$11,690 for 20-30% Improvement: My Experience with Fat and Plasma Knee Injections

By Matt Hirschberg, MTI Contributing Writer

I spent just under $11,690 on a pair of knee injections — micro-fragmented fat (MFAT) and platelet-rich plasma (PRP) — hoping to buy myself more time in the mountains. The result? About a 20–30% improvement. Not a miracle, but not nothing either. This is my honest account of that process — what I did, what it cost, how recovery went, and whether I think it was worth it.

I started climbing later than most — and immediately fell in love with it. Mount Hood. Mount Washington. And most recently, Mount Rainier. I was hooked. But every summit brought the same problem: brutal pain in my left knee on the descent. And the bigger the mountain, the worse it got.

I’m 45, and for many, that’s the age when risk tolerance starts to shrink and the wear and tear of decades of use catches up with the body. Most climbers are slowing down. For me, it’s just the beginning, and I plan to keep climbing as long as I can.

This article is my account of that experience and what I’ve learned so far. My hope is that it gives other athletes who “aren’t as young as they used to be” a clearer picture of what to expect, and a reminder that age doesn’t have to mean giving up the things you love.

My regenerative medicine journey began after my Mount Rainier climb when I had an MRI done on my knee. These were the key MRI findings: 

IMPRESSION:

1. Grade 4 cartilage fissuring lateral femoral trochlea, with mild subchondral edema.
2. Grade 2 chondromalacia in the medial patellar facet.
3. Grade 2 chondromalacia medial compartment.
4. Mild edema in the suprapatellar quadriceps fat pad, suggestive of impingement.
5. Minimal effusion within the knee.
6. Minimal medial popliteal cyst.
7. Intraosseous 14 x 14 x 13 mm chondroid-appearing lesion in the mid to distal diaphysis of the femur, suggestive of enchondroma. 

In plain English: my knee has severe cartilage loss in one area (bone-on-bone), moderate damage in others, some swelling with a small cyst and irritation behind the kneecap, plus a small, likely benign bone lesion

There was enough going on to explain the pain—and to make it clear I needed to take action if I wanted to keep climbing. This wasn’t something I could just train my way out of, though I knew there were changes I would need to make on that front as well.

From there, I met with one of the best sports medicine doctors I could find in my area—Dr. Michael Roselli. He had previously served as the Medical Director for Event Medical Services for the NBA, so he knows all about getting athletes back in the game. His recommendation was MFAT and PRP. The goal was to try to regenerate cartilage in the Grade 2 areas and reduce inflammation in the Grade 4 spots. Once you’re bone-on-bone, there isn’t much you can do beyond supporting and strengthening the surrounding tissue.

There were other options on the table. I could have gone the cortisone or hyaluronic acid injection route for short-term relief, or even looked at surgical cartilage grafting procedures like microfracture or autologous chondrocyte implantation. But none of those made sense given my situation. My knee is still structurally sound, and the cartilage degeneration doesn’t cause much discomfort in daily life or during most of my training. The real issue shows up on long mountain descents, so regenerative work with MFAT and PRP felt like the best fit at this stage.

• MFAT (Micro-Fragmented Adipose Tissue): Doctors take a small amount of fat from your own body, process it into tiny fragments, and inject it into the damaged joint. The idea is that these fat-derived cells can help cushion and support healing.
• PRP (Platelet-Rich Plasma): They draw your blood, spin it down in a centrifuge, and concentrate the platelets. Those platelets carry growth factors that can reduce inflammation and signal your body to repair tissue. That concentrated plasma gets injected into the joint.

MFAT provides structure and protection, while PRP boosts the body’s natural repair signals. When used together, they can be a powerful option for athletes trying to extend the life of their joints without going straight to surgery.

The cost isn’t cheap. My MFAT procedure was $8,000, the PRP was $2,850, and physical therapy added another $840 – $11,690 total. None of it was covered by insurance. For me, it was a strategic investment, with the hope that it would extend the life of my knee and delay any need for surgery.

As luck would have it, a good friend of mine, and fellow Rucker, Dr. Trevor Turner is one of the leading experts in regenerative medicine. I gave him a call, and he agreed with the plan to move forward with MFAT and PRP. That sealed the deal for me.

The Procedure

On the day of the procedure, things were surprisingly straightforward. First, they drew blood—about 60 mL—to prepare the PRP. Then they took fat from my lower abdomen (40 mL total), which would later be processed into MFAT. None of this was as bad as it sounds: it was a little uncomfortable, but not painful.

Once everything was processed, Dr. Roselli used ultrasound to guide the injections into the problem areas of my left knee. The PRP went in first, followed by the MFAT. In total, the procedure took only a couple of hours, and then I was headed home with a compression wrap and strict instructions to take it easy.

