The hip evidence is contested and smaller than the knee. Across 5 randomised trials every one reported pain and function improvement, and leukocyte-poor single injections did best. Across 6 trials against hyaluronic acid there was no difference, and NICE advises against hyaluronic acid in the hip. PRP is a reasonable option for early to moderate hips, not a proven one.

For knee osteoarthritis, benefit usually peaks within 6 months and holds for 6 to 12 months, where most trials stop measuring. One 610-patient trial found benefit still present at 5 years after a single course. A repeat is reasonable when the first course helped and has faded, not on a calendar, and not when the first course did nothing.

Both are true. Across 26 randomised trials, PRP beat a steroid injection beyond 6 months. A 2026 meta-analysis of placebo-controlled trials found PRP no better than saline at any point up to 26 weeks. Steroid makes tennis elbow worse in the long run, so PRP wins by not being steroid, and the loading programme does the rest.

Almost nothing sold as a stem cell injection contains many stem cells, and the British Orthopaedic Association calls the term misleading. In the only randomised trial comparing them directly, bone marrow concentrate andPRP were equivalent at 12 months. Cell therapies in London cost from £2,800 to £4,995 per joint against £780to £950 for PRP, on thinner evidence.

The best trial says no. A 2025 double-blind trial of 90 patients found a single PRP injection no better than saline for thumb base arthritis at 6 months, and a 2024 meta-analysis of 10 studies found no difference between steroid and alternatives including PRP. The treatments that help are a splint, hand therapy and, when needed, surgery.

For joint and tendon injections, PRP has a good safety record. A 2026 meta-analysis of randomised trials found mild, transient pain and swelling as the main side effects, more with leukocyte-rich preparations, and no severe adverse events. NICE found no major safety concerns. The real risks sit in who prepares it, who injects it, and who was not told no.

Less often than the marketing suggests. A 240-patient UK trial in JAMA found PRP no better than sham forAchilles tendinopathy, a trial in athletes found it no better than saline for jumper’s knee, and 16 trials found it added nothing to ACL reconstruction. It earns its place in tennis elbow, plantar fasciitis and some cuff problems.

For plantar fasciitis that has lasted more than 3 months, PRP gives better pain and function than a steroid injection at 3 and 6 months across 24 randomised trials, with no difference at 1 month or 12 months. Steroid works faster and fades. Neither replaces stretching, load management and footwear, and not all heel pain is plantar fasciitis.

Sometimes, and the two best trials disagree. An 80-patient Australian trial found a single guided PRP injection beat steroid, sustained at 2 years. A 79-patient UK trial in 2025 found PRP no better than saline in refractory cases. Both agree the problem is usually the gluteal tendons rather than the bursa, and that education plus exercise comes first.

For ankle osteoarthritis, the only placebo-controlled trial found PRP no better than saline, and its authors donot support its use. For ankle sprains and ligaments there is no good trial evidence either way. We say thisplainly because most clinics do not. The useful answer for an ankle is usually a diagnosis, a brace, aphysiotherapist or a surgeon.

Leukocyte-poor PRP has the better record in arthritic joints, where the hip trials favoured it and a 2026network meta-analysis of 21 knee trials found it the more prudent choice. Leukocyte-rich PRP is often chosenfor tendons, though the best patellar tendon trial found it did worst. The difference is modest, and most clinicscannot tell you which they used.

Four injections are commonly offered for knee osteoarthritis in London. NICE advises against hyaluronic acidand limits steroid to 2 to 10 weeks of relief. PRP beat hyaluronic acid across 26 randomised trials but failedagainst placebo in a 288-patient JAMA trial. Arthrosamid has 1 randomised trial. Which suits you depends onyour stage of disease and what you need.

Intraosseous PRP injects platelet rich plasma into the bone beneath the cartilage as well as the joint, becausedamaged subchondral bone drives osteoarthritis. A 2025 double-blind trial of 86 patients with severe kneeosteoarthritis found adding bone injections to joint injections gave greater improvement at 3, 6 and 12 months.The evidence is promising, small and partly industry-linked.

For some people, yes, for a period. A 2026 trial of 90 patients on knee replacement waiting lists found 2 PRPinjections beat steroid and anti-inflammatories at 6 months, which the authors called a bridge before surgery.PRP does not rebuild cartilage, and a 2021 JAMA trial found no benefit over placebo, so it is a bridge, not areplacement.

Platelet rich plasma can reduce pain and improve function in knee osteoarthritis. A 2026 randomised trial inlate stage disease found it outperformed corticosteroid at six months, and meta-analyses in milder diseaseagree, though a 2021 trial in JAMA found no benefit over placebo and NICE calls the evidence limited. Tenniselbow evidence is strongest, hip and Achilles more mixed.

Hair loss is a long-term condition, so treating it in single sessions is the reason most people are disappointed. A proper programme runs across twelve months in four phases. Diagnosis and correction first, then an intensive treatment course, then review and adjustment, then maintenance. Knowing the whole sequence before you start is the difference between a plan and a series of purchases.

Online hair loss services deliver finasteride and minoxidil cheaply and conveniently, and for straightforward early male pattern loss they are a reasonable place to start. What they cannot do is examine your scalp, order and interpret blood tests, take a biopsy, or offer anything beyond two medications. If a subscription has not worked for you, those four gaps are usually the reason.

PRP is a reasonable alternative to surgery in chronic tendon conditions that have failed rehabilitation, and it is not an alternative to surgery for a mechanical problem or an advanced arthritic joint. The distinction is whether the tissue has failed to heal, which regenerative treatment can address, or whether the structure is damaged or worn out, which it cannot. Getting that distinction right saves both money and years.

Image-guided joint and tendon PRP at specialist central London clinics commonly costs from around £780 to £900 or more per injection including assessment, with a course of two to three taking a full plan past £2,000. Elsewhere in the UK the range is roughly £250 to £500. The gap is not only location. Whether the injection is image guided and whether a doctor assessed you first are what actually differ.

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