Orthobiologics explained · MJRC
PRP, PRS and BMAC: what is the difference?
These names describe different preparations from a patient’s own blood, adipose tissue or bone marrow. Understanding the source and purpose helps you ask better questions before treatment.
They are not interchangeable products. Preparation methods, composition, delivery and clinical evidence differ. A consultation should explain exactly what is proposed for your knee.
From your blood
Platelet-rich plasma · PRP
A blood sample is processed to prepare plasma with concentrated platelets. Platelets carry proteins and signalling molecules involved in the body’s response to injury.
Different PRP preparations contain different amounts of platelets and white blood cells. Dr. Venkatachalam uses leukocyte-poor PRP in selected knee treatment plans. The preparation and delivery should be explained for your procedure.
What does the evidence show?
PRP may reduce symptoms in some people with knee osteoarthritis, but response varies and studies use different preparations. Symptom improvement is not proof of cartilage regrowth.
Background reading: American Academy of Orthopaedic Surgeons: PRP ↗. This information concerns PRP; it does not establish results for PRS, BMAC or the complete PRASAD pathway.
From blood and adipose tissue
Platelet-rich stroma · PRS
In the practice’s terminology, platelet-rich stroma (PRS) combines PRP with stromal vascular fraction (SVF), prepared from a small adipose harvest by mechanical processing and fractionation. It contains a mixture of tissue and cellular components; it is not a purified stem-cell product.
Mechanical processing differs from enzyme-based isolation or growing cells in a laboratory. The proposed processing method, harvest and purpose should be described in your consent discussion.
Research findings for one adipose preparation cannot automatically be applied to every other preparation or combination. Ask what evidence supports the product and procedure being offered for your condition.
From bone marrow
Bone marrow aspirate concentrate · BMAC
Bone marrow is aspirated, usually from the pelvis, and processed to produce a concentrate. It contains a mixture of marrow cells and other components. BMAC is different from laboratory-expanded mesenchymal stem cells.
In selected patients, the PRASAD pathway may include delivery into subchondral bone—the bone beneath the cartilage—when a clinically relevant bone marrow lesion is identified. This is an intraosseous procedure, distinct from an injection into the joint.
The presence of an MRI finding alone does not determine treatment. Its location, the examination, symptoms and the complete clinical picture matter.
How do these relate to PRASAD™?
PRASAD™—Platelet Rich Adipose Stromal Advanced Derivative—is the practice’s integrated knee-preservation pathway. It combines assessment and preparation with selected biological treatment, rehabilitation and bracing when indicated.
The plan is individual. It should state which components are being used, why they are being considered, where they will be delivered, and how recovery will be monitored.
Questions worth asking before a procedure.
What exactly will I receive?
Ask about tissue source, preparation method, delivery site and the clinical reason for each component.
What improvement is realistic?
Discuss pain and function goals, time to review, the possibility of insufficient benefit and what happens next.
What are the risks and alternatives?
Review harvest and injection risks, anaesthesia, aftercare, costs and the other reasonable treatment choices.
Potential complications include pain, swelling, bruising, bleeding and infection. Using your own tissue does not remove these risks. Additional risks depend on the procedure.
No preparation on this page can be promised to rebuild a normal knee, restore all cartilage or permanently prevent replacement.
Start with a clinical assessment.
Bring existing imaging, reports, a medicine list and details of previous injections or surgery.