Will I need PRP or another stem cell treatment later?

Others benefit from follow-up PRP sessions, usually starting a few weeks to months after the stem cell application and spaced about one month apart. When a second stem cell application is considered, patients usually return between 3 and 6 months after the first one, depending on the doctor's evaluation. These decisions are made with your doctor during your follow-up calls, based on your progress, your goals and your condition, and they are never assumed in advance.

Patients often ask whether stem cell therapy is a one-time treatment or the start of a series. The honest answer is that both are possible, and the plan is adapted to each person. This guide explains when additional treatments are recommended, how PRP fits in, when a second stem cell application may make sense and how the decision is made.

One application is often the starting point

Your first treatment plan is designed to address your condition with the right dose of mesenchymal stem cells (MSCs) from Wharton's jelly, the right route and, for joints, platelet-rich plasma (PRP). After the application, the regenerative process takes time. Improvement, when it comes, is usually gradual over weeks to months, so it is important to give the treatment time before deciding on anything else.

Many patients, especially those with early or moderate joint wear, are satisfied with one application combined with a good rehabilitation program.

When additional treatments are considered

The doctor may recommend additional treatments when:

• The condition is advanced, for example severe osteoarthritis or degeneration in several spinal levels.
• Several areas are involved, and the plan was designed in stages.
• The response is partial: the patient improved, but not as much as expected.
• The goal is long term, for example in systemic or neurological conditions, where repeated applications may be part of the plan.
• The patient wants to maintain the results over time.

PRP follow-up sessions

What they are

PRP is prepared from a small sample of your own blood and concentrates the platelets and their growth factors. It is included in our joint treatments with the stem cells, and it can also be used on its own as a follow-up.

When they are used

• Timing: follow-up PRP sessions are usually scheduled weeks to months after your stem cell application, according to the doctor's recommendation. For example, a doctor may recommend two PRP sessions over the six months after the first treatment.
• Spacing: sessions are usually spaced about one month apart.
• Number: the number of sessions depends on the condition and the response. When PRP is used on its own as the main treatment, several sessions are usually needed, since one session alone is rarely enough.

How they work in your visit

A PRP session is an outpatient procedure. It usually takes 30 to 60 minutes, and most patients return home the same day.

A second stem cell application

When it may be considered

A second stem cell application is evaluated individually. In our experience, patients who need it usually return between 3 and 6 months after their first application. In some treatment plans, a second round is planned from the start, for example three months after the first one, when the doctor considers that a staged approach is better for the condition.

How the decision is made

The doctor considers:

• Your progress: pain, mobility and function since the first application.
• Your imaging, if a new study is needed to see the current state of the area. Remember that we ask for MRIs no older than three months.
• Your goals: returning to a sport, walking without pain or maintaining your results.
• Your overall health and laboratory results.

Second-round visits

A second round follows a similar itinerary: arrival with laboratory tests and consultation, treatment with a night at our facilities under nursing and medical monitoring, and discharge. Returning patients already know the process, which makes the visit easier.

Systemic and neurological plans

For IV treatments aimed at systemic goals, such as inflammation, autoimmune conditions, healthy aging or neurological conditions, the plan may include more than one application from the start, or the doctor may evaluate additional applications during follow-up. In these cases, the decision considers how your symptoms, energy, mobility or daily function have changed, together with your laboratory results and, when relevant, reports from your specialist at home. Some plans combine stem cells with exosomes or complementary therapies such as NAD+, according to the doctor's recommendation.

Planning for possible future treatments

• Ask at your first consultation whether the doctor expects you may need more than one application, so you can plan your time and budget.
• Keep your documents: your treatment plan, discharge instructions and any reports, which help the team plan a second visit.
• Share new studies: if you have new imaging or laboratory results at home, send them to your advisor before your follow-up call.
• Request a quote in advance: when the doctor recommends PRP or a second application, your advisor sends you a written quote and helps you choose a date.

How follow-up supports these decisions

Our plans include a 12-month follow-up program:

• First follow-up call: usually around one month after your application.
• Additional calls: to review your progress, answer questions and recommend next steps.
• Recommendations: physical therapy, PRP sessions or, when appropriate, a second stem cell application.

Keeping a simple weekly log of your pain, mobility and activities helps you and the doctor see your progress clearly and make better decisions.

What the research says

For knee osteoarthritis, a 2024 systematic review and meta-analysis of randomized controlled trials in the Journal of Orthopaedic Translation reported improvements in pain and function with MSC injections in many of the included trials. Clinical studies have used single and repeated applications, depending on the condition. For PRP, the International Olympic Committee consensus paper and the 2020 NBA Orthobiologics Consensus Statement describe PRP as a widely used biologic treatment in sports medicine. Results vary between patients and depend on the condition, its stage, age, weight and activity level.

Factors that help your results last

• Follow the aftercare instructions, including avoiding alcohol for at least 2 weeks and avoiding anti-inflammatory drugs and supplements unless the doctor approves them.
• Do your rehabilitation, ideally guided by a physical therapist.
• Maintain a healthy weight, since body weight affects the load on knees, hips and the spine.
• Return to sport gradually, as cleared by the doctor.
• Avoid steroid injections in the treated area unless the doctor approves them.

Example scenarios

One application. A patient with moderate knee osteoarthritis receives stem cells and PRP, follows the rehabilitation plan and reports steady improvement at her follow-up calls. No further treatment is needed at this time.

PRP follow-up. A patient who improved after his shoulder treatment receives two PRP sessions in the following months, as recommended by the doctor, to support his return to tennis.

Second application. A patient with advanced degeneration in both knees improves partially after the first application. At her follow-up, the doctor recommends a second application, and she returns a few months later.

Common questions

Is a second application always needed? No. Many patients do well with one application and a good rehabilitation plan. The decision depends on your progress.

How much does a follow-up PRP session cost? It depends on the area. Your advisor sends you a quote when the doctor recommends it.

Can I do PRP with my local doctor? You can discuss it with your doctor at home. Tell our team, so we can keep your follow-up information complete.

Will a second application work better than the first? Not necessarily; each application is evaluated on its own. The doctor recommends it when your case suggests it can help.

Do I need new imaging for a second application? Often yes, so the doctor can see the current state of the area. MRIs should be no older than three months.

Questions to ask your doctor

• Do you expect that I will need more than one application?
• Would PRP sessions help me after my stem cell treatment?
• When should we evaluate whether a second application makes sense?
• What can I do to help my results last?

Bottom line

Some patients need only one application, while others benefit from PRP follow-up sessions, usually spaced about a month apart, or from a second stem cell application, usually evaluated between 3 and 6 months after the first. The doctor decides with you during your follow-up, based on your progress and goals. A medical evaluation can help determine whether this type of regenerative treatment is appropriate for your condition, goals and medical history.