Our patients often ask whether PRP, bone marrow concentrate (BMC), microfragmented adipose tissue (MFAT), or prolotherapy is the best choice for them.

With the exception of studies involving knee treatments, there is currently no high-quality scientific research directly comparing all four procedures. The choice of the most appropriate treatment therefore depends on several factors, including the area being treated, the type and severity of the condition, previous treatments, cost, and the treating physician’s clinical judgment.

Microfragmented Adipose Tissue (MFAT)

In appropriately selected patients, MFAT may provide outcomes comparable to, and in some cases possibly better than, BMC. It is considered an excellent regenerative treatment option; however, for anatomical and technical reasons, it cannot be used safely or practically in every area of the body. One example is the C0–C1 region, located at the junction of the skull and the cervical spine.

Bone Marrow Concentrate (BMC)

Based on our clinical experience with regenerative treatments since 2006, BMC—which is usually combined with PRP—may be one of the most effective treatment options. Patients typically require one or two treatments.

Platelet-Rich Plasma (PRP)

PRP is also a highly useful and effective regenerative treatment. It is less invasive than BMC or MFAT; however, achieving lasting improvement generally requires two to four treatments.

Prolotherapy

Prolotherapy is usually the most affordable option. Its main disadvantage is that achieving a lasting result generally requires more treatments, approximately four to eight sessions.

What Does the Research Show?

There is currently very limited published evidence regarding regenerative treatments of the cervical spine. No reliable study has directly compared all four treatment methods in this anatomical region.

For the lumbar spine, one published study found no significant difference between the outcomes of BMC and PRP. However, this does not mean that the two treatments are equally effective for every patient or every spinal condition (Navani, 2024).

Considerably more research is available regarding the treatment of the knee. Several larger studies suggest that MFAT may provide particularly favorable outcomes and, when appropriately indicated, may be one of the most effective regenerative treatment options.

General Clinical Ranking

When all procedures are anatomically and technically appropriate, the general ranking based on expert clinical opinion may be:

  1. MFAT
  2. BMC combined with PRP
  3. PRP
  4. Prolotherapy

This ranking should not be considered a universal rule for every patient. The treatment listed first is not automatically the best or safest choice in every case.

The treating physician will make an individualized recommendation based on the exact diagnosis, anatomical considerations, the patient’s medical history, treatment goals, and the available scientific evidence.