Treatment that works with your own biology
PRP, prolotherapy, bone marrow concentrate and image-guided joint injections — day-care procedures that reduce pain and stimulate repair, often postponing surgery by years.
Written and medically reviewed by Dr. Tarun Baghla, MBBS, MS (Orthopaedics)
Why regenerative treatment exists
Painkillers mask a signal. Surgery removes and replaces tissue. Between those two extremes sits a large group of patients — early arthritis, chronic tendon pain, a stretched ligament — for whom neither is right.
Regenerative therapy targets that gap. By concentrating your own healing factors, or by deliberately provoking a controlled healing response, these treatments aim to change the biology of the tissue rather than simply numb it.
None of it is magic. It will not regrow a joint that is bone-on-bone. Used at the correct stage, in the correct tissue, with the injection actually placed where it needs to go, it can make a genuine difference to pain and function.
- Day-care at the Sector 88 clinic — in and out within a couple of hours
- Local anaesthesia only; no hospital stay
- Autologous (from your own body) — no rejection, minimal allergy risk
- Repeatable, and never burns a bridge to surgery later
PRP — Platelet-Rich Plasma therapy
Platelets are not just for clotting. They carry a dense payload of growth factors that the body releases at every injury site. PRP takes a small sample of your blood, concentrates those platelets several times over, and delivers them precisely where healing has stalled.
Conditions PRP is used for
- Early to moderate osteoarthritis of the knee (grade 1–3)
- Hip osteoarthritis and early AVN, delivered under image guidance
- Tennis elbow and golfer's elbow that has not settled
- Plantar fasciitis (chronic heel pain)
- Rotator cuff tendinopathy and partial tears
- Patellar and Achilles tendinopathy in athletes
- Alongside cartilage or ligament surgery to support healing
What actually happens on the day
Arrival & consent
Nothing special is needed — eat normally, stay hydrated. Anti-inflammatory tablets are stopped 5–7 days earlier as they blunt the effect.
Draw & process
15–30 ml of blood is taken and spun in a closed kit. Takes about 20 minutes.
Injection
The area is cleaned and numbed; the PRP is placed under ultrasound or anatomical guidance. The injection itself takes a couple of minutes.
Go home
Rest for 24–48 hours, ice for soreness, paracetamol only. Back to routine walking the next day.
How many sessions?
Typically 2–3 injections spaced 3–4 weeks apart for arthritis; often a single injection for tendon problems, repeated at 6 weeks if needed.
When will I feel better?
PRP is not instant. Expect mild soreness for 2–4 days, gradual improvement from week 3, and peak benefit at 6–12 weeks. Relief commonly lasts 9–18 months.
Who should not have it?
Active infection, certain blood disorders, very low platelet counts, active cancer, pregnancy, or patients on blood thinners that cannot safely be paused.
PRP works best in early and moderate arthritis. In a grade 4 bone-on-bone knee, it may give short-term comfort but will not restore the joint — and it should not be sold as a substitute for replacement.
Prolotherapy — proliferation therapy
Ligaments and tendons have a poor blood supply. When they are chronically stretched or partially injured, the body's healing response simply stops halfway, leaving a loose, painful and permanently "irritable" structure. Prolotherapy restarts that response deliberately.
How it works
A small volume of an irritant solution — most often concentrated dextrose (sugar water) with local anaesthetic — is injected at the point where the ligament or tendon attaches to bone. This creates a brief, controlled inflammatory response, which recruits the body's repair cells and lays down new collagen. Over several sessions the structure becomes measurably thicker and tighter, and the pain generated by a loose joint settles.
Typically used for
- Chronic mechanical low-back pain and sacroiliac joint pain
- Neck pain from ligament laxity after whiplash
- Recurrent ankle sprains and chronic ankle instability
- Tennis and golfer's elbow
- Knee pain from collateral ligament laxity
- Shoulder instability and painful AC joint
- Early osteoarthritis where surgery is not yet appropriate
Course & response
Usually 3–6 sessions at 3–4 week intervals. Expect a day or two of increased ache after each session — that is the intended reaction, not a complication. Improvement is cumulative rather than sudden, and anti-inflammatory tablets are avoided throughout because they work against the mechanism.
Bone marrow aspirate concentrate (BMAC)
Bone marrow contains mesenchymal stromal cells and a rich mix of growth factors. Marrow is aspirated from your pelvic bone under anaesthesia, concentrated, and delivered to the target site — most commonly the femoral head in early AVN, or a cartilage defect in the knee.
- Combined with core decompression for Stage I–II AVN of the hip
- Used for focal cartilage defects and selected non-unions
- Performed as a short day-care or single-night procedure
- Protected weight-bearing on crutches afterwards, as advised
BMAC is offered selectively, with a clear explanation of the current state of evidence — it is promising in early-stage disease and of little value once the joint has collapsed.
Read about AVN stagingIntra-articular injections compared
Four different agents, four different jobs. Picking the wrong one is the commonest reason patients say "injections did not work for me".
| Injection | What it does | Best for | Onset | Duration |
|---|---|---|---|---|
| Corticosteroid | Powerful anti-inflammatory; switches off a flare | Acute painful swelling, inflammatory arthritis, patients unfit for surgery | 1–3 days | 4–12 weeks |
| Hyaluronic acid (viscosupplementation) |
Restores the thickness and lubrication of joint fluid | Mild to moderate osteoarthritis, especially the knee | 2–4 weeks | 6–12 months |
| PRP | Delivers concentrated growth factors to stimulate repair | Early–moderate arthritis, tendinopathy, partial tendon tears | 3–6 weeks | 9–18 months |
| Prolotherapy | Provokes controlled healing to tighten lax tissue | Ligament laxity, chronic back and joint instability pain | Cumulative over sessions | Often long-lasting |
Why guidance matters
Studies repeatedly show that "blind" injections miss the joint space in a significant share of cases — particularly the hip, which is deep, and a swollen knee where landmarks are distorted. An injection placed into the fat pad instead of the joint does nothing except convince the patient that injections do not work. Ultrasound or fluoroscopic guidance is used wherever it improves accuracy.
The honest limits of steroids
Steroid injections are excellent for calming a flare, but repeated use in the same joint can damage cartilage and raise infection risk around future surgery. As a rule they are limited to roughly three per joint per year, spaced widely, and avoided within three months of a planned joint replacement.
Regenerative therapy questions
Find out whether you are a candidate
Regenerative therapy suits some patients beautifully and is a waste of money for others. A single consultation with your X-rays will tell you which group you fall into.