Exploring the Fundamentals of Orthobiologics
Platelet-Rich Plasma (PRP) is a concentrated preparation of autologous blood that has become a focal point of study in the field of orthobiologics. While the FDA currently considers many applications of PRP to be investigational, it is frequently utilized by orthopedic specialists who are exploring non-operative paths for musculoskeletal shoulder management.
Emerging research from 2024-2025 continues to investigate PRP's potential role in shoulder care, particularly for conditions where traditional conservative measures have not reached the desired outcome. For active individuals in the San Diego area, understanding the biological premise of these programs is the first step in exploring non-surgical options.
Clinical Process & Procedural Overview
A Precision-Focused Approach to Orthobiologic Care
Designed for clinical efficiency, PRP sessions are performed as an outpatient procedure in our San Diego office. The process follows a standardized protocol to ensure the highest concentration of autologous platelets:
Comprehensive Clinical Evaluation:
Every procedure begins with a thorough diagnostic review. Dr. DuBois evaluates your specific injury through a physical exam and a review of specialized imaging—typically MRI—to determine if the biological profile of your injury is suitable for PRP.
Sample Preparation:
A small sample of your blood is drawn in-office. It is immediately processed using a specialized centrifuge to isolate the platelets and growth factors, creating your personalized Platelet-Rich Plasma.
Precision Ultrasound-Guided Delivery:
To ensure the highest degree of accuracy, Dr. DuBois performs 100% of PRP injections under real-time ultrasound guidance. While ultrasound is not typically used as our primary diagnostic tool, it is essential during the procedure to visualize the needle’s path and ensure the concentrate is delivered precisely to the targeted anatomical structure.
Precision Guidance for PRP Delivery
Accuracy is a critical variable in the clinical application of Platelet-Rich Plasma. To ensure the highest degree of procedural precision, Dr. DuBois utilizes real-time musculoskeletal ultrasound to navigate every injection.
This imaging technology allows for the direct visualization of the needle as it enters the targeted anatomical site, such as the rotator cuff tendons or the glenohumeral joint space. By avoiding "blind" injections, this guided approach ensures that the autologous concentrate is placed exactly within the area of pathology identified on the patient's diagnostic MRI.
Is PRP Right for You?
While a definitive determination can only be made during a clinical evaluation, research suggests PRP may be most appropriate for individuals meeting the following criteria:
- Confirmed Diagnosis: You have a diagnosed condition such as a partial-thickness rotator cuff tear, shoulder bursitis, or mild-to-moderate osteoarthritis.
- Failed Conservative Therapy: You have completed a course of physical therapy or activity modification without adequate improvement in function.
- Surgical Alternative: You are seeking a non-operative path to manage pain and wish to postpone or avoid invasive surgical intervention.
- Overall Health: You do not have active infections, severe anemia, or specific blood-borne disorders that may impact platelet quality.
- Note on Advanced Conditions: Patients with "massive" retracted rotator cuff tears or advanced "bone-on-bone" arthritis are typically better served by traditional surgical repair or replacement.
Investment and Insurance Guidance
Transparency regarding the financial aspects of orthobiologic care is a priority for our office.
- The Diagnostic Visit: If we participate with your insurance provider, your initial consultation—which includes a comprehensive physical exam and a review of your MRI imaging—can typically be billed to your insurance.
- PRP Procedure: Because PRP is currently categorized as an investigational treatment, it is a self-pay procedure and is generally not covered by standard health insurance plans.
- HSA and FSA Eligibility:
PRP is a recognized medical expense. Patients are encouraged to utilize their Health Savings Account (HSA) or Flexible Spending Account (FSA) to cover the cost of treatment. - Customized Estimates: Total costs are determined by the specific treatment protocol required for your injury. A full financial estimate will be provided following your diagnostic evaluation with Dr. DuBois.
Consult with a Fellowship-Trained Shoulder Specialist
Determining the appropriateness of orthobiologic programs requires a specialized understanding of shoulder anatomy and biomechanics. Dr. Benjamin DuBois is a board-certified orthopedic surgeon who has dedicated his practice exclusively to shoulder care since 2004. His specialized background ensures that every patient receives a comprehensive diagnostic workup prior to considering PRP.
