Orthobiologics at the Scheinberg Clinic: Frequently Asked Questions

Orthobiologics is the field of medicine that uses naturally occurring substances from the body — primarily blood-derived and marrow-derived concentrates — to support the healing of musculoskeletal injuries and degeneration. The two most commonly used orthobiologic therapies at the Scheinberg Clinic are PRP (Platelet-Rich Plasma) and BMAC (Bone Marrow Aspirate Concentrate). Both are derived from your own body, which means there is no risk of rejection or allergic reaction. The goal is to harness your body's existing healing mechanisms and amplify them at the site of damage — whether that's an arthritic knee, a torn tendon, or a degenerating joint.

This is one of the most common questions patients ask, and it deserves a precise answer. The devices and equipment used to process PRP and BMAC — the centrifuges, collection kits, and filtration systems — are FDA-cleared. The FDA's oversight in this space pertains to the devices and processing equipment rather than to the injections themselves, because the treatments are autologous (derived from your own body) and do not involve manipulation that crosses the threshold requiring independent drug approval.

PRP and BMAC do not have the same regulatory pathway as pharmaceutical drugs, and some professional associations have not yet issued formal endorsements — partly because the research is still accumulating. What exists is a substantial and growing body of peer-reviewed clinical evidence supporting their use for specific orthopedic conditions. Dr. Scheinberg's protocols are grounded in that evidence, and he will give you an honest assessment of where the science is strong and where uncertainty remains.

Most insurance plans, including Medicare, do not currently cover PRP or BMAC therapy for orthopedic conditions. These treatments are classified as elective procedures pending broader regulatory endorsement, and reimbursement is not typically available. Payment is generally out-of-pocket. Dr. Scheinberg's clinic provides transparent pricing, and candidacy is determined before any financial commitment is made. For many patients, the cost of one to three biologic treatments compares favorably to the full cost — financial and otherwise — of joint replacement surgery and its rehabilitation.

The number of treatments depends on the condition being addressed, its severity, and how your body responds. For soft tissue injuries such as tendinopathy or partial ligament tears, one to two PRP sessions is often sufficient. For knee or hip arthritis, a series of two to three injections spaced several weeks apart is typically recommended. For more advanced joint degeneration treated with BMAC or the combined approach, a single comprehensive treatment session is often the starting point, with follow-up assessment at 12 weeks to evaluate response. Dr. Scheinberg will not recommend additional treatments unless the clinical picture supports them.

Most patients describe the experience as manageable. The blood draw for PRP is no different from a standard lab draw. The injection into a joint or around a tendon involves a brief feeling of pressure and mild discomfort. For BMAC procedures, the bone marrow harvest from the iliac crest is performed under local anesthetic, which minimizes the sensation at the harvest site. Post-procedure soreness for 24 to 48 hours is common and expected — it reflects the healing response being activated, not a complication.

Orthobiologics work through a biological healing process, which takes time. PRP patients typically begin noticing improvement four to eight weeks after treatment. The full benefit of BMAC often becomes apparent at two to three months and can continue improving for six months or more. This is a meaningful difference from cortisone injections, which may provide faster initial relief but fade quickly. The timeline is part of an honest conversation Dr. Scheinberg has with every patient before treatment begins.

Candidacy is determined through a formal assessment — not assumed. The best candidates are generally patients with moderate joint degeneration or soft tissue injury who have not found lasting relief from physical therapy, NSAIDs, or cortisone injections, and who want to pursue a regenerative approach before considering surgery. Patients with bone-on-bone arthritis in all joint compartments, significant structural deformity, or other complicating factors may have more limited potential benefit, though this is evaluated on an individual basis. Dr. Scheinberg will give you a straight answer about whether you are a likely responder.

