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⚡ Quick Answer: Dr. Matthew Kanaan has performed PRP injections since 2012 — more than 50,000 ultrasound-guided injections at Carolina Nonsurgical Orthopedics in Raleigh and Cary. That experience shows up in three places patients can verify: the dose (larger blood draws, platelet counts guided by published research), the guidance (every injection placed under ultrasound), and the plan around the injection (often paired with shockwave or MLS laser therapy). PRP is not one stan

Quick Answer: An epidural steroid injection does one specific job: it delivers anti-inflammatory medication around an irritated spinal nerve root. If some or all of your pain is coming from the muscles around your spine — guarded, knotted, trigger-point pain that develops after months of hurting — the epidural was never aimed at it, and its "failure" may really be a missed target. Residual muscular pain is treatable without any procedure on the spine itself. But some post-epi

Quick Answer: When PRP "doesn't work," the failure usually traces to how the treatment was performed, not to the treatment itself. The two most common reasons we see are dose — the injection delivered far fewer platelets than the doses that showed benefit in research — and placement, when the injection was done without ultrasound guidance and never reached the target. A failed first attempt doesn't prove PRP can't help you, but it doesn't guarantee a second one will, either.

Quick answer: PRP uses concentrated platelets from your own blood; cell-based therapy (MFAT) uses a concentrated sample of your own adipose tissue. Both are nonsurgical, cash-pay treatments we offer in Raleigh & Cary, and neither has been proven to regrow cartilage — the real differences are how involved the procedure is, which conditions each fits best, and where the evidence is strongest. Two patients, same waiting room, same diagnosis of knee arthritis. One leaves with a P

Quick answer: In a young athlete after a twist or collision, the same appearance is a "bone bruise" and usually heals. Of all the findings on a knee MRI, this is one of the ones that actually tells us something useful about your pain and where your arthritis may be headed. Somewhere in your knee MRI report, between the cartilage description and the meniscus findings, there's a phrase patients tend to Google in the parking lot: "bone marrow lesion" — or its older name, "bone m

Quick answer: No amniotic, umbilical cord, Wharton's jelly, or exosome product is FDA-approved for any orthopedic condition, and independent lab testing has found no viable stem cells in leading commercial birth-tissue products. The cell treatments we offer use your own tissue (MFAT). If a clinic quotes you a price for an off-the-shelf "stem cell" vial, this post explains what is actually in the syringe. The pitch is attractive: stem cells from donated birth tissue, no blood

Quick answer: PRP (platelet-rich plasma) is a concentrated injection of platelets from your own blood, placed under ultrasound guidance. At our Raleigh & Cary offices it is a cash-pay, nonsurgical treatment, and candidacy and exact pricing are reviewed at the evaluation, before you commit. Two clinics can both advertise a "PRP injection" for knee arthritis, charge similar prices, and deliver products that differ several-fold in the number of platelets actually injected. Two c

Quick answer: Cell therapy (MFAT) uses your own microfragmented adipose tissue, prepared and injected the same day under ultrasound guidance. It is a cash-pay, nonsurgical option we offer in Raleigh & Cary for selected joint and tendon problems, and candidacy is decided at an evaluation. That's exactly why cell-based therapy — widely searched as "stem cell therapy" — earns a serious look in the ankle. Ankle arthritis is a different animal from knee or hip arthritis, and the p

Quick answer: Cell therapy (MFAT) uses your own microfragmented adipose tissue, prepared and injected the same day under ultrasound guidance. It is a cash-pay, nonsurgical option we offer in Raleigh & Cary for selected joint and tendon problems, and candidacy is decided at an evaluation. Honest answer: studies follow patients one to two years, with many maintaining improvement through that window. There is no permanent fix: arthritis severity, weight, and activity level all a

Quick answer: Cell therapy is not for everyone. Bone-on-bone arthritis with deformity, active infection, certain blood disorders, and uncontrolled medical problems are common reasons we say no. This post lists the exclusions we apply at our Raleigh & Cary evaluations, before anyone spends anything. Most stem cell websites are lists of reasons to say yes. This one is the opposite — and we think it matters more. Cell-based therapy (like MFAT, the treatment we offer at Carolina

