As joints deteriorate, many people face the decision of whether to improve their quality of life with an endoprosthesis (joint replacement). Hyaluronic acid and autologous blood therapy (also known as ACP and PRP) have emerged in recent years as potential alternatives. These therapies utilize the body's own healing powers and biologically active substances to alleviate pain and improve joint function. But how effective are they really? Can they delay or prevent an endoprosthesis in advanced cases?

How do hyaluronic acid and autologous blood therapy work?

• Hyaluronic acid is injected directly into the joint, where it acts as a lubricant and shock absorber. It can improve joint gliding and reduce inflammation, especially in so-called "dry" osteoarthritis, where the joint is painful due to friction.
• Autologous conditioned plasma (ACP/PRP) therapy is based on concentrated platelets rich in growth factors. These stimulate tissue regeneration, reduce inflammation, and promote cell renewal, which can be helpful in pain relief.

Areas of application and effectiveness in advanced osteoarthritis

Both treatment methods show promising results in mild to moderate osteoarthritis. However, in advanced stages, success is often limited

• Knee osteoarthritis : Studies have shown that hyaluronic acid and PRP can slow the progression of osteoarthritis and alleviate symptoms in moderate cases. However, their effectiveness decreases when cartilage is severely damaged.
• Hip osteoarthritis : Because the hip joint is anatomically located lower and has more sensitive structures nearby, the application of hyaluronic acid or PRP is more complex and carries a certain risk. In advanced cases of hip osteoarthritis, the chances of success decrease, as the tissue is often already too severely damaged.

When is an endoprosthesis the better solution?

In cases where cartilage wear is already advanced, hyaluronic acid and autologous blood therapy can usually only provide short-term pain relief. Signs that an endoprosthesis might be a more sensible option include:

• Persistent pain that also occurs at night and disrupts sleep.
• Limited mobility that restricts everyday activities.
• No or only slight improvement in symptoms after hyaluronic acid or PRP treatments.

Current state of research on effectiveness and sustainability

• Long-term studies on hyaluronic acid show that patients with moderate osteoarthritis benefit most. The positive effect is generally limited to about 6–12 months, after which its effectiveness decreases.
• PRP studies have shown a slightly stronger and longer-lasting effect in moderate osteoarthritis, particularly in the knee joint. The pain-relieving effects can last up to a year, but are highly dependent on the severity of the osteoarthritis.

Advantages and risks of each method

• Hyaluronic acid : Easy to use and well tolerated, but only has limited effectiveness in cases of advanced osteoarthritis.
• ACP/PRP : More effective in mild to moderate osteoarthritis, but more complex and expensive to perform. Effectiveness is reduced in advanced stages.

When is combination therapy advisable?

For patients in the intermediate stages of osteoarthritis, a combination therapy of hyaluronic acid and PRP, or other approaches such as physiotherapy and exercise training, can achieve the best results. However, in advanced stages, often only an endoprosthesis can offer long-term relief and mobility.

Conclusion: Hyaluronic acid and PRP as an option before endoprosthesis



Hyaluronic acid and ACP/PRP offer a valuable, but limited, alternative to endoprosthesis for patients in early to middle stages of osteoarthritis. In cases of advanced osteoarthritis, patients should, after a comprehensive consultation at the ENDOPROTHETICUM, consider whether joint replacement might ultimately be the more sustainable solution.