The Sports Docs Podcast
Could something as simple as a 20-minute bike ride improve the quality of platelet-rich plasma?
In this episode of Overtime with The Sports Docs, Drs. Ashley Bassett and Catherine Logan explore an intriguing laboratory study examining whether exercise performed immediately before a PRP blood draw can enhance the cellular composition of platelet-rich plasma.
As biologic therapies continue to expand throughout sports medicine, optimizing PRP has become increasingly important. While most discussions focus on centrifuge systems, platelet concentrations, leukocyte content, and injection techniques, this study introduces another potential variable: the patient.
The authors found that a brief bout of vigorous exercise significantly increased platelet concentrations and mobilized hematopoietic progenitor cells, raising the possibility that exercise could serve as a simple, low-cost strategy to optimize biologic treatments.
In This Episode, We Discuss:
- The fundamentals of PRP and how it works
- Why PRP variability remains one of the biggest challenges in interpreting the literature
- Conditions with the strongest evidence supporting PRP:
- Knee osteoarthritis
- Lateral epicondylitis
- Patellar tendinopathy
- Plantar fasciitis
- The concept of exercise-mobilized PRP
- Differences between plasma-based and buffy coat PRP systems
- Whether higher platelet concentrations actually translate into improved clinical outcomes
- How this research may influence real-world PRP protocols
Study Breakdown
Study Design: Prospective laboratory study
Participants:
20 healthy volunteers (ages 21–45 years)
Exercise Protocol:
- 5-minute warm-up
- 20 minutes of cycling
- Target heart rate: 70–85% of predicted maximum
Blood samples were obtained before and immediately after exercise and processed using two PRP systems:
- ACP System (plasma-based PRP)
- Angel System (buffy coat PRP)
Key Findings
Whole Blood Changes After Exercise
- Platelet count increased approximately 22%
- White blood cell count increased approximately 50%
ACP System
- Platelet concentration increased from approximately:
- 457,000/µL → 562,000/µL
Angel System
- Platelet concentration increased from approximately:
- 2.95 million/µL → 3.77 million/µL
- PRP volume increased
- Hematopoietic progenitor cell concentrations increased significantly
Why This Matters
The study suggests that patient physiology before blood collection may significantly influence the final biologic product.
A brief exercise session may:
- Increase platelet yield
- Mobilize progenitor cells
- Potentially enhance biologic activity
- Provide a low-cost method to optimize PRP preparation
For clinicians performing biologic injections, exercise may become another controllable variable alongside:
- PRP preparation system
- Centrifuge settings
- Leukocyte concentration
- Injection technique
Clinical Pearls
- PRP is not a single product. Composition varies substantially between systems.
- Patient factors may influence PRP quality just as much as centrifuge settings.
- Twenty minutes of exercise increased platelet concentrations in both PRP systems.
- Buffy coat systems demonstrated increased progenitor cell concentrations.
- The clinical significance of these changes remains unknown.
The Big Question
Does exercise-enhanced PRP actually improve patient outcomes?
This study demonstrates changes in laboratory measurements, but it does not tell us whether patients:
- Heal faster
- Experience less pain
- Return to sport sooner
- Demonstrate better tendon or cartilage healing
Future studies are needed to determine:
- Optimal exercise type
- Ideal exercise intensity
- Timing before blood draw
- Which conditions benefit most
Dr. Logan's Clinical Perspective
At the Joint Preservation Center, this study has prompted discussions about incorporating pre-injection exercise into PRP protocols. A simple 20-minute cycling session before blood collection may represent a practical strategy to optimize a patient's own biology before treatment.
While additional evidence is needed, this concept aligns with the broader goal of maximizing the effectiveness of biologic therapies through thoughtful patient preparation.
Take-Home Points
- Exercise before PRP collection significantly increases platelet concentrations.
- Short bouts of exercise may mobilize progenitor cells.
- Patient physiology may influence PRP composition.
- Exercise represents a low-cost, non-pharmacologic optimization strategy.
- More research is needed to determine whether these laboratory changes improve clinical outcomes.
Resources Mentioned
- Episode #161: Platelet concentration and outcomes following PRP for lateral epicondylitis
- Recent Sports Docs episode with Dr. Arianna Gianakos discussing PRP for plantar fasciitis
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Our Hosts:
Ashley Bassett, MD & Catherine Logan, MD, MBA / www.cosportsmedicine.com
From Defect to Comeback: Modern Cartilage Treatment Strategies: Dr. Aaron Krych LIVE at AOSSM 2026
Recorded live from the American Orthopaedic Society for Sports Medicine (AOSSM) Annual Meeting in Seattle, Dr. Aaron Krych joins Drs. Catherine Logan and Ashley Bassett for an in-depth discussion on the rapidly evolving field of cartilage restoration. The conversation explores how treatment has shifted from simply filling cartilage defects to restoring the entire knee joint through comprehensive patient evaluation, biologic innovations, and advanced surgical techniques.
