Autologous Blood Therapy for Osteoarthritis
PRP and ACS, depending on the stage and joint
Osteoarthritis does not progress the same way in all patients. Early-stage cartilage damage requires different active ingredients than an acutely inflamed joint. In my private practice in Kronberg, I use leukocyte-poor White PRP, leukocyte-rich Red PRP, or autologous conditioned serum (ACS, also known as “bio-cortisone”) in a targeted manner based on the findings and the condition of the joint. All preparations are produced from the patient’s own blood components using the IMPACT® Platform and are administered under ultrasound guidance to all areas of the musculoskeletal system.
Key Points at a Glance
Autologous Blood Therapy for Osteoarthritis: Key Points at a Glance
What is osteoarthritis?
Degenerative cartilage breakdown in the joints, commonly affecting the knee, hip, shoulder, or ankle. It leads to pain, stiffness, and limited mobility.
Which type of PRP is used to treat osteoarthritis?
Depending on the stage and condition of the joint: White PRP (anabolic, regenerative) for early cartilage damage; Red PRP (catabolic, anti-inflammatory) for chronic inflammatory processes; ACS (autologous conditioned serum) for acutely active osteoarthritis.
How many sessions?
Typically, 3 injections spaced about 1 week apart. Duration of effect: based on experience, 6–12 months.
How much does the treatment cost?
270 € per preparation, plus the GOÄ injection fee. Approximately 70% of private health insurance plans cover the costs.
Which joints?
Knee, hip, shoulder, ankle, and wrist—ultrasound-guided and precisely targeted at the target tissue.
IMPACT®
Autologous Cell Therapy
Manufactured using the IMPACT® Platform, approved under the German Medicines Act (AMG)
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AGA-Certified Surgeon
Certified by the Society for Arthroscopy and Joint Surgery
FOCUS Recommendation 2026
Recommended Doctor in the Hochtaunuskreis Region
Patient Reviews
Rated by patients on jameda.de
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DIN ISO 9001
Certified Quality Management at the Practice
What Happens in a Joint with Osteoarthritis
Osteoarthritis begins in the cartilage. The protective layer that covers the joint surfaces breaks down due to age, stress, misalignment, or a combination of these factors. Without this cushion, the bone surfaces rub against each other; the body responds with inflammation, which accelerates cartilage breakdown, and this breakdown triggers further inflammation. This cycle is self-perpetuating.
What many people don't know is that cartilage tissue is virtually avascular in adulthood. It has no blood vessels of its own and receives nutrients only through the synovial fluid. Repair substances hardly reach it at all. This makes osteoarthritis a condition that the body has a hard time managing on its own.
Cortisone reduces inflammation in the short term and provides rapid relief. This is often helpful in acute situations. However, according to current research, cortisone does not affect the underlying cartilage degeneration, and there is evidence that repeated use can damage cartilage. For this reason, cortisone is generally not used as a long-term treatment in orthopedics.
This is where autologous cell therapy comes in. It delivers concentrated, body-derived active substances directly into the joint—whether regenerative or anti-inflammatory—depending on what the diagnosis calls for.
Preparations
Three formulations, one principle: the right remedy for each specific diagnosis
The choice of preparation is crucial in autologous blood therapy for osteoarthritis. In my practice, I offer three options, which I select based on clinical findings, imaging results, and the condition of the joint.
White PRP – low-leukocyte plasma (anabolic, regenerative)
White PRP contains a reduced number of leukocytes. It has an anabolic effect: The concentrated growth factors can support repair processes in cartilage tissue without causing additional inflammation. White PRP is my first choice for:
- Early-stage osteoarthritis (Grades 1 and 2) with cartilage that is still present but damaged
- Joints that need support to heal but are not acutely inflamed
- Sports injuries involving cartilage that require regeneration
Red PRP – platelet-rich plasma (catabolic, anti-inflammatory)
Red PRP contains a higher concentration of white blood cells. It has a catabolic effect, which may be the appropriate strategy in cases of chronic inflammation: It triggers a controlled, new healing response in the body that can break the vicious cycle of inflammation. Red PRP may be considered for:
- moderate osteoarthritis with active inflammation
- Joints for which conservative treatments have provided relief but have not offered lasting relief
- Transitional situations between regenerative and anti-inflammatory demands
ACS – autologous conditioned serum (the “bio-cortisone”)
ACS is the most complex of the three procedures. In a multi-step process, highly concentrated levels of the body’s own anti-inflammatory substances—primarily interleukin-1 receptor antagonists—are extracted from the drawn blood. The anti-inflammatory effect can be comparable to that of a cortisone injection, but it comes exclusively from the body’s own material and can be administered without the known side effects associated with repeated cortisone use. ACS is indicated for:
- Acute, active osteoarthritis with joint effusion, heat, and severely limited mobility
- Patients who no longer wish to receive cortisone injections or who have received them repeatedly
- Situations in which a rapid anti-inflammatory effect is needed
I will determine which treatment is appropriate for you based on your test results, ultrasound images, and clinical examination. In some cases, a combination or sequential therapy is the best approach—for example, starting with ACS to control inflammation and then following up with White PRP to support regeneration.
