Question 1

Does PRP regenerate cartilage or reverse arthritis?

Accepted Answer

No. The best available placebo-controlled evidence, the RESTORE trial published in JAMA, found no difference in cartilage volume on MRI between PRP and a saline injection at 12 months, even though PRP did produce a modest pain benefit. PRP is best understood as a treatment that can reduce symptoms in appropriately selected patients, not one that rebuilds damaged cartilage or halts arthritis.

Question 2

What exactly is BMAC, and is it the same as stem cell therapy?

Accepted Answer

BMAC stands for bone marrow aspirate concentrate. It is made by drawing a patient's own bone marrow, usually from the pelvis, and spinning it in a centrifuge to concentrate the cells and growth factors it contains. It is not a laboratory-grown or donor stem cell product, and calling it "stem cell therapy" overstates what is actually being injected. Dr. Raffo uses BMAC selectively as a surgical adjunct, not as a standalone office treatment.

Question 3

Why would a surgeon decline to offer a treatment that other clinics offer?

Accepted Answer

Because a product being marketed and a product being supported by strong clinical trial evidence are two different things. Some biologic treatments marketed regionally, particularly certain stem cell and amniotic-tissue products, do not have trial evidence that meets the standard Dr. Raffo applies to his own practice. He would rather tell a patient a treatment isn't well supported than sell it because it is available.

Question 4

Is PRP covered by my insurance?

Accepted Answer

Generally not. Most commercial insurers, Medicare, and Medicaid classify PRP and BMAC as investigational and do not cover them, which means the cost is typically paid out of pocket. Coverage policies vary by plan, so it is worth confirming directly with your insurer before scheduling.

Question 5

If PRP doesn't rebuild the joint, why would I bother with it?

Accepted Answer

Because pain relief and structural regeneration are different outcomes, and PRP has real evidence for the first even where it lacks evidence for the second. In appropriately selected patients — particularly those with mild-to-moderate osteoarthritis or certain tendon conditions — PRP has outperformed comparison treatments like hyaluronic acid or dry needling in multiple randomized trials on pain and function scores, even though it has not been shown to reverse the underlying structural disease.

Question 6

Does Dr. Raffo perform biologic treatments at all his office locations?

Accepted Answer

Biologic injections such as PRP are performed in the Bethesda and Germantown offices serving patients throughout Montgomery County. Physical therapy, which is often paired with a biologic injection as part of a full treatment plan, is available at the Rockville location.

Question 7

Are BMAC and PRP the same thing?

Accepted Answer

No. PRP concentrates platelets and growth factors from a blood draw. BMAC concentrates cells and growth factors from bone marrow, usually obtained during a surgical procedure. They are both autologous — made from the patient's own tissue — but they come from different sources, are used in different clinical situations, and have different evidence bases behind them.

Biologics in Orthopedic Practice

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Related Procedures

Platelet-Rich Plasma (PRP)

Biologic Augmentation During Surgery