His credentials include:
- Board Certification: American Board of Orthopaedic Surgery; Fellow of the American Academy of Orthopaedic Surgeons.
- Specialized Training: Advanced Shoulder Fellowship at the University of Washington (2003).
- Clinical Experience: Over 5,000 successful shoulder surgeries performed.
- Educational Leadership: Co-founder of the MSK Ultrasound Course, having trained thousands of physicians in precision injection techniques.
- Academic Honors: MD with highest honors (top 5%) from USC Keck School of Medicine.
Nationally Recognized Leadership in Shoulder Care Ranked Among the Top 10 Shoulder Specialists in the U.S.
Dr. Benjamin DuBois has been recognized by Newsweek as one of America’s Leading Doctors for 2025. This national ranking, conducted in partnership with Statista, identifies the most respected specialists in the field of shoulder surgery based on peer recommendations and clinical excellence.
For patients navigating the complex research surrounding Platelet-Rich Plasma and orthobiologics, this recognition reinforces the importance of receiving a clinical evaluation from a fellowship-trained specialist with a proven track record in shoulder pathology and diagnostic precision.
Nationally Recognized Leadership in Shoulder Care Ranked Among the Top 10 Shoulder Specialists in the U.S.
Dr. Benjamin DuBois has been recognized by Newsweek as one of America’s Leading Doctors for 2025. This national ranking, conducted in partnership with Statista, identifies the most respected specialists in the field of shoulder surgery based on peer recommendations and clinical excellence.
For patients navigating the complex research surrounding Platelet-Rich Plasma and orthobiologics, this recognition reinforces the importance of receiving a clinical evaluation from a fellowship-trained specialist with a proven track record in shoulder pathology and diagnostic precision.
Frequently Asked Questions: Research & Clinical Perspectives
Clinical studies are currently investigating whether Platelet-Rich Plasma can assist in the healing environment of partial-thickness rotator cuff tears. Research suggests that the concentrated growth factors may potentially support tendon health in cases where the tear is not large enough to require surgical reattachment.
For patients with mild-to-moderate shoulder osteoarthritis (wear and tear of the glenohumeral joint), PRP is being studied as a way to modulate joint inflammation. While it is not a replacement for surgery in advanced "bone-on-bone" cases, research explores its potential to assist in symptomatic management for earlier stages of degeneration.
In a specialized clinical setting, precision is verified through real-time musculoskeletal ultrasound. This allows the physician to visualize the needle's tip as it enters specific narrow spaces, such as the subacromial bursa or the biceps tendon sheath, ensuring the concentrate is delivered exactly where the pathology was identified on the MRI.
An MRI is the gold standard for a definitive diagnosis of shoulder pathologies. Because PRP is highly dependent on the "biological profile" of the injury, Dr. DuBois utilizes MRI imaging to determine the extent of tissue damage. This ensures that the procedure is only considered for patients whose injuries align with current clinical research.
Corticosteroids are powerful anti-inflammatory agents designed for short-term pain relief by suppressing the immune response. In contrast, PRP is a biological concentrate studied for its potential to utilize the patient’s own signaling proteins to influence the healing environment. Research is ongoing to compare the long-term functional outcomes of both methods.
Currently, most insurance providers categorize PRP as an "investigational" or "experimental" treatment for shoulder conditions. Consequently, it is a self-pay procedure. However, diagnostic visits, physical exams, and MRI reviews are typically covered under standard specialist co-pays for in-network patients.
Yes. Because the procedure is performed by a board-certified physician to treat a diagnosed medical condition (such as tendinopathy or arthritis), it is generally recognized as a qualified medical expense for Health Savings Accounts (HSA) and Flexible Spending Accounts (FSA).
The premise relies on the fact that platelets contain over 300 bioactive proteins and growth factors. By concentrating these platelets through centrifugation (spinning the blood), the goal is to deliver a higher-than-normal "dose" of these proteins directly to an area of the shoulder that typically has poor blood supply, such as the rotator cuff tendons.