Joints
Joints for which I use autologous blood therapy to treat osteoarthritis
Osteoarthritis can affect any joint. How a joint responds to autologous blood therapy depends on the stress it is under, its blood supply, and the stage of cartilage damage. The smaller or deeper a joint is, the more important it is to use ultrasound guidance to ensure that the preparation reaches the target tissue safely.
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Knee Osteoarthritis (Gonarthrosis)
The large joint most commonly affected. White PRP for early stages, Red PRP or ACS for advanced osteoarthritis. Detailed information is available on the subpage.
Hip Osteoarthritis (Coxarthrosis)
Ultrasound-guided injection into the hip joint to ensure precise placement at the target tissue, which cannot be reliably achieved without imaging. Solution to be used based on findings: White PRP or ACS.
Shoulder Osteoarthritis (Omarthrosis) and the Shoulder Joint
Depending on the findings, osteoarthritis and active inflammation in the shoulder joint may respond to White PRP or ACS. This should be distinguished from calcific tendinitis and rotator cuff problems.
Ankle Osteoarthritis (OSG Osteoarthritis)
Subject to high biomechanical stress and poor blood supply. The ankle joint responds to PRP in a similar way to the knee. Early- and mid-stage conditions benefit particularly.
Wrist Osteoarthritis
Small joint space, thin layer of cartilage: Injections into the wrist can only be performed reliably under ultrasound guidance. Choose the appropriate preparation based on the findings: White PRP for early-stage cartilage damage, ACS for active osteoarthritis with swelling.
Procedure
Here's how treatment works at my practice
The production of autologous cell therapies under the German Medicines Act requires regulatory approval. My practice has obtained this approval from the Darmstadt Regional Council. All production steps, quality standards, and hygiene requirements are therefore government-certified. Not every practice that offers PRP or ACS has this approval.
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Blood draw
Approx. 10–15 ml of blood from a vein in the arm. From that point on, the blood remains in a closed, sterile system.
Fully automated processing with the IMPACT® Platform
The IMPACT® Platform processes blood fully automatically. A built-in optical sensor precisely identifies the blood fractions and controls the separation process without manual intervention. Depending on the clinical decision (White PRP, Red PRP, or ACS), different fractions are concentrated. The result is a highly concentrated, autologous preparation.
Ultrasound-guided injection into the joint
The prepared solution is injected directly into the affected joint under ultrasound guidance. Ultrasound guidance ensures that the solution reaches the target tissue precisely and does not end up in the periarticular fat or the joint capsule. Especially for the hip and shoulder, this cannot be done reliably without imaging.
The entire treatment takes about 45–60 minutes. Afterward, I recommend resting the treated joint for the rest of the day.
For more information on the IMPACT® Platform: autologe-zelltherapien.de
Medical assessment
Why, as a surgeon, I make a careful distinction between the different preparations
As an orthopedic surgeon, I perform joint surgeries: arthroscopies, cartilage procedures, and, when necessary, preparatory procedures for joint replacement. I am familiar with the process leading up to surgery, and I understand its consequences: rehabilitation, risks, and my patients’ realistic expectations following joint replacement.
If I decide to use autologous blood therapy, I don’t take a one-size-fits-all approach. A knee with early-stage osteoarthritis that still responds to regenerative stimuli requires a different clinical approach than an acutely inflamed hip joint with effusion, where the inflammation must first be controlled before regeneration can even be considered.
In cases of chronic osteoarthritis that do not improve sufficiently despite physical therapy and conservative treatment, my clinical experience has shown that PRP and ACS are effective additions to existing therapy for some of these patients. My goal is not to avoid surgery at all costs. My goal is for you to make the right decision for your joint, based on your medical findings.
If surgery has already been recommended and you are unsure, seeking an independent second opinion can be a sensible first step. Learn more about getting a second opinion before orthopedic surgery
Patients from Frankfurt, Bad Homburg, Bad Soden, Wiesbaden, Bad Nauheim, Königstein, and the Hochtaunus district come to me with exactly these questions. I carefully review the test results and explain whether a medication is appropriate in your case—and, if so, which one.
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Costs
Costs and Coverage
Depending on your plan, private health insurance providers may cover all or part of the costs. We will provide you with a claim form in advance so that you have complete transparency regarding costs before treatment begins.
The production cost per preparation (White PRP, Red PRP, or ACS) is €270; in addition, there are medical fees in accordance with the GOÄ for the ultrasound-guided injection. Self-pay patients are welcome.
Autologous blood therapy is an individualized health service (IGeL). For some indications, conclusive scientific evidence in accordance with the criteria of evidence-based medicine is still pending. Individual treatment outcomes may differ from the results of published studies.
Dr. Braune's practice is a private practice and is open exclusively to private patients and self-pay patients.
Schedule an appointment now for osteoarthritis treatment in Kronberg
Patients from Frankfurt, Bad Homburg, Königstein, and throughout the Hochtaunus district come to my private practice in Kronberg im Taunus for autologous blood therapy. Appointments are often available on short notice.
