Not all knee or hip pain requires surgery. Hyaluronic acid and platelet-rich plasma (PRP) injections are office-based treatments that can significantly relieve pain and improve joint function—without general anesthesia, hospitalization, or a long recovery period.
They are valuable options, especially for patients with mild-to-moderate osteoarthritis who do not respond sufficiently to medication and physical therapy, or for those who wish to postpone or avoid a surgical procedure.
The injections are administered during a consultation in the orthopedic office. The procedure takes a few minutes, and the patient goes home immediately.
Hyaluronic Acid — Joint Viscosupplementation
Hyaluronic acid is a substance naturally produced by the body, present in the synovial fluid of every joint. Its role is twofold: it lubricates the joint surfaces and absorbs mechanical forces with every step.
With osteoarthritis, the concentration of hyaluronic acid in the joint decreases. The synovial fluid becomes 'thinner' and more watery, lubrication becomes insufficient, and the unprotected cartilage degrades more rapidly.
Hyaluronic acid injection (viscosupplementation) partially restores the quality of the synovial fluid. Specifically, it involves injecting a hyaluronic acid preparation directly into the joint, where it acts as a lubricant and shock absorber.
Indications: Stage II–III knee osteoarthritis (best results), but also for the hip, shoulder, or ankle.
Results: Improvement is gradual, usually within 10–14 days. In patients who respond, the effect is usually maintained for 6 to 12 months; some patients experience only a modest improvement.
PRP — Biological Therapy from Your Own Blood
PRP (Platelet-Rich Plasma) is a biological therapy obtained from the patient's own blood. After a simple blood draw, the blood is centrifuged to concentrate the platelets—cells rich in growth factors that stimulate tissue repair and regeneration.
Unlike hyaluronic acid (which lubricates), PRP acts biologically: the aim is to stimulate the tissue repair processes and to reduce inflammation.
Indications: Osteoarthritis (knee, hip), tendinopathies (Achilles tendon, epicondylitis, painful shoulder), muscle or ligament injuries, recovery after trauma.
Results: The effects appear progressively, usually within a few weeks, and can last for months. The treatment can be repeated; the risks remain small at each administration.
Hyaluronic Acid vs. PRP vs. Intra-articular Anti-inflammatory. Which is more suitable?
This is one of the most common questions I receive. The short answer: it depends on the situation.
Hyaluronic acid
What it does
Lubricates the joint, absorbs shock
Most effective for
Stage I-II-III Osteoarthritis
When effects are felt
10-14 days
How long it lasts
6-12 months
How many sessions
Usually 1 injection
Strengths
Well-researched, well tolerated; response varies from patient to patient
Limitations
Does not repair cartilage, does not stop osteoarthritis progression
PRP (Platelet-Rich Plasma)
What it does
Stimulates tissue regeneration through growth factors
Most effective for
Osteoarthritis, tendinopathies, muscle injuries
When effects are felt
2-4 weeks
How long it lasts
Variable, lasts for months
How many sessions
1-3 sessions, 2-4 weeks apart
Strengths
prepared from your own blood, which makes the risk of an allergic reaction practically negligible, a biological action on tissue repair processes
Limitations
Results are more individually variable, not all PRP preparations are equivalent
Anti-inflammatory (cortisone injection)
What it does
Rapidly reduces inflammation and pain
Most effective for
Acute episodes of joint inflammation
When effects are felt
24-72 hours
How long it lasts
2-4 weeks (temporary effect)
How many sessions
Maximum 3-4 per year for the same joint
Strengths
Rapid effect, useful in acute flare-ups
Limitations
NOT recommended long-term — repeated doses can accelerate cartilage degradation
Conclusion: Hyaluronic acid and PRP are long-term treatments (medium-to-long term improvement), while cortisone is a crisis treatment (rapid but temporary relief). They can be combined in various formulas: for example, cortisone to calm an acute episode, followed by HA and/or PRP for long-term improvement.
The choice is always made individually, during the consultation, based on the type of condition, the stage of osteoarthritis, and the patient's preferences.
What Injections Cannot Do
It's important to be honest: injections alleviate symptoms, but they do not reverse the process of osteoarthritis or regenerate destroyed cartilage. They are a valuable part of a broader therapeutic plan that includes physical therapy, weight management, and activity modification, as I also explained in the Digi24 feature on choosing the right injection.
When injections are no longer sufficient:
- • Stage IV osteoarthritis — 'bone on bone' on X-ray, with severe deformity
- • Pain persists even after correctly performed injections
- • Joint function is severely compromised
In these cases, the discussion moves to joint replacement:
Transitioning from conservative treatment to surgery is not a failure—it's a natural step in managing advanced osteoarthritis. Between these two moments there is also the stem cell injection, the newest biological option in knee osteoarthritis.
Frequently Asked Questions
Detailed Information — Patient Brochures
I have created two brochures that explain each treatment in detail: how it works, the procedure steps, what to expect afterwards, risks, contraindications, and practical recommendations.