March 19, 2026
Author: Dr. Alexandru Grecu — Senior Orthopedic and Trauma Surgeon
Medically reviewed by Dr. Alexandru Florian Grecu, Senior Orthopedic Surgeon · Published: March 19, 2026 · Updated: 2 mai 2026
PRP (platelet-rich plasma) therapy has become one of the most discussed treatments in orthopedics. Patients frequently ask me if it's "worth it," if it "really works," and if it's a real alternative to surgery. The short answer: it depends on the situation. The long answer is in the article below.
PRP stands for Platelet-Rich Plasma. It's a concentrate prepared from the patient's own blood. A small amount of blood (usually 15-30 ml) is drawn, centrifuged to separate its components, and a concentrate with a platelet density 3-7 times higher than normal blood is obtained.
Platelets contain growth factors that stimulate the body's natural healing processes: tissue regeneration, inflammation reduction, and collagen production stimulation. This is precisely why PRP is used in regenerative orthopedics.
The entire procedure takes about 30-45 minutes and is performed in the medical office, without general anesthesia and without a hospital stay.
The steps are as follows: venous blood is drawn from the arm (like for a regular blood test), the blood is centrifuged for 5-15 minutes to separate it, the platelet-rich fraction is extracted, and the resulting PRP is injected into the affected joint under ultrasound guidance. Ultrasound guidance is not mandatory, but I prefer to use it for placement accuracy. The injection pain is minimal — comparable to a regular injection. After the procedure, the patient goes home on their own two feet.
PRP yields the best results in the following situations: early to moderate knee osteoarthritis (grades I-III Kellgren-Lawrence), patellar tendinopathy (jumper's knee), partial collateral ligament injuries, patellar chondromalacia, and as an adjuvant therapy post-arthroscopy (to accelerate healing).
PRP is not a magic solution and does not work equally well in all cases. I do not recommend it for: advanced osteoarthritis (grade IV), where the cartilage is completely destroyed — in these cases, a knee replacement is the correct solution; active rheumatoid arthritis; joint infections; tumors in the joint area; or severe coagulation disorders.
The scientific evidence is growing, but not unanimous. Here's what we know at this time:
Several meta-analyses (studies that synthesize the results of other studies) show that PRP is more effective than placebo and hyaluronic acid in relieving pain for patients with mild to moderate knee osteoarthritis, at a 6-12 month follow-up.
A study published in the American Journal of Sports Medicine reported that patients with knee osteoarthritis treated with PRP had significantly better pain and function scores than those treated with hyaluronic acid at a 12-month follow-up.
On the other hand, the effects are variable from one patient to another, and the benefit in advanced osteoarthritis is minimal. PRP does not regenerate destroyed cartilage — it modulates inflammation and can slow the progression of the disease.
This is a common question. The two treatments have different mechanisms. Hyaluronic acid acts as a joint "lubricant" — it supplements the degraded synovial fluid and improves the gliding of joint surfaces. The effect is predominantly mechanical and symptomatic. PRP acts biologically — it stimulates tissue repair processes through growth factors.
In my practice, I choose between the two based on the clinical situation. Hyaluronic acid is a good option for rapid symptom relief, especially for patients with moderate osteoarthritis who want a simple solution. I prefer PRP for younger patients with early osteoarthritis, where the goal is not only to relieve symptoms but also to slow progression. I sometimes combine them, a few weeks apart, for a synergistic effect.
The standard protocol I recommend is 1 to 3 injections, spaced 2-4 weeks apart. The effect builds gradually, with maximum improvement seen 4-8 weeks after the last injection. The duration of the effect varies: between 6 and 18 months, depending on the severity of the osteoarthritis and the patient's lifestyle. The treatment can be repeated annually or as needed.
For the first 48 hours: avoid strenuous physical activity, you can apply local ice if there is discomfort, normal walking is allowed, and do not take non-steroidal anti-inflammatory drugs (ibuprofen, ketoprofen) for the first 5-7 days — they can reduce the effectiveness of PRP.
After the first 48 hours: gradually resume activity, physical therapy if indicated, and joint maintenance exercises.
PRP is a valuable therapeutic tool, but it's not for everyone. It works best when used at the right time, for the right patient, with realistic expectations.
It does not replace surgery when surgery is necessary. It does not regenerate completely destroyed cartilage. But it can provide many months of pain relief and improved function, can postpone or even avoid surgery in correctly selected patients, and has an excellent safety profile — being prepared from your own blood, the risk of allergic reaction or infection is minimal.
If you're wondering if PRP is an option for you, schedule an orthopedic consultation. I will evaluate your clinical case, explain the options, and we will decide on the best treatment plan together.