PRP (Platelet-Rich Plasma) is derived from your blood and contains concentrated platelets loaded with growth factors. It is most effective for soft tissue injuries, early-to-moderate arthritis, and tendon or ligament damage. BMAC (Bone Marrow Aspirate Concentrate) is derived from your bone marrow and contains mesenchymal stem cells — cells with genuine regenerative potential — as well as a broader and more potent array of growth factors and anti-inflammatory agents. BMAC is used for more advanced joint degeneration, complex structural injuries, and cases where PRP alone is unlikely to provide sufficient support. In many cases, Dr. Scheinberg combines both treatments to maximize the biologic environment in the joint.

Yes, and this is often Dr. Scheinberg's recommendation for patients with the most significant joint degeneration or complex orthopedic pathology. The combined approach uses BMAC's stem cell and regenerative signaling properties alongside PRP's growth factor concentration to create the most comprehensive healing environment possible in the joint. Both are harvested and processed on the same day and delivered in sequence. This is the highest-intensity protocol at the Scheinberg Clinic and is reserved for patients with advanced arthritis or complex sports pathology.

Dr. Scheinberg treats a broad range of orthopedic conditions with orthobiologics, with particular focus on:

Knee osteoarthritis (mild, moderate, and advanced), hip arthritis and labral tears, shoulder arthritis and rotator cuff injuries (partial tears, tendinopathy, and labral tears), patellar tendinopathy and patellar tendon injuries, Achilles tendinopathy, tennis elbow (lateral epicondylitis), partial ligament tears of the knee and ankle, meniscal pathology, and spinal degeneration in appropriate candidates.

His surgical background means he also evaluates patients whose condition may ultimately require surgery — and he'll tell you clearly if that's the case.

Dr. Scheinberg is a board-certified orthopedic surgeon with 40 years of experience and a Harvard and Duke-trained background. Most PRP providers are not orthopedic surgeons. Many come from internal medicine, pain management, or other general practice backgrounds and have received limited specialized training in musculoskeletal anatomy and orthopedic diagnosis.

The distinction matters for two reasons. First, accurate diagnosis requires the depth of knowledge to interpret imaging, examine the joint, and identify precisely which structure is damaged — skills built over decades of surgical training and practice. Second, procedural precision is a surgical discipline. Injecting the right substance at the correct concentration into the exact anatomical location requires the kind of expertise that orthopedic surgery demands. Dr. Scheinberg applies both to every patient he treats.

The Scheinberg Clinic is located on Chapala Street in Santa Barbara, California. It is co-located with the Pueblo Surgical Center, an AAAHC-accredited ambulatory surgical facility. The practice serves patients from throughout the Santa Barbara and Montecito area, the broader Central Coast, Bakersfield, and patients who travel from elsewhere in California and nationally for access to Dr. Scheinberg's specialized care.

The first step is a surgical-grade consultation to evaluate your condition, review your imaging, and determine candidacy. Appointments can be requested through the Scheinberg Method website at scheinbergmethod.com. You will be asked to bring any recent imaging to your first visit — or arrangements can be made to obtain appropriate imaging prior to the consultation.

Costs vary depending on the treatment protocol. PRP treatment is generally in the range of $1,000 to $2,500 per session. BMAC therapy is more involved and is typically in the range of $3,000 to $6,000 per session. The combined approach reflects the complexity of both procedures. Exact pricing is discussed during consultation and is transparent before any treatment decision is made. While these costs are not trivial, they should be evaluated in context: a knee replacement, with all associated hospital fees, anesthesia, rehabilitation, and time away from work, can cost $30,000 to $50,000 or more. For patients who can achieve lasting relief through biologics, the economics are favorable.

Orthobiologic treatments using PRP and BMAC are among the lowest-risk medical procedures available, because they use materials derived from your own body. The most common side effects are temporary soreness, swelling, or stiffness at the injection site, which typically resolve within a few days. There is a small risk of infection with any injection, which is minimized by the clinic's use of sterile technique and surgical-grade standards. There have been no documented cases of systemic adverse reactions to autologous PRP or BMAC in the peer-reviewed literature. For patients on blood thinners or with certain medical conditions, Dr. Scheinberg will assess these factors as part of the consultation. The treatment is not appropriate for patients with active infection, certain clotting disorders, or active malignancy.