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PRP vs Stem Cell Injections: Evidence, Cost & Which to Choose

Curated by Michel Oliver, Restore Wellness Group · Independent Health Researcher & Patient Advocate · Last reviewed October 2026 · How we research

About this guide: We are independent patient researchers, not medical doctors. We review peer-reviewed literature (PubMed), government trial registries and regulators’ guidance, plus documented patient reports, to help you navigate clinic options and spot predatory marketing. How we research.

IN SHORT

PRP (platelet-rich plasma) is a concentrate of your own blood platelets, while stem cell injections use cells from bone marrow, fat or donor tissue. For knee arthritis, head-to-head trials have generally found similar results, and PRP is usually cheaper and simpler.

What is prp vs stem cells?

PRP is made from a sample of your own blood, spun to concentrate the platelets, which carry growth factors. It contains no stem cells. ‘Stem cell’ injections may use bone marrow concentrate, fat-derived cells, or donor birth-tissue products. Both are called ‘orthobiologics’ and are mainly used for joints and tendons.

How it works

For PRP, a small amount of blood is drawn from your arm, spun in a centrifuge and injected the same day, often in about an hour. Bone marrow concentrate requires a needle into the hip bone under local anaesthetic, while fat-derived cells need a mini-liposuction. Donor products are thawed and injected. All are thought to work by releasing signals that may ease inflammation, not by regrowing cartilage.

Legal status

In the US, PRP is prepared with FDA-cleared devices and doctors can use it ‘off label’, so it is legal but not FDA-approved for arthritis. Same-day bone marrow concentrate can be exempt from drug rules under the ‘same surgical procedure’ exception. Lab-grown cells, processed fat cells (SVF) and donor birth-tissue injections are regulated as drugs and are not approved for orthopaedic use. In the EU, PRP is usually treated as a blood-derived procedure, while expanded cells are advanced therapy medicines.

What the evidence shows

For knee arthritis, several randomised trials, including a 2020 trial and a 2025 trial, found bone marrow concentrate no better than PRP. A 2026 network meta-analysis found PRP, bone marrow, fat-derived and cord cell injections all produced improvements over hyaluronic acid that did not reach a clinically meaningful level.

A 2025 Cochrane review found stem cell injections may slightly improve knee pain versus placebo, with low certainty. Three 2021 JAMA trials found PRP no better than saline for knee or ankle arthritis or Achilles tendon problems, though other trials are more positive. Neither PRP nor stem cells has been shown to regrow cartilage in people.

Commonly marketed for

  • Knee and hip arthritis
  • Tennis elbow and other tendon problems
  • Rotator cuff and shoulder pain
  • Plantar fasciitis
  • Sports muscle and ligament injuries
  • Hair loss and skin (PRP)

Cost

Typical price range: $300 – $12,000. Mayo Clinic Press reports PRP costs about $300 to $2,500 depending on provider and sessions, with few insurers covering it. A 2017 survey of 317 US clinics found stem cell knee injections cost $1,150 to $12,000 (average $5,156).

Risks

  • Short-term pain or flare for one to two weeks after injection
  • Infection at the injection site
  • Bone marrow harvest pain or bruising at the hip
  • Fat harvest risks such as bruising or rarely more serious liposuction complications
  • Spending money on treatments that may work no better than placebo

Questions to ask first

  1. Which treatment has the better evidence for my exact problem and stage?
  2. Has PRP or a standard treatment been tried first, and why do you recommend cells?
  3. How many injections are included, and what is the total cost?
  4. How will we measure whether it worked, and when?
Before You Pay: The Stem Cell Clinic Checklist – free 9-page PDF
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Before You Pay: The Stem Cell Clinic Checklist

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  • Realistic 2026 cost ranges: US, Mexico, Panama & Europe
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PRP vs Stem Cells: FAQs

Is PRP a stem cell treatment?

No. PRP is a platelet concentrate from your blood and contains no stem cells. Clinics sometimes blur the two, so ask exactly what is being injected.

Which works better for knee arthritis?

Head-to-head trials have found bone marrow concentrate no better than PRP. Gains with either are generally modest and short-term.

Is PRP FDA-approved?

PRP is made with FDA-cleared devices, but PRP itself is not FDA-approved for arthritis. Doctors use it off label.

Does insurance cover PRP or stem cell injections?

Few insurers cover PRP, and stem cell injections for joints are generally not covered. Expect to pay out of pocket.

Can either avoid knee replacement?

There is no reliable evidence that either prevents or delays knee replacement. They may help symptoms for some people.

Related guides

Sources

Last reviewed October 2026. For general information only — not medical advice. We do not endorse any clinic or product. Always consult a qualified, licensed healthcare professional. See our medical disclaimer and editorial policy.