluates in every consultation:
Severity of degeneration — visible on MRI or X-ray. Early to moderate arthritis often responds well to PRP. More advanced cases may warrant BMAC.
Type of tissue involved — Tendon and ligament injuries frequently respond to PRP. Cartilage involvement often benefits from the additional biological components in BMAC.
Prior treatment history — Has the patient already tried PRP without adequate response? That’s relevant to the recommendation.
Patient goals and timeline — A patient trying to avoid surgery in the near term has different needs than one managing chronic pain long-term.
Overall health and candidacy — Certain conditions may affect the quality of harvested cells or platelets, which factors into the recommendation.
A Note on “Stem Cell” Marketing
We want to address something directly, because patients deserve transparency on this point. The term “stem cell therapy” is used broadly in the marketplace — and not always accurately. Many clinics offering “stem cells” are using amniotic or umbilical cord-derived products that do not contain living stem cells by the time they are injected. The FDA has taken enforcement action against some of these products and providers.
The BMAC approach Dr. Rankin uses draws from your own bone marrow, which is the source with the most established evidence base in orthopedic regenerative medicine. When you hear claims about regenerative treatments, it’s worth asking: what is the actual biological product being used, and what does the evidence say?
What to Expect from Either Procedure
Both PRP and BMAC are performed under image guidance at our office — either ultrasound or fluoroscopy — to ensure precise delivery to the target tissue. This is a non-negotiable part of how we practice, because placement accuracy directly affects outcomes.
Most patients experience some soreness at the injection site for several days following the procedure. This is a normal part of the biological response. Functional improvement typically begins between 4 and 12 weeks, with continued progress over several months as the tissue remodels.
We provide detailed post-procedure guidance, and Dr. Rankin follows up with every regenerative patient to monitor progress and adjust the plan if needed.
Is One of These Right for You?
The best way to find out is a thorough evaluation. Dr. Rankin reviews your imaging, your history, and your goals — and gives you a direct, honest recommendation. If regenerative medicine isn’t appropriate for your situation, he’ll tell you that too.
Schedule a consultation
Better Health Medical Center · 505 W. Market St, Suite 100, Georgetown, DE 19947
Phone: 302-899-7588 · Email: info@bhmcde.com · www.bhmcde.com