You’ve already tried physical therapy..
Maybe injections.
Maybe surgery.
You were told it was arthritis.
Or a meniscus tear.
Or simply “wear and tear."
Yet you still avoid stairs.
Still hesitate before standing up.
Still wonder why the pain keeps coming back.
The problem is not always that treatment failed.
Sometimes the problem is that the structure actually causing pain was never identified.
Most people with persistent knee pain already have an MRI.
The challenge is not finding abnormalities.
The challenge is determining which abnormality actually matters.
A meniscus tear may not be causing pain.
Arthritis may only explain part of the problem.
The painful structure may actually be a ligament, tendon, bursa, peripheral nerve, or biomechanical issue that was never fully evaluated.
Finding the true pain generator changes the conversation.
Most treatment plans are built around the most obvious finding.
Arthritis.
A meniscus tear.
Inflammation.
When that finding is not the primary source of pain, treatment often provides only temporary relief.
The question is not:
“What does the MRI show?”
The question is:
“What structure is actually causing the pain?”
Text Dr. BernhardtPlatelet-Rich Plasma (PRP) is often delivered into the knee joint itself.
However, knee pain frequently arises from structures outside the joint, including the patellar tendon, quadriceps tendon, medial collateral ligament, or the pes anserine region along the inner knee.
When indicated, treatment at Alypos may therefore be directed not only into the joint, but toward specific tendons, ligaments, or bursae contributing to symptoms.
Ultrasound guidance allows these structures to be visualized directly so that treatment can be delivered with precision.
Treatment depends entirely on what is found during evaluation.
For some patients, treatment may involve rehabilitation or biomechanical correction.
For others, image-guided procedures, PRP, PRF, hydrodissection, or bone marrow concentrate may be considered.
Treatment follows diagnosis.
Not the other way around.
When appropriate, regenerative and precision-based therapies may be considered within the context of a comprehensive evaluation.
Treatment decisions are guided by clinical findings, imaging correlation, patient goals, and overall joint health — not by protocol or predetermined pathways.
Platelet-Rich Plasma (PRP) utilizes autologous platelet concentrate derived from the patient’s own blood.
In carefully selected cases, PRP may be considered for knee osteoarthritis, early degenerative joint disease, patellar or quadriceps tendinopathy, ligament injury, and persistent inflammatory conditions.
All injections are performed with image guidance to ensure precise intra-articular or peri-tendinous placement.
Treatment planning emphasizes appropriate patient selection, joint mechanics, and long-term tissue health rather than short-term symptom suppression.
Platelet-Rich Fibrin (PRF) is a related biologic derived from the patient’s own blood, prepared to allow for a slower release of growth factors within treated tissue.
In contrast to standard platelet-rich plasma preparations, PRF forms a fibrin matrix that may be useful in certain tendon, ligament, or soft tissue applications where a more sustained biologic effect is desired.
Selection between PRP and PRF is based on the specific tissue involved, mechanical considerations, and overall treatment goals, rather than a fixed protocol.
In contrast to standard platelet-rich plasma preparations, PRF forms a fibrin matrix that may be useful in certain tendon, ligament, or soft tissue applications where a more sustained biologic effect is desired.
Selection between PRP and PRF is based on the specific tissue involved, mechanical considerations, and overall treatment goals, rather than a fixed protocol.
In some cases, persistent knee pain is influenced not only by joint or soft tissue structures, but by irritation or sensitization of small peripheral nerves contributing to symptoms.
When identified, treatment may be directed toward these nerve interfaces using platelet-rich fibrin (PRF) placed under ultrasound guidance.
This approach is designed to support the local biologic environment surrounding the nerve rather than suppress or destroy it.
This is considered selectively, based on clinical findings, and is integrated with treatment of the primary structural source of pain rather than used as an isolated or protocol based intervention.
For patients seeking knee arthritis treatment in Southlake, Bone Marrow Aspirate Concentrate (BMAC) may be considered in carefully selected cases of moderate to advanced degenerative joint disease.
BMAC involves the use of autologous bone marrow–derived cellular components and is considered only after comprehensive evaluation, imaging review, and discussion of realistic expectations.
This option may be appropriate when conservative therapies have not provided durable relief and when joint structure remains suitable for biologic intervention.
Treatment decisions are individualized and guided by clinical findings, functional goals, and long-term joint preservation strategy.
Most patients do not need another injection.
They need a better diagnosis.
The consultation is designed to determine exactly which structures are generating symptoms and why previous treatment has not provided lasting relief.
Evaluation includes:
• Review of prior imaging
• Dynamic ultrasound examination
• Assessment of tendons, ligaments, bursae, nerves, and joint structures
• Functional and biomechanical assessment
• Identification of the primary pain generator
If you are unsure whether your knee pain is appropriate for this approach, you may text directly to discuss your situation.
Text Dr. Bernhardt