Hyaluronic Acid vs. PRP vs. Cortisone — A Complete Comparison

Three Injections, Three Different Mechanisms

"Which is better—hyaluronic acid or PRP? And what about cortisone?" This is the question I get most often. Each treatment has a different role, and the choice depends on the diagnosis and stage.

Hyaluronic Acid—The Joint Lubricant

What it is: a natural substance in synovial fluid, administered by direct injection.

How it works: restores the viscosity of the synovial fluid, reduces friction, and cushions impact.

Best results: stage II-III knee osteoarthritis. Can also be used for the hip, shoulder, and ankle.

Protocol: 1 injection or 3 injections one week apart. Repeated every 6-12 months.

Takes effect in: 10-14 days. Lasts: 6-12 months.

Advantages: well-studied, predictable effect, excellent tolerance.

Limitations: does not repair or regenerate. Does not work in stage IV.

📄 Brochure: Hyaluronic Acid

PRP—The Biological Growth Factor

What it is: plasma enriched with platelets from your own blood.

How it works: platelets release growth factors that stimulate regeneration and reduce inflammation.

Best results: chronic tendinopathies, stage I-III osteoarthritis, muscle injuries.

Protocol: 1-3 sessions 2-4 weeks apart.

Takes effect in: 2-4 weeks. Lasts: months.

Advantages: 100% biological, no risk of allergy, regenerative effect.

Limitations: results vary between individuals.

📄 Brochure: PRP Therapy

Cortisone—The Inflammation Firefighter

What it is: a synthetic corticosteroid injected into the joint.

How it works: quickly and powerfully reduces inflammation. It does not repair, regenerate, or lubricate—it just puts out the fire.

Best results: acute inflammation episodes, bursitis, acute tendinitis.

Protocol: a single injection. Maximum of 3-4 per year in the same joint.

Takes effect in: 24-72 hours (fast!). Lasts: 4-8 weeks (temporary).

Advantages: rapid effect, useful in acute crises.

Limitations: NOT for long-term use—repeated doses can accelerate cartilage degradation.

When to Use Each—A Practical Summary

• Stage II-III osteoarthritis, chronic pain: Hyaluronic acid ± PRP
• Chronic tendinopathy: PRP
• Acute crisis: Cortisone, followed by HA or PRP
• Stage IV osteoarthritis: neither provides sustained relief → joint replacement

Can they be combined?

Yes. A common strategy: 1) Cortisone in the acute phase, 2) PRP or HA after 2-4 weeks, 3) Physical therapy in parallel.

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