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Knee Arthritis Treatment in Bielefeld

SVF cell therapy and PRP for the knee, hand, shoulder and other joints, used within arthritis care once a doctor has reviewed your tests and case

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Knee joint: regenerative treatment without surgery
Joint treatment without surgery. Free consultation and review of your scans

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What it is

What is arthritis
and when does this treatment fit?

With arthritis, a joint is inflamed. Signs to watch for: pain while resting and at night, morning stiffness lasting more than half an hour, swelling, redness and warmth over the joint. There are several causes — autoimmune conditions (rheumatoid, psoriatic arthritis), gout, infection or an injury from the past.

  • No surgery — an injection instead of an operation
  • Own tissue — your blood and adipose tissue
  • Ultrasound guidance for every injection
Knee joint: an injection under ultrasound guidance

Who the treatment suits

Whether this treatment fits you is a doctor's decision, made after an examination and a scan review

Suitable

A doctor reviews knee X-rays with a patient
  • Pain, crunching or stiffness in a joint
  • Painkillers only help for a short time
  • Recovery after injuries and surgery
  • You need a second opinion on your scans
  • You want to avoid or postpone joint replacement
  • Early or moderate arthrosis or arthritis
  • High load on the joints — sport or physical work

Not suitable

A doctor examines a patient's knee
  • Cancer
  • Pregnancy
  • Blood clotting disorders
  • Acute infections, including infection in or near the joint
  • Flare-up of a serious chronic illness
  • Temporary contraindications: flu, a cold or fever, and skin inflammation over the joint to be treated

Not sure the treatment is right for you?

Leave your number — the coordinator will ask for your scans (X-ray, MRI or ultrasound), and the doctor will tell you whether treatment without surgery suits you.

Find out if it suits me

What we treat

Conditions we treat

How it works

How the procedure goes: step by step

Consultation and scan review1

Consultation and scan review

First comes an examination of the joint and a look at your X-rays, MRI or ultrasound; then the doctor decides whether the procedure fits your case. Existing scans can be sent before the visit.

Blood sample for PRP2

Blood sample for PRP

From a small amount of blood drawn from a vein, platelet-rich plasma with growth factors is prepared later on.

Adipose tissue sample3

Adipose tissue sample

The doctor numbs the area with local anaesthetic and takes about 30 ml of adipose tissue through a puncture on the abdomen or inner thigh; stitches are not needed.

Processing in a centrifuge4

Processing in a centrifuge

A centrifuge spins the sample until it forms layers. The stromal vascular fraction is isolated from them and mixed with platelet-rich plasma.

Injection into the joint5

Injection into the joint

Guided by ultrasound for accurate placement, the doctor injects the prepared material directly into the affected joint.

Follow-up6

Follow-up

No hospital stay and no crutches. Once the procedure is done, the doctor remains in touch and tracks how your joint responds.

Book a consultation

Call or message us — our coordinator will contact you shortly and book your consultation

A doctor talks with a patient about joint treatment
Book a consultation
A doctor talks with a patient about joint treatment

Results

After the procedure

  • Doctor talking warmly with a patient after the procedure

    1 week

    The joint may ache a little more — this is an expected reaction.

  • Doctor consulting an older patient one month after treatment

    1 month

    The pain usually eases.

  • Doctor explaining progress to a patient using a knee joint model

    ~3 months

    Mobility and activity improve.

  • Doctor and patient walking together at a follow-up visit

    ~6 months

    The full effect develops.

How long it lasts differs from person to person and depends on the stage of the condition, body weight, activity and other factors — no one can promise a fixed result.

Comparison

Methods we use

Just your blood and your adipose tissue; donor and synthetic materials are not used

Cell therapy (SVF) from your own adipose tissue

Your adipose tissue, in a small sample, is processed to isolate the stromal vascular fraction (SVF) — a combination of cells engaged in tissue repair. The affected joint then receives it by injection, together with your own plasma.

A doctor explains SVF cell therapy for the knee to a patient on a tablet

In inflammatory arthritis, after the acute flare has passed, it is chosen for how it acts on local inflammation and tissue repair.

Material
Your adipose tissue and plasma
How it is given
Into the joint, under ultrasound
Duration
The whole procedure is done in one day.

PRP — platelet-rich plasma from your own blood

From a small amount of your blood, plasma rich in growth factors and platelets is separated and injected into the joint. It helps to calm inflammation and creates better conditions for repairing tissue.

A doctor explains PRP therapy for joints to a patient on a monitor

It may be recommended for rheumatoid and other inflammatory arthritis as one part of the overall treatment plan.

Material
Your blood from a vein
How it is given
Into the joint, under ultrasound
Duration
The whole procedure is done in one day.

The benefits and timings shown are averaged and given for guidance: the plan and recovery depend on your joint and individual features, and the doctor confirms them at the consultation.

