Who walks through this door
- The knee that isn't ready for a replacement — arthritis that's real but not end-stage, and an owner who wants years more mileage first.
- The endurance athlete — this is Ironman Texas country, and tendons here log real volume. Recovery is a discipline, not a rest day.
- The optimizer — you've read about peptides and want a medical answer, not a med-spa menu.
The injection ladder, honestly ranked
For an arthritic or aching joint, the realistic options run: activity change and PT → cortisone → gel injections → PRP → surgery. Each rung buys different things for different joints. The skill isn't any single injection — it's knowing which rung you're actually on. About a third of the people who come in asking about surgery hear "not yet." This page is what "not yet" looks like.
- Cortisone
Fast relief, short lease
Works within days, typically lasts six weeks to six months, usually covered by insurance. The catch: joints have a yearly limit (3–4 shots), and cortisone calms fire without changing the fuel.
- PRP
Your own blood, concentrated
Platelet-rich plasma — we draw your blood, spin out the platelets, and inject the concentrate where healing needs a push. Recent meta-analyses favor PRP over cortisone for knee-arthritis pain and function at 6–18 months. Slower to start, longer to last. Usually not covered by insurance; nationally ~$500–$2,500 per injection.
- Peptides
The frontier — read this part carefully
BPC-157 and friends have jumped from forums to gym conversations. Straight talk from the medical side: human evidence is thin, the hype is ahead of the science, and the unregulated market has a genuine quality-control problem. Our answer is the Peptide Program: a $300 consultation with our nurse practitioner, honest screening, and sourcing through a reputable local compounding pharmacy — the only way we'll do it.
- Not on the menu
"Stem cell" miracle promises
Clinics promising to regrow your cartilage with a stem-cell injection are ahead of the evidence and, frequently, the law. We won't sell you that — and we'd gently suggest not buying it anywhere else either.
Why get this care from surgeons?
Because the person recommending your injection should be equally comfortable telling you it won't help. Our physicians see the whole board — PT, injections, surgery — so nobody here needs to sell you the only tool they have. Ultrasound-guided hands, imaging on-site, and a co-founder who's finished four Ironmans and treats recovery as seriously as you do.
Common questions
Can PRP help me avoid a knee replacement?
Sometimes it can push the date years down the road — that's a win worth having. It cannot regrow a bone-on-bone joint. An X-ray and an honest conversation will tell us which side of that line your knee is on. Start with the self-assessment →
How many PRP injections do I need, and when does it kick in?
Protocols vary from one to a short series; benefits typically build over weeks rather than days. We'll lay out the plan — and the total cost — before you commit to anything.
What's the difference between PRP and peptides?
PRP is a procedure using your own concentrated platelets, with a growing evidence base. Peptides are compounds (injected or oral) whose human evidence is still early. One is an established option; the other is a frontier we'll only walk with you carefully.
Is any of this a substitute for physical therapy?
No — and anyone who says otherwise is selling. Injections buy a window; strength work is what the window is for.
Medically reviewed by Keith W.V. Johnson, MD, FAAOS · Updated September 28, 2026