Arthrosis or better known as osteoarthritis is a natural degenerative process that can affect all joints. Our joints wear out sooner or later depending on how resilient they are and how much stress they suffer. The result is a degeneration of cartilage. When x-raying 65-year olds and plus, you can find signs of osteoarthritis in almost 70 per cent of the tested persons. This does not automatically implicate that the tested persons feel pain. However, 50 per cent of 60-year olds suffer from typical osteoarthritis symptoms.
Osteoarthritis can also be found in younger people. The first symptom of osteoarthritis is pain when initiating movement for example after a longer time of sitting or lying. When moving the joints again, the patient feels the pain quickly decrease or even vanish. With the progression of osteoarthritis, joint movements become more and more painful, you can hear cracking and crunching sounds in the joints and/or the mobility of a particular joint can be limited.
In a very advanced state of the illness the patient feels pain when resting or during the night, which can prevent him from sleeping well. Moreover, in each phase of the illness the joint can be inflamed or swollen. Some risk factors enhance osteoarthritis and they can speed up the degenerative process in the joints.     
  • Overweight
  • Inflammations
  • Joint misalignment
  • Sports with a high injury rate
  • Professions where heavy goods have to be lifted or carried.
  • Inactivity (due to immobilisation of a joint or or lifestyle)

What can be done?

Which joints can be affected?

Basically all synovial joints of the body can be affected by osteoarthritis. In particular, osteoarthritis problems frequently occur with the bigger joints:  
  • Knee
  • Hip
  • Shoulder

Arthrosis pain in your smaller joints can make your everyday life more difficult:
  • Thumb carpometacarpal joint
  • All other finger joints
  • Toe joints (especially the big toe)
  • Facet joints of the spine

You might also have problems with your:      
  • Elbow joint
  • Upper and lower ankle joint

Bioregenerative Medicine

Bioregenerative medicine is based on the fact that the but contains regenerative factors that can initiate and support healing processes in chronic diseases, arthrosis or injuries. In orthopaedics, blood plasma therapy (PRP) is a very successful cell therapy, which can often be considered in the treatment of arthrosis, e.g. in knee joints, before surgery.
PRP plasma has shown in studies a high density of cytokines, which on the one hand reduce inflammatory reactions, scarring and infections, and on the other hand can support the healing of wounds, bone lesions or soft tissue injuries.
After processing, blood platelets are extracted from the blood, which can release various growth factors with regenerative capacity in the joint or soft tissue.
In osteoarthritis, this inhibits toxic inflammatory reactions to cartilage cells and increases the synthetic activity of the cartilage.

Platelet-rich plasma (PRP)

Platelet-rich plasma (PRP) is a biological product obtained from the patient's own blood, processed in a highly concentrated manner using a special process and injected back into the diseased or injured tissue as an injection solution in order to naturally support the body's own regeneration processes.

As a biological product it is very well tolerated, safe and without allergy risk.
The body's own blood platelets (thrombocytes) contained in the blood contain large amounts of growth factors which can activate or accelerate repair and regeneration processes in the tissue during painful inflammatory processes caused by arthrosis, sports or overload damage.
The injection of platelet-rich plasma (PRP) into joints, ligaments, tendons or muscles is an effective alternative therapy method to inhibit inflammation, relieve pain and improve mobility.


Blood is taken from the arm vein.

The various blood components are separated from each other by subsequent, gentle centrifugation.

The platelet-rich plasma concentrate with the thrombocytes is now extracted with a special filter in the tube.
A completely closed and sterile system ensures safe and sterile processing.

The platelet-rich plasma is then injected with a syringe into the
affected body area (joints, tendons, ligaments or muscles).


  • arthrosis
  • tendon attachment problems (e.g. knee, hand, ankle joint)
  • tennis elbow
  • hamstring problems
  • meniscus disease
  • shoulder complaints
  • heel spur
  • Achilles tendon complaints and many more.

Hyaluronic acid injections

Hyaluronic acid is a natural substance which can be found in the human body wherever moisture is absorbed or when tissue is rubbed . This is for example the vitreous of the eye, the precorneal film (tear film), the cartilage, the synovial fluid, all mucous membranes of the body, but also the basic substance of the skin consisting of 55 per cent of hyaluronic acid. Hyaluronic acid fulfils various functions. It can absorb and save enormous amounts of moisture, it can be a kind of lubricant, but also the transport medium for nutrients. It also functions as a filter or strainer in the synovial fluid and thus prevents the passage of inflammatory molecules.
Under an electron microscope hyaluronic acid looks similar to a plate of spaghetti. A lack of hyaluronic acid in various tissues is rather common. This can lead to annoying pain up to chronic illnesses.
Missing hyaluronic acid can be replaced by biotechnologically produced hyluronic acid and injections can help alleviate pain. This applies for hyaluronic acid products used in ophthalmology as well as in orthopaedics.
Nowadays the highly modern production process can regulate the size of hyaluronic acid molecules precisely. This helps maximising the therapeutic benefit.

How is hyaluronic acid injection administered?

Depending on the affected joint and how far osteoarthritis has progressed, you will be given three to five injections with hyaluronic acid. These injections are administered once a week at your orthopeadist’s.

Knee joint injection

Normally your orthopaedist uses prefilled syringes for bigger joints such as knee, hip and shoulder whereas individually dosed injections are used with the smaller joints, i.e. finger and toe joint. 

Finger joint injection

Toe joint injection

During the treatment you will experience a decrease in pain and an increase in mobility. This treatment with hyaluronic acid may provide pain relief for up to 12 months. If necessary, this therapy can be repeated as often as required. 

What benefit can I expect from a treatment with hyaluronic acid?

Hyaluronic acid is injected into the joint to supplement the synovial fluid. There, it helps the body to re-establish the balance between hyaluronic acid degradation and synthesis.

Orthopäden Nürnberg - Arthrosebehandlung

Knee joint after treatment

The synovial fluid becomes more viscous (semi-fluid) again and can therefore fulfil its lubricating and protective functions much better. The joint cartilage is then relieved by the protective hyaluronic acid layer. The degenerative process is interrupted and the mobility of the joint improves and pain decreases.

What can I do myself?

You should help increase mobility of your joints by making use of the positive effects of the treatment with hyaluronic acid. After consulting your orthopaedist you should start exercising again. If you have osteoarthritis in knee, shoulder or hip joint:   
  • A lot of physical exercise without putting too much stress on your joints (e.g. swimming, walking, bicycle riding)
  • Strengthen your muscles around the affected joint with specific exercises
  • Reduce overweight.

Osteoarthritis in finger and toe joints:
  • Doing your exercises on a regular basis to retain long-term mobility of your joints.
  • Bathe fingers or toes in warm water to relieve pain.
  • Stretch your fingers or toes up to your pain threshold.

Osteoarthritis in your vertebral joints:
  • Train and stretch your trunk muscles (back and abdominal muscles)
  • Relax your aching back muscle by heat treatment (e.g. hot-water bottle)