PRP, BMAC, and Lipogems: What Orthobiologics Can and Cannot Do
- Justin Smith
- Jun 18
- 4 min read
If you have been told you need surgery, or you are stuck in a cycle of cortisone shots that wear off, you have probably heard about orthobiologics. PRP, BMAC, and Lipogems get a lot of hype online, and the truth is more useful than the marketing. This is a plain English guide to orthobiologics (PRP BMAC Lipogems) from a surgeon who will tell you honestly when they make sense and when they do not.
What orthobiologics actually are
Orthobiologics use components from your own body to support healing in joints, tendons, and soft tissue. The idea is simple. We concentrate cells and growth factors your body already makes, then place them where you are injured. They are not stem cell miracle cures, and no honest practice should sell them that way.
Here is the plain English version of the three we offer.
PRP (platelet rich plasma) is made by drawing a small amount of your blood and spinning it down to concentrate platelets and growth factors. We then inject that concentrate into the area of injury.
BMAC (bone marrow aspirate concentrate) is drawn from your own bone marrow, usually from the pelvis, then concentrated. It contains a richer mix of cells than blood alone.
Lipogems is processed from a small sample of your own fat. The fat is cleaned and gently broken down into a form that can cushion and support tissue when injected.
What orthobiologics PRP BMAC Lipogems can do
For the right patient, these treatments can reduce pain and improve function without an operation. The strongest, most consistent signal in the literature is for certain tendon problems and for mild to moderate osteoarthritis, especially in the knee. PRP in particular has reasonable evidence for knee arthritis and for stubborn tendon issues like tennis elbow and some patellar and Achilles tendon pain.
Realistic wins look like this. Less pain. Better function. A delay of surgery, sometimes for years. A chance to rehab harder because the joint or tendon hurts less. These are meaningful outcomes, and they are worth pursuing when the situation fits.
What they cannot do
This is where the honesty matters. Orthobiologics cannot regrow a joint that is bone on bone. They will not reattach a fully torn ACL, repair a large full thickness rotator cuff tear, or reverse advanced end stage arthritis. They are not a guaranteed fix, and results vary from person to person. A torn structure that needs surgical repair still needs surgery.
We will not sell you an injection that we do not believe will help you. If your problem is mechanical and structural, the right answer may be therapy, a brace, or surgery done well at the right time.
Who may be a candidate
You may be a reasonable candidate for orthobiologics if:
You have mild to moderate joint arthritis, or a chronic tendon problem, that has not responded to rest, therapy, or other conservative care.
You want to delay or avoid surgery and your imaging supports a non surgical trial.
You are not ready for, or not a candidate for, an operation right now.
The only way to know is a real evaluation. We look at your history, your exam, and your imaging, then tell you whether a biologic is likely to help or whether something else fits better.
How pricing works at JOI
Journey Orthopaedic Institute is a cash based, insurance free practice. That means transparent, upfront pricing with no surprise bills, and a superbill you can submit for possible out of network reimbursement.
A few of our visit prices are public. An in person new patient office visit (45 minutes) is 400 dollars. A virtual second opinion or new patient tele visit (30 minutes) is 350 dollars. A mobile medical unit consult, where we come to you (45 minutes), is 500 dollars.
Orthobiologic procedures are priced individually, because the right plan depends on your diagnosis, the area treated, and which biologic fits. For that reason we do not post a single biologics price. Instead, we give you a written Good Faith Estimate before anything is scheduled, so you know your number in advance. Ask us whether you are a candidate and request your estimate.
A note on this article
This article is general education and is not medical advice. Orthobiologics are not right for everyone, and the only way to know what fits your injury is a personal evaluation with a qualified physician.
Book a visit or request a Good Faith Estimate
If you want a straight answer about whether PRP, BMAC, or Lipogems can help you, we are happy to look. Dr. Justin T. Smith is a double board certified orthopaedic sports medicine and shoulder surgeon, and you can usually be seen in days, not months.
Visit jo.institute to book a visit or request your Good Faith Estimate. We see patients in person at our Fort Mill clinic (441 Mercantile Place, Suite 101, Fort Mill, SC 29715) and by mobile medical unit across the Fort Mill, South Charlotte, and Rock Hill corridor. You can also reach us at Schedule@jo.institute.
Questions, or ready to book? Call or text Journey Orthopaedic Institute at 803.220.4207, or book your visit at jo.institute.
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