Quick answer: This post compares MFAT and Bone Marrow Concentrate head-to-head — how each works, where the evidence is stronger, and how we choose for patients in Raleigh & Cary. If you've been researching stem cell therapy for arthritis, you've probably noticed something confusing: different clinics use completely different source tissue. If you've been researching stem cell therapy for arthritis, you've probably noticed something confusing: different clinics use completely

Quick answer: Cell therapy (MFAT) uses your own microfragmented adipose tissue, prepared and injected the same day under ultrasound guidance. It is a cash-pay, nonsurgical option we offer in Raleigh & Cary for selected joint and tendon problems, and candidacy is decided at an evaluation. Cell therapy sits on the rung between "injections aren't enough anymore" and "I'm not ready for a replacement." You can read more about how MFAT works on our stem cell therapy page. Shoulder

Quick answer: "Bone on bone" means that gap has narrowed to nothing in one or more compartments: the cartilage has worn through. Plenty of bone-on-bone patients do well for years with the right program, and plenty of moderate-arthritis patients need replacement because nothing else touched their pain. "You're Bone on Bone" — The Scariest Sentence in Knee Care It's the phrase that ends conversations. The X-ray shows no joint space, the doctor says "bone on bone," and the patie

Quick answer: Crepitus — the medical term for joint popping, crackling, or grinding — is one of the most common things patients ask about and one of the least understood. Painless noise gets reassurance — which, honestly, is the treatment most noisy knees need. Your Knee Sounds Like Bubble Wrap. Should You Worry? Crepitus — the medical term for joint popping, crackling, or grinding — is one of the most common things patients ask about and one of the least understood. The shor

Quick answer: NSAIDs work, but chronic use is a meaningful source of harm: GI bleeding, kidney injury, cardiovascular risk, and impaired tendon and bone healing. This post reviews the alternatives with real evidence behind them. If ibuprofen is part of your daily routine, that's information — it means the current plan isn't working. The Ibuprofen Habit Nobody Questions NSAIDs — ibuprofen, naproxen, meloxicam — are the default daily habit for millions with joint pain. They wor

Quick answer: What doesn't restart healing: cortisone (suppresses the inflammation that's part of the healing cascade — short-term pain relief, long-term tendon weakening), and more rest. "Will this just get better on its own?" It's the right question, and the honest answer is: sometimes — but chronic tendinopathy usually doesn't, and waiting is often what makes it chronic. The Question Every Tendon Patient Asks "Will this just get better on its own?" It's the right question,

Quick answer: Locking — the joint catching and refusing to straighten or bend — means something is mechanically interfering inside the joint. A displaced bucket-handle meniscus tear jamming the joint is a mechanical problem that rehab and injections can't fix, so a locked knee needs prompt evaluation. A Locking Knee Is a Mechanical Problem — Treat It Like One There's knee pain, and then there's a knee that physically won't move. Locking — the joint catching and refusing to st

"How Long Until I'm Better?" — The Honest Timelines Recovery from a meniscus tear depends entirely on which treatment path you're on. Here are the real numbers, not the optimistic ones. Rehab Without Surgery: 6–12 Weeks For degenerative tears and stable traumatic tears without mechanical symptoms, structured physical therapy is first-line — and the evidence supports it. Expect: Weeks 1–3: Pain and swelling settle; range of motion returns Weeks 4–8: Progressive strengthening;

Quick answer: The scan shows a degenerative meniscus tear, so it gets scoped — even though the pain pattern pointed to arthritis all along. MRI findings and pain correlate poorly, and often the answer isn't visible on that particular test at all. The Most Confusing Conversation in Orthopedics It happens in our office weekly, in both directions: "My MRI is terrible, but I feel fine." Advanced arthritis, torn meniscus, bulging everything — and the patient came in for something

Quick answer: This post compares Repeated Cortisone Shots and Hyaluronic Acid — the differences that matter, and how treatment choices are made at our Raleigh & Cary offices. It means cortisone is a short-term pain tool with a long-term cost, and a treatment plan built on repeating it indefinitely is a plan to arrive at joint replacement faster. The Shot That Helps Today and Hurts Tomorrow Cortisone injections are the most common first-line treatment for arthritic joint pain