Osteoarthritis — regenerative treatment

Want to dive deeper into pathogenesis, Kellgren–Lawrence stages and differences from arthritis? Complete guide to osteoarthritis — educational longread with decision tree.

Joints

Knee (gonarthrosis)

The most common case. Pain when climbing stairs, standing up from a chair, squatting. Whether regenerative treatment is an option in this condition is assessed by the clinic doctor.

→ Knee osteoarthritis treatment

Hip (coxarthrosis)

Pain in the groin, buttock, anterior thigh. Limited rotation. Regenerative treatment — intra-articular injection under ultrasound guidance.

→ Hip osteoarthritis treatment

Shoulder (omarthrosis)

Pain and limited arm elevation. Often accompanies rotator cuff damage. Combined protocol with regenerative products.

→ Shoulder osteoarthritis

Hand (rhizarthrosis, Heberden/Bouchard nodes)

Osteoarthritis of the 1st carpometacarpal joint — "hurts when I hold things". Ultrasound-guided injections into the joint space.

→ Hand osteoarthritis treatment

Foot and ankle (hallux rigidus)

Often post-traumatic. Whether regenerative treatment is an option in this condition is assessed by the clinic doctor.

→ Foot osteoarthritis treatment

Spine (spondyloarthrosis)

Facet joints — a source of chronic low back and neck pain. Targeted CGF injections into facet joints under ultrasound guidance.

→ Spine treatment

Osteoarthritis: treatment options and what is known about them

The treatment plan is made by the clinic doctor after an examination and a review of your images. The table shows the options usually discussed for this diagnosis and how well they have been studied.

Option	What to expect	How well studied
Exercise therapy and physiotherapy	Reduces pain, strengthens muscles, improves function; the basis of treatment	Well studied, recommended
Load management, weight loss	Takes load off the affected area; if overweight, losing 5–10% noticeably reduces pain	Well studied, recommended
Painkillers and NSAIDs	Ease pain during flare-ups; long-term use is limited by side effects	Moderate evidence
Corticosteroid injection	Quickly reduces inflammation and pain, the effect is often temporary; frequent injections are undesirable	Moderate evidence
Hyaluronic acid	Reduces pain for a few months in some patients	Limited or conflicting evidence
PRP / CGF	Concentrate from your own blood; may reduce pain, growth of new tissue has not been shown	Limited or conflicting evidence
BMAC / MFAT	Cell preparations from bone marrow or fat; more expensive, no proven advantage over PRP	Little data
Surgery — the type depends on the diagnosis	If conservative treatment does not help or there is an indication	When indicated — the doctor decides

We send your request to several partner clinics. Some will suggest conservative treatment or injections, others surgery; each clinic quotes its own conditions and price. We help you compare the options.

Regenerative methods: realistic expectations

In osteoarthritis, regenerative injections can reduce pain and improve function for a period of several months to a year. PRP in knee osteoarthritis is the best studied: in a number of trials it reduced pain more than hyaluronic acid, but not in all of them. Restoration of damaged cartilage has not been shown. Cell-based methods (BMAC, MFAT) are less well studied and more expensive. Exercise and weight control remain the basis of treatment — injections add to them rather than replace them.

When surgery is discussed. Surgery is discussed when marked pain and restricted movement do not improve after 3–6 months of conservative treatment, and in advanced stages with deformity.

If an injection helps, the effect usually builds up over 6–12 weeks, and the result is assessed after 2–3 months. No clinic can guarantee a result.

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:

Next steps: Treatment methods · Treatment cost · How treatment in Germany is organised

Frequently asked questions

Can osteoarthritis be stopped?

Reversing advanced cartilage loss is not possible, but slowing or halting progression is achievable. At stages I–II, partial cartilage restoration is possible with regenerative methods (PRP, CGF, MFAT).

At which stage does regenerative treatment help?

Best effect at stages I and II. At stage III — pain reduction and slowing of progression. At stage IV — joint replacement is usually indicated.

How many sessions are needed?

Typically 2–4 sessions every 2–4 weeks. Advanced stages may require 3–5 sessions and combinations of products.

Can multiple joints be treated at once?

Yes, if total invasiveness is acceptable. The plan is always tailored individually.

How does RegenPAS help organise treatment?

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.

What is needed for a preliminary assessment?

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.

How much does treatment cost and how long do I need to stay in Munich?

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.