The Evolution of Cartilage Restoration
- Why focal cartilage defects should be viewed as a "whole joint disease"
- Moving beyond isolated microfracture
- The growing importance of correcting alignment, instability, and meniscal deficiency
- Earlier intervention in young athletic patients to preserve long-term joint health
Understanding Natural History
- Why untreated cartilage defects can enlarge over time
- Risk factors for lesion progression and development of secondary cartilage injuries
- Counseling patients on long-term consequences and timing of intervention
Modern Treatment Algorithms
- Why strict size-based algorithms are becoming less relevant
- Patient-specific factors influencing procedure selection:
- Age
- Activity level
- Defect size and location
- Subchondral bone involvement
- Previous surgery
- Overall joint health
Diagnostic Evaluation
- The expanding role of advanced MRI
- When diagnostic arthroscopy remains essential
- Emerging applications of nano-arthroscopy for:
- Preoperative lesion evaluation
- Assessment of graft incorporation
- Evaluation of persistent postoperative symptoms
Single-Stage Cartilage Restoration Techniques
AutoCart
- Single-stage autologous cartilage restoration
- Surgical technique pearls
- Cartilage harvest using GraftNet technology
- PRP/BMAC augmentation
- Technical considerations for successful implantation
Osteochondral Options
- When bone involvement changes the treatment strategy
- Indications for:
- Osteochondral Autograft Transfer (OATS)
- Fresh Osteochondral Allograft Transplantation
- Choosing between autograft and allograft techniques
Alignment Matters
- Why cartilage restoration cannot succeed in an overloaded compartment
- Indications for combining osteotomy with cartilage restoration
- Medial high tibial osteotomy (HTO)
- Distal femoral osteotomy (DFO)
- Benefits of patient-specific instrumentation for osteotomy planning and execution
Lessons Learned
Dr. Krych shares valuable experience on why successful cartilage restoration depends on more than the graft itself.
Key factors influencing outcomes include:
- Proper patient selection
- Mechanical alignment
- Knee stability
- Meniscal integrity
- Patient commitment to rehabilitation
Key Takeaways
- Cartilage restoration has evolved from treating isolated defects to preserving the entire joint.
- Modern decision-making is individualized rather than based solely on defect size.
- Addressing alignment, instability, and meniscal deficiency is often just as important as restoring cartilage.
- Biologic augmentation and single-stage procedures continue to expand treatment options.
- Successful outcomes rely on appropriate patient selection and meticulous surgical technique.
Featured Guest
Dr. Aaron Krych is an orthopedic sports medicine surgeon at Mayo Clinic specializing in cartilage restoration, complex knee preservation, ligament reconstruction, and sports-related injuries. His clinical expertise and research have helped shape many of today's modern cartilage restoration strategies.
Subscribe to The Sports Docs Podcast for conversations with leaders in orthopedic sports medicine, surgery, injury prevention, rehabilitation, and athlete performance.
https://orthopedicnj.com/physicians/ashley-bassett
From Tear to Return to Play: Optimizing Rotator Cuff Outcomes w/ The Sports Docs Live at AOSSM 2026
In this episode of The Sports Docs Podcast LIVE from the AOSSM Annual Meeting in Seattle, Dr. Albert Lin and Dr. JT Tokish join Dr. Ashley Bassett and Dr. Catherine Logan to discuss strategies for optimizing rotator cuff repair outcomes.
The conversation begins with the evolution of the SpeedBridge repair construct and the emergence of the FiberTak SpeedBridge, including the potential advantages of smaller all-suture medial anchors, bone preservation, independent tensioning, and rip-stop techniques.
The discussion then moves into one of the most rapidly evolving areas in rotator cuff surgery: biologic and structural augmentation.
Evolving the SpeedBridge
The SpeedBridge technique has become one of the most established approaches to arthroscopic rotator cuff repair, with more than 15 years of clinical experience supporting its durability.
The group discusses:
How SpeedBridge has changed arthroscopic rotator cuff repair
Footprint restoration and broad tendon-to-bone compression
Load distribution across the repair construct
Long-term clinical outcomes and survivorship
FiberTak SpeedBridge: The Next Evolution
The conversation then turns to the FiberTak SpeedBridge, which incorporates smaller all-suture anchors in the medial row.
