ACT vs PRP: What's the Difference and Which Is Right for You? | ALIV

Platelet-Rich Plasma (PRP) therapy has become widely available across India in orthopaedic, sports medicine, and aesthetic clinics over the past decade. ALIV's Autologous Cell Therapy (ACT) is a different approach that shares the autologous principle with PRP but differs significantly in source material, cell content, growth factor profile, and clinical applications. Understanding the distinction helps patients make informed decisions about which approach — or which combination — is most appropriate for their specific clinical situation.

PRP: Concentrated Platelet Growth Factors from Blood

PRP is produced by drawing a small volume of peripheral blood (50–100ml) and centrifuging it to separate and concentrate the platelet-rich fraction. Platelets — the blood cells involved in clotting and early wound healing — contain alpha granules packed with growth factors including PDGF, TGF-β, VEGF, and EGF. Concentrating platelets from peripheral blood produces a growth factor-rich preparation that can be injected into joints, tendons, the scalp, or skin to support localised tissue repair and reduce inflammation.

PRP's evidence base is most established for musculoskeletal applications — particularly tendinopathy (patellar, Achilles, lateral epicondyle), osteoarthritis of the knee, and hair restoration for androgenetic alopecia. Multiple systematic reviews support PRP for these conditions, though evidence quality varies between applications and preparation methods. PRP is relatively straightforward to produce (a clinic-based centrifuge is sufficient), and is the most widely available autologous regenerative option in India.

ACT: Cell Populations and Richer Growth Factor Matrix from Bone Marrow or Adipose Tissue

ACT at ALIV uses bone marrow or adipose tissue as its source — these sources contain not just platelets and their associated growth factors, but adult mesenchymal stromal cell populations (which have more potent paracrine regenerative capacity than platelets alone) and a broader growth factor profile including HGF (hepatocyte growth factor, relevant for liver and epithelial repair), IGF-1 (insulin-like growth factor, relevant for metabolic and neurological applications), and neurotrophic factors (BDNF, NGF) from adipose-derived preparations. The MSC populations in bone marrow and adipose tissue have immune-modulatory capacity that platelets do not — they can suppress chronic inflammation more broadly and durably than a platelet concentrate.

This richer biological content makes ACT the more appropriate approach for systemic conditions (neurological disease, metabolic disease, liver disease, COPD) where the therapeutic goal is systemic anti-inflammatory and regenerative signalling beyond what a peripheral blood platelet concentrate can achieve. For localised musculoskeletal applications — a single knee tendon, for example — PRP may be an adequate and more straightforward first-line autologous option. The clinical decision depends on the condition, the goal, and the evidence context. See the broader framework: what is ACT.

When ALIV Recommends ACT Over PRP — and Vice Versa

ALIV uses ACT where the therapeutic goal requires: systemic or multi-site paracrine regenerative signalling; cell populations beyond platelets (MSCs for immune modulation); growth factor profiles broader than peripheral blood can provide; and applications in systemic conditions beyond localised musculoskeletal pathology. PRP remains the appropriate first-line autologous choice for: localised tendinopathy; mild to moderate knee osteoarthritis in younger patients; hair restoration (where scalp PRP has reasonable evidence); and as an adjunct to surgical procedures in appropriate settings. ALIV's specialty PRP programme covers these applications: ALIV PRP and specialty therapy overview.

Is ACT more expensive than PRP?

Yes — ACT is significantly more resource-intensive than PRP and correspondingly more expensive. The bone marrow or adipose harvest requires a minor procedure under local anaesthesia; the processing is more complex and time-intensive; the cell populations being prepared require more sophisticated quality assessment; and the clinical time and expertise involved are substantially greater. PRP can be produced in approximately 30 minutes with basic centrifuge equipment; ACT requires a full laboratory processing protocol over several hours. The cost differential reflects this genuine difference in clinical complexity and resource investment.

Can ACT and PRP be used together?

Yes — in some protocols, PRP is used as a local adjunct alongside systemic ACT, to provide concentrated local growth factors at a specific target site while ACT provides systemic regenerative signalling. This combined approach is used in some ALIV joint protocols where both local cartilage support (PRP) and systemic anti-inflammatory modulation (ACT) are clinically relevant. The appropriateness of a combined approach is assessed at the pre-ACT consultation.

Why doesn't every orthopaedic clinic offering PRP also offer ACT?

The bone marrow or adipose harvest for ACT requires a trained clinical team, a sterile minor procedure environment, and a dedicated cell processing laboratory — considerably more infrastructure than the clinic-based centrifuge required for PRP. The clinical expertise required for the harvest procedure, processing quality assurance, and appropriate patient selection is also significantly greater. These barriers mean that genuine ACT (as opposed to PRP marketed as "cell therapy") is only available in specialist regenerative medicine facilities. ALIV's clinical infrastructure has been built for this purpose since 2015.