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A detailed comparison of four regenerative orthopaedic methods: how they are obtained, what they contain, and what the evidence and limitations are.
1. PRP — platelet-rich plasma
Harvest: 10–60 ml of blood, centrifugation. Contains: platelets and growth factors, no stem cells. Evidence: moderate for knee osteoarthritis and tennis elbow, mixed for plantar fasciitis; in the RESTORE trial in knee osteoarthritis PRP did not outperform placebo. Limitations: the effect is temporary, and product composition varies between systems.
2. SVF — stromal vascular fraction
Harvest: mini-liposuction; cells are isolated with enzymes in a laboratory. Contains: a mixture of fat-tissue cells, including a small number of mesenchymal cells. Evidence: small studies in knee osteoarthritis. Regulation: in the EU, enzymatic processing makes it an advanced therapy medicinal product requiring special authorisation.
3. BMAC — bone marrow aspirate concentrate
Harvest: aspiration from the iliac crest under local anaesthesia. Contains: bone marrow cells, few mesenchymal cells. Evidence: used in osteoarthritis and in avascular necrosis together with core decompression; studies are small and results inconsistent.
4. CGF — concentrated growth factors
Harvest: blood, variable-speed centrifugation producing a fibrin matrix. Contains: platelets and growth factors, no stem cells. Evidence: most data come from dentistry and maxillofacial surgery; in orthopaedics there are few comparative studies with PRP.
Comparison
| PRP | SVF | BMAC | CGF | |
|---|---|---|---|---|
| Source | Blood | Fat (enzymes) | Bone marrow | Blood |
| Stem cells | No | Yes, few | Yes, few | No |
| Harvest invasiveness | Minimal | Moderate | Moderate | Minimal |
| Evidence in orthopaedics | Largest | Limited | Limited | Little data |
| EU regulation | Procedure | Medicinal product | Procedure | Procedure |
How to choose
None of the methods has been shown to restore cartilage or discs. The choice depends on the diagnosis, stage, previous treatment and budget, and is made by the clinic physician. We send your images to several clinics, and you compare their offers. More in the article PRP and cell-based methods.
Who it is not suitable for and possible risks
Contraindications
- Active infection — at the injection site or systemic, with fever.
- Active cancer or ongoing chemotherapy.
- Blood clotting disorders or a low platelet count. Anticoagulants are discussed with the physician.
- Pregnancy and breastfeeding — the procedure is usually postponed.
- A corticosteroid injection into the same area in recent weeks.
- Severe stage IV osteoarthritis with axial deformity and joint destruction — joint replacement is usually discussed instead.
Possible risks
- Pain and swelling at the injection site for 1–3 days.
- Bruising where blood or fat tissue is taken.
- Rarely, infection. The procedure is therefore performed under sterile conditions with ultrasound or X-ray guidance.
- The effect may be absent or smaller than expected.
If any of these apply to you, mention it in your request. The coordinator will check with the clinic physician whether treatment is possible. Contact a coordinator.
Scientific evidence
Studies of regenerative methods show mixed results. Clinic physicians rely on research including the following:
- Sheth U et al. Efficacy of autologous platelet-rich plasma use for orthopaedic indications: a meta-analysis. J Bone Joint Surg Am, 2012.
- Pas HI et al. Stem cell injections in knee osteoarthritis: a systematic review of the literature. Br J Sports Med, 2017.
Next steps: Treatment methods · Treatment cost · How treatment in Germany is organised
Frequently Asked Questions
RegenPAS is a patient service centre in Munich, not a clinic. We review your images and symptoms and send a request to several partner clinics at once. Clinics that can accept you send their own conditions and price; prices differ between clinics, and you choose the option that suits you. The coordinator replies within 24 hours, and a clinic physician’s preliminary opinion follows in 1–3 business days. We then arrange the appointment, visa invitation, interpreter, transfers and accommodation. Treatment decisions are made by the clinic physician. Contact a coordinator.
Your MRI (or CT, X-ray) report and the images if you have them, plus a short description of your symptoms and previous treatment. Send them via the form on the website — the assessment is free and without obligation: the coordinator replies within 24 hours, and the clinic physician’s preliminary opinion follows in 1–3 business days.
The cost depends on the method, the diagnostics needed and the clinic itself: prices differ between clinics. We request offers from several clinics and send you their conditions and quotes so you can compare. Price guidance is on the treatment cost page. For an outpatient procedure, 2–3 days in Munich are usually enough: examination, procedure and follow-up visit.
Clinic and method matching — free of charge
Describe your case and attach your MRI report. We will identify clinics that use the relevant methods and forward your request to them. No obligation; we reply within 24 hours.
Send a request