There are several potential advantages:
Smaller drill holes and reduced bone removal
Preservation of greater tuberosity bone stock
Potential advantages in revision surgery
Additional fixation points with less disruption of the footprint
Strong fixation and straightforward tensioning
Increased flexibility when treating complex tear patterns
The smaller 2.6-mm FiberTak RC anchor may allow surgeons to maximize fixation while minimizing disruption of the tuberosity footprint.
Tensionable Knotless Anchors and Delaminated Tears
One of the challenges in rotator cuff surgery is that many tears are not simply a single layer of retracted tendon. In delaminated tears, the articular and bursal layers may retract differently.
The team discuss how independently tensionable knotless medial-row anchors allow surgeons to:
Evaluate the entire repair before final tensioning
Independently tension individual limbs
Better reduce different layers of the tendon
Improve control of tissue reduction
Avoid simply forcing multiple layers into one fixed position
The conversation also explores the role of a medial pulley rip-stop, which can distribute forces across a larger area of tendon and potentially decrease suture cut-through in compromised tissue.
The Rotator Cuff Healing Index
The discussion includes the Rotator Cuff Healing Index (RoHI), a scoring system designed to predict the likelihood of healing following rotator cuff repair.
The guests discuss how risk stratification can help surgeons determine when the additional cost and complexity of augmentation may be justified.
Biceps Smash: Turning the Long Head of the Biceps Into an Autograft
One of the most fascinating concepts discussed is the use of the long head of the biceps tendon as an autologous scaffold for rotator cuff augmentation.
Dr. Tokish discusses the development of the Biceps Smash, in which the harvested proximal long head of the biceps tendon is compressed into a flattened graft that can be incorporated into the rotator cuff repair.
Potential advantages include:
Readily available autologous tissue
No additional donor-site morbidity
No immunologic concerns associated with allograft tissue
Highly organized parallel collagen architecture
Potential biologic activity from viable tenocytes
Dermal Allograft and Other Scaffold Options
The conversation then expands to other augmentation strategies- The guests discuss the differences between structural support and biologic integration, as well as the importance of understanding how different scaffold materials interact with the host tissue.
Dermal allograft has accumulated substantial clinical evidence supporting its use in selected rotator cuff repairs, particularly larger and higher-risk tears.
The discussion also addresses concerns surrounding xenograft and synthetic materials, including inflammatory and foreign-body responses.
CuffMend: Simplifying Dermal Allograft Augmentation
For surgeons who elect to augment a repair with dermal allograft, the procedure itself can add complexity and operative time.
The CuffMend system is designed to streamline graft handling and delivery.
The guests also discuss SpeedFlex, which uses pre-sized and pre-sutured ArthroFlex grafts.
Available graft configurations include:
20 × 25 mm and 25 × 30 mm
1-mm and 2-mm thicknesses
Rather than requiring surgeons to prepare and load the graft intraoperatively, the pre-sutured configuration is designed to streamline preparation and reduce variability.
FiberStitch RC Simple
Another innovation discussed is the FiberStitch RC Simple implant for medial graft fixation.
This episode of The Sports Docs Podcast was sponsored by Arthrex.
Sports medicine is a constantly evolving field, with hundreds of new articles published each month on the topic. This ever-growing wealth of information can make it challenging to stay updated on the newest approaches and techniques, and to know which data should actually change your practice.
Join Drs. Catherine Logan and Ashley Bassett
Join Orthopaedic surgeons, Dr. Catherine Logan and Dr. Ashley Bassett, as they chat about the most recent developments in sports medicine and dissect through all the noise. On each episode of The Sports Docs podcast, the hosts will tackle a specific injury – from ACL tears to shoulder instability – and review the top research from various high-impact journals that month, including The American Journal of Sports Medicine, Arthroscopy: The Journal of Arthroscopic and Related Surgery, Sports Health, Journal of Shoulder and Elbow Surgeons, and more. The Sports Docs will also be joined by experts in the field of sports medicine – Orthopaedic surgeons, nonoperative sports medicine specialists, athletes, physical therapists, athletic trainers and others – to provide a fresh and well-rounded perspective based on their unique experiences.
Friends and peers
The Sports Docs – Dr. Logan & Dr. Bassett – are friends & former co-residents from the Harvard Combined Orthopaedic Residency Program, who went onto esteemed sports medicine fellowships at The Steadman Clinic and The Rothman Institute, respectively.
More about Drs. Logan and Bassett
Dr. Logan practices in Denver, CO, and serves as Head League Physician of the Premier Lacrosse League & as a team physician for U.S. Ski & Snowboard. Dr. Bassett is the director of the Women’s Sports Medicine Center at the Orthopaedic Institute of New Jersey and practices across northern NJ, primarily in Morris and Sussex Counties.
Together, they will bring monthly conversations on how to care for athletes of all ages and levels of play, with a healthy mix of cutting-edge science and real-world application.