Here’s a breakdown of what was actually done:

MFAT (Micro-Fragmented Adipose Tissue):

• Harvest site: right and left lower abdomen
• Fat collected: 40 mL total
• Processed into Lipogems: 5 mL injected into each site of the knee

PRP (Platelet-Rich Plasma):

• Blood drawn: 60 mL
• PRP yielded: 5 mL, concentrated to about 7–10x baseline levels
• Platelet recovery rate: ~81% (EmCyte kit)

Injection details (Left Knee):

• 5 mL PRP + 3 mL MFAT into suprapatellar recess
• 1 mL MFAT into medial compartment
• 1 mL MFAT into lateral compartment

Everything was done under ultrasound guidance, and there were no complications. I went home that same day. My knee felt “full,” but the pain was mild enough that I never even touched the prescription pain meds they gave me. From a seated position, I could extend my leg and actually hear the extra fluid squishing around inside the joint, which was kind of wild. That extra fluid also caused the cyst in the back of my knee to flare up, but it went down on its own over the first four weeks. Now the real work began—resting and giving the biologics time to do their thing.

The first couple of days were tough, not because of pain but because of sitting around “taking it easy.” The thought of doing this for the next 4–6 weeks was honestly terrifying. In my early 20s, I was 100 pounds overweight and depressed. Exercise became more than just conditioning for climbing—it was part of my identity, my antidepressant, and my weight management tool. Losing that outlet, even temporarily, felt like a big step backward. So, I did the only “logical” thing: ate my sorrows away and burned through some Netflix. Not smart, I know.

By the following week, I started physical therapy, and that helped a lot. Just getting out of the house and moving again—even a little—got my head back in the game.

One thing I found helpful in reducing inflammation was elevating my feet on a wall or high bed for 20–30 minutes a day. It became part of my routine, and I’ve found it helps recovery in general—especially after a long ruck.

The outline below is what my recovery looked like. This is not a one-size-fits-all plan; my doctors and I built this specifically around my pre-procedure fitness level. 

Recovery Timeline 

Phase 1: Weeks 1–2

• Focus: Reduce inflammation, protect the joint, begin gentle activation.
• PT: Stretching, e-stim, soft tissue work.
• Strength: Very light movements—clam shells, Swiss ball curls, glute medius raises.
• Frequency: 3x/week.

Phase 2: Weeks 3–4

• Focus: Rebuild baseline strength and stability.
• Strength: Progressions of earlier exercises (Swiss ball curls with hips raised, side planks) plus bodyweight upper body (pull-ups, push-ups).
• Frequency: 3x/week.

Phase 3: Weeks 5–6

• Focus: Add controlled cardio and reintroduce climbing.
• Cardio: Walking 2–3 miles.
• Climbing: Light sessions to reintroduce movement and grip endurance.
• Strength: Hip and core work (clam shells, Swiss ball curls with hips raised, glute medius raises), step downs, bodyweight step-ups, calf raises, TRX extensions, side planks, bird dogs, plus bodyweight upper body (pull-ups, push-ups).
• Frequency: 5x/week.

Phase 4: Weeks 7–8

• Focus: Transition back toward sport-specific work with added load and complexity, plus Krav Maga.
• Cardio: Rucking with 20 lbs to reintroduce impact and endurance.
• Krav Maga: Controlled return to training, focusing on movement and technique before intensity.
• Strength: Progressions of earlier movements plus heavier, more functional lifts:
  • Weighted step-ups (16” box, 20 lb pack)
  • Kettlebell deadlifts
  • Band-assisted Nordic curls
  • Kettlebell shoulder press
  • Kettlebell rows
  • Kettlebell Turkish Get-Ups
  • Step downs (increased volume/intensity from Phase 3)
  • Core and stability: push-ups, pull-ups, jackknifes, bird dogs, side plank progressions. 
• Frequency: 5x/week.

Phase 5: Weeks 9–12

• Focus: Build volume and intensity across strength, conditioning, and sport-specific work until I’m back to full strength and conditioning.
• Cardio: Increase ruck mileage, add running, and push intensity toward pre-procedure levels.
• Strength: Maintain the core lifts while adding more dynamic, athletic movements:
  • Trap bar deadlifts (heavier load with joint protection)
  • Multiplanar lunges
  • Kettlebell swings
  • Russian twists
  • Plyometric exercises (jumps, bounds, explosive push-ups)
  • Continued weighted step-ups (progressing load and reps)
• Climbing & Krav Maga: Ramp intensity and frequency to match pre-procedure training.
• Frequency: 6x/week, with increasing workload across all domains.

I’m just starting Phase 5 and still have a ways to go before my strength and conditioning are fully back, but I’m well on my way. Which brings me to the million-dollar question: was it worth it?

My knee isn’t perfect, but it’s measurably better by around 20 to 30 percent. It moves smoother and seems to bounce back faster after training. It might still bother me a bit during step-ups, but it doesn’t swell up and linger for days afterward. For me, that’s a huge win. My hope is that between the MFAT & PRP procedure and smarter training—not getting so caught up in chasing endless step-up targets, and taking a more balanced approach that includes at least a 3:1 step-up to step-down ratio—I’ll be able to keep climbing, and hopefully with less pain, for years to come.

The real test will be the Mexico Volcanoes in January. For me, the answer is yes—it was worth it. I wanted every edge I could get. If you’re on a super tight budget, maybe not. We live in an exciting time, and with the rapid advances in AI, I’m sure regenerative medicine will only get better in the years ahead. Until then, do what you can with what you have—and remember: pain or no pain, we can always take one more step forward. Get some!