Regenerative medicine: PRP, amniotic tissue and BMAC

Platelet-rich plasma (PRP): in the office

What it is. A small amount of your own blood is drawn and spun in a centrifuge to concentrate the platelets, which carry growth factors involved in healing. The concentrated plasma is then injected into the injured area, often with ultrasound guidance.

Where it helps. For chronic plantar fasciitis that hasn’t responded to stretching, footwear and inserts, a meta-analysis of 15 studies found PRP gave better pain relief than corticosteroid injections at three, six and twelve months, with no short-term advantage for corticosteroid. The authors noted that study quality was low to moderate.^[1] See heel pain.

Where it doesn’t. For chronic Achilles tendinopathy, a JAMA trial found a PRP injection was no better than a saline injection when both groups did eccentric exercises,^[2] and a 2025 meta-analysis of randomized trials found no benefit over placebo.^[3] For ankle arthritis, PRP did not improve symptoms or function over a year compared with placebo.^[4]

What to expect. The injection takes minutes after a short blood draw. Soreness for a few days is common; you may be asked to avoid anti-inflammatory medicine around the treatment and to protect the area for a short time. Improvement, if it comes, builds over weeks.

Amniotic and placental tissue: in the operating room

Amniotic and placental membranes are donated tissues, processed under FDA regulations, that contain growth factors and a supporting matrix. They are used as injections or grafts to support soft-tissue healing. For plantar fasciitis, a randomized trial found a micronized amnion/chorion injection reduced pain more than placebo at three months,^[5] and a network meta-analysis found early benefit over corticosteroids in the first two months, with little longer-term data.^[6] At the practice these products are used in the operating-room setting, as part of surgical care.

Bone marrow aspirate concentrate (BMAC): in the operating room

BMAC is prepared during surgery from a small amount of your own bone marrow, usually taken from the pelvis or the heel, and concentrated. It contains cells and growth factors that may support bone and cartilage healing, and it is used alongside procedures such as fusions, fracture repair and cartilage repair. Laboratory results are promising, but clinical evidence in the foot and ankle is still limited.^[7] See cartilage repair and avascular necrosis.

A word on “stem cell” claims

You may see clinics advertising stem-cell injections that promise to regrow tissue. Be cautious. Biologic treatments can support healing in selected situations, but they don’t grow new body parts, and some products are marketed beyond what the evidence supports. We’ll tell you plainly what the research shows for your condition.

Insurance

PRP is often not covered by insurance, while some biologic products used in surgery are covered as part of the procedure. We’ll confirm your cost with you before you decide.

When to seek care