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Comparing PRP and hyaluronic acid
| Hyaluronic acid | PRP | |
|---|---|---|
| What it is | A ready-made product similar to a component of joint fluid | A platelet concentrate from your own blood |
| How it works | Improves lubrication and shock absorption | Growth factors influence inflammation in the joint |
| Course | 1–5 injections, depending on the product | Usually 1–3 injections |
| What studies show | Moderate pain reduction | In a 2021 meta-analysis, on average slightly better than hyaluronic acid after 6–12 months |
| Guidelines | Ratings differ: from a conditional recommendation to none | Ratings differ; OARSI 2019 does not recommend PRP because of inconsistent data |
| Who it will not help | Severe grade 4 osteoarthritis, deformity | Severe grade 4 osteoarthritis, deformity |
How the choice is made
- The basis of osteoarthritis treatment is weight loss, exercise and load management; injections only add to it.
- In early and moderate stages the doctor may offer PRP or hyaluronic acid, taking previous injections and expectations into account.
- If pain did not improve after a course, repeating the same injection usually makes little sense — the plan should be reviewed.
- In grade 4 with deformity and constant pain, joint replacement is discussed.
We send your images to several clinics and help you compare their offers. More on the knee osteoarthritis page.
Scientific evidence
Studies and guidelines this comparison is based on:
- Belk JW et al. Platelet-rich plasma versus hyaluronic acid for knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Am J Sports Med, 2021.
- Bannuru RR et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage, 2019.
- McAlindon TE et al. Effect of intra-articular triamcinolone vs saline on knee cartilage volume and pain in patients with knee osteoarthritis: a randomized clinical trial. JAMA, 2017.
Frequently asked questions about PRP and hyaluronic acid
Can PRP and hyaluronic acid be combined?
Some clinics do this, but there is little convincing evidence that the combination is better than PRP alone.
Do these injections restore cartilage?
No. They can reduce pain and improve function, but they do not restore cartilage thickness.
How long does the effect last?
It varies — from a few months to a year. Some patients see no effect.
Which is cheaper?
Hyaluronic acid is usually cheaper than PRP. We request each clinic’s prices in advance.
How can RegenPAS help?
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.
Choosing an injection for knee osteoarthritis? Send your images — we will compare clinic offers
Send your MRI or ultrasound and describe where and when it hurts. The coordinator replies within 24 hours; a clinic physician gives an opinion in 1–3 business days.
Send images