As joint wear increases, many people are faced with 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 come into focus in recent years as potential alternatives. These therapies utilize the body's own healing forces 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" arthrosis, where the joint is painful due to friction.
• Autologous blood therapy (ACP/PRP) is based on concentrated platelets that are rich in growth factors. These stimulate tissue regeneration, alleviate inflammation, and promote cell renewal, which can be helpful in pain relief.

Areas of application and effectiveness in advanced osteoarthritis

The two treatment modalities show promising results in mild to moderate osteoarthritis. In advanced stages, however, the successes are often limited:

• Knee osteoarthritis: Studies have shown that hyaluronic acid and PRP can slow the progression of osteoarthritis and alleviate symptoms in moderate osteoarthritis. However, in cases of severely damaged cartilage, its effectiveness decreases.
• Hip osteoarthritis

When is an endoprosthesis a better solution?

In cases where cartilage wear is already far advanced, hyaluronic acid and autologous blood therapy can usually only alleviate pain in the short term. Signs that an endoprosthesis might be more useful include:

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

Study situation on efficacy and sustainability

• Long-term studies on hyaluronic acid show that patients with moderate osteoarthritis benefit the most from it. The positive effect is usually limited to about 6–12 months, after which the efficiency 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 strongly dependent on the severity of the osteoarthritis.

Benefits and risks of the individual methods

• Hyaluronic acid: Easy to apply and well tolerated, but with limited effect in advanced osteoarthritis.
• ACP/PRP: Shows stronger efficacy in mild to moderate osteoarthritis, but is more complex to administer and more expensive. In advanced stages, its effectiveness is reduced.

When is combination therapy useful?

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. In advanced stages, however, often only an endoprosthesis can provide long-term relief and mobility.

Conclusion: Hyaluronic acid and PRP as an option before endoprosthesis



Hyaluronic acid and ACP/PRP offer a valuable, yet limited, alternative to endoprosthesis for patients in the early to moderate stages of osteoarthritis. In advanced osteoarthritis, patients should weigh, after comprehensive consultation at ENDOPROTHETICUM, whether joint replacement is ultimately not the more sustainable solution.