Knee pain that is keeping you off the course
StemWave plus ultrasound-guided PRP at FirstCall DPC, Santa Rosa Beach
See if I'm a candidateFor a knee, that means we look at the cartilage, the meniscus, the tendons and the fluid before we decide anything. Plenty of knees that hurt the same way have different problems inside, and PRP helps some of them a lot more than others.
Is this you?
- You are walking 18 and the back nine hurts more than the front nine.
- The first few steps after sitting are the worst, then it loosens up.
- You have had a cortisone shot. It helped for a while. It is not helping anymore.
- You have been told it is arthritis and to come back when it is bad enough for a replacement.
- You are not ready to stop doing the things you do.
If you are bone-on-bone, this is not your treatment, and I will tell you that in the first five minutes.
How it works
1.Exam and ultrasound
I examine the knee, then put the probe on it. We look at the cartilage edge, the meniscus and any fluid. If the ultrasound says the joint is past what PRP can help, you hear that from me at this visit, not after you have paid for a series.
2.StemWave sessions
Six StemWave sessions, one or two a week, before the injection. Focused acoustic wave sessions are done in the office by Ronna, take about fifteen minutes, and wake the tissue up so the PRP has something to work with. Most people walk out and go about their day.
3.PRP under ultrasound
We draw your blood, spin it, and inject the platelet-rich layer into the joint while watching the needle on the screen. A knee injection done blind misses the joint space more often than people expect. Ours does not.
4.Loading plan
PRP is not a shot and a wait. You get a strengthening program for the quad and hip that starts within days. The injection changes the environment in the joint. The loading is what builds on it.
For knee arthritis we use the Rebuild package: six StemWave sessions over three to four weeks, then one ultrasound-guided PRP injection within two or three days of the last session, then the loading program. Most patients notice a difference by six to eight weeks and the benefit keeps building for three to six months. If the ultrasound shows more than one problem, Dr. Petersen may recommend Elite Recovery, which adds a second injection.
What the evidence says
For mild to moderate knee osteoarthritis, PRP has done at least as well as hyaluronic acid and better than placebo in a number of trials, with the benefit lasting longer than cortisone. The trials are small and the preparations vary, so I would call the evidence reasonable, not settled. For advanced arthritis the evidence is thin, and I will not sell you a series to find that out.
“If I ever have to exaggerate the evidence to justify offering something, I probably shouldn't be offering it.”Dr. Petersen
What it costs
- Reset3 StemWave sessions + 1 ultrasound-guided PRP injection$1,395
- Elite Recovery10 StemWave sessions + 2 ultrasound-guided PRP injections$2,995
FirstCall DPC members get 15% off every package.
Both sides or a second site: add $600 per PRP site and $500 per StemWave region.
The exam and the ultrasound are included. HSA and FSA accepted. Financing available.
Dr. Petersen chooses the package at the exam based on what the ultrasound shows. If a single ultrasound-guided PRP injection without StemWave is the right call for you, that is offered through the main practice and he will say so.
Look, I love advanced treatments. We use them every day. But most knee pain gets better with a loading program and time. If yours hasn't, that is when we talk about PRP.
What I will not do is inject a knee I have not looked at. A cortisone shot in an urgent care takes four minutes and nobody looks at the joint. That is why it works for a few weeks and then it doesn't. The ultrasound takes ten minutes and tells us whether we are treating the right thing.
Meet the physicians
Erik Petersen, DO
Board-certified in Internal Medicine. Twenty years of emergency medicine, and the person holding the ultrasound probe.
Co-founder of FirstCall DPC. Former All-American football player who still thinks a loading program beats a shortcut.
Will Carlson, MD
Board-certified in Internal Medicine. Emergency medicine experience, and the slower, more careful half of this partnership.
Co-founder of FirstCall DPC. He is the one who asks what happens if we are wrong, which is why we rarely are.