At the consultation the doctor will review your scans and suggest a treatment plan

Free consultation

Book a consultation

Joints

Joints we treat

From large joints to small ones — which joint, which method and how many injections is decided by the doctor once your scans are reviewed

  • KneeKneeCartilage wear, meniscus problems, pain on stairs and after walking
  • HipHipEarly hip osteoarthritis, groin pain, limited rotation
  • ShoulderShoulderPain when lifting the arm, and wear affecting the joint and surrounding tendons
  • ElbowElbowWear of the joint surfaces, and pain after overuse or strain from sport
  • Hand and wrist jointsHand and wrist jointsStiffness with pain in the small joints of the fingers and the wrist
  • AnkleAnklePain and stiffness after sprains and old injuries

Advantages

Why patients choose City Medical Centre

Preserving your own joint, not replacing it, is the goal of our treatment without surgery

Your own tissue

Your own tissue

Just your blood and your adipose tissue; donor and synthetic materials are not used

No crutches

No crutches

No long rehabilitation — just punctures instead of incisions and local anaesthetic

Second opinion

Second opinion

A doctor independently assesses the X-rays, MRI or reports you send — free of charge

Support after the procedure

Support after the procedure

After the procedure we keep in touch and follow the result, not only the day of the injection

About the clinic

A clinic where you can feel at ease

Modern equipment, comfortable rooms and care for every patient

A doctor and a patient at the clinic

Contact us the way that suits you

We will answer your questions and find a convenient time for a consultation

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Request a free call

Price

Arthritis treatment prices

Since the price depends on the joint, the method and the type of arthritis, the doctor gives it after the consultation

FAQ

Joint treatment: frequently asked questions

About the conditions

More about these conditions

Other services of our clinic

Arthritis treatment in Bielefeld: what you should know

The causes of arthritis vary: autoimmune diseases such as rheumatoid or psoriatic arthritis, gout, infection or an old injury. In Bielefeld, the doctor first confirms the type of arthritis, because treatment depends on it.

If you are being treated by a rheumatologist, do not stop your prescribed medication without talking to them. In Bielefeld, regenerative injections are planned together with your ongoing treatment.

Joint inflammation that does not settle? Book a free consultation in Bielefeld: the doctor reviews your case and suggests whether PRP or SVF makes sense now. The price is set individually.

Flares in a city of ridges and rain

Bielefeld sits on the watershed between the Weser and the Ems, and the Teutoburger Wald runs through the city from west-northwest to east-southeast. The terrain has a practical side for someone with inflammatory arthritis. The highest point, Auf dem Polle in Lämershagen, stands at 320 m above sea level, the lowest, Brake, at 71 m, and the Rathaus at 114 m. Daily routes in the city can therefore involve gentle slopes, and a swollen knee, ankle or hip may react to them differently from flat ground. Note this in your records: "uphill, worse" and "downhill, worse" are two different observations, and the doctor can use both when judging which joint is under strain.

The weather is the other recurring question. At the Bielefeld-Deppendorf station the mean temperature is 18.4 °C in July and 2.7 °C in January, with an annual mean of 10.4 °C. Annual precipitation is 822 mm over 194 rainy days, and December (102 mm) and January (93 mm) are the wettest months, while April is the driest at 33 mm. Some people with arthritis say damp, cold weeks make their joints feel worse. A general impression is not evidence, though, and it can be wrong in both directions. The consultation will not assume that rain causes your flares. It will ask whether your own records show a pattern.

Light is part of the same picture. Sunshine averages 4.5 hours a day over the year, but only 1.1 hours in December and 1.2 in January, against 7.8 hours in June. Short winter days tend to reduce outdoor activity, and a drop in activity can itself change how stiff a joint feels in the morning. So when you review a bad stretch, ask whether it coincided with a cold spell, a quiet month indoors, an infection, a missed medication or a stressful week. Usually it is a combination, and the doctor needs to see which factors came together.

Years differ as well. Annual precipitation in the city has ranged from 652.6 mm (2018) to 1,466.2 mm (2023), and annual sunshine from 1,418.4 hours (2013) to 1,918.3 hours (2022). The record high is 39.0 °C (25 July 2019) and the record low −21.3 °C (13 February 2021). Extremes like these are a reason to keep notes over a full year, not a few weeks. A single hot or frozen week proves little, but several seasons of records show whether your joints really track the weather.

A symptom diary the doctor can read in two minutes

The core of arthritis is an inflamed joint, and the signs to record are specific: pain at night or at rest, morning stiffness lasting longer than half an hour, swelling, and a joint that looks red and feels warm. A useful diary captures exactly these, in the same form each day, so that entries can be compared over weeks.

A simple layout works best. Record the date and which joint is affected, left or right. Then note how long the morning stiffness lasted, using the thirty-minute threshold as a reference point. Note whether night pain woke you, and whether the joint looked swollen, red or warm. Add a pain score from 0 to 10, and the time you took any pain medication and whether it helped. Painkillers that only help briefly are worth noting, because the doctor will ask about it.

Add a few lines of context. Record the outside temperature if you like, whether it rained, how long you were on your feet, whether you were ill, and anything unusual you ate or drank. This matters particularly if the cause is uncertain. Arthritis can be autoimmune (rheumatoid or psoriatic), gout, infection or the late result of an old injury, and each type has its own pattern. A hot, sharply painful big-toe joint after a heavy meal tells a different story from symmetrical stiffness in both hands every morning.

Mark flares clearly: start date, end date, and what you did. This matters because the doctor will not act during a severe flare or an active joint infection. PRP and SVF are considered only after the acute flare has calmed. A diary that shows when the joint was last quiet helps identify the right moment. It also helps the doctor tell whether the problem is inflammatory or mainly wear of the cartilage. Osteoarthritis is gradual wear that usually shows up as a dry crunch and aching pain on movement, not as marked redness, warmth and tenderness to touch.

Finally, write down questions as they occur to you. A diary that doubles as a question list makes the consultation much shorter and more focused.

Insurance, specialist access and the role of injections

About 92% of the population in Germany is covered by statutory health insurance. As of 2024, roughly 88% of the working population is insured through statutory funds and about 11% privately. For most people with arthritis, then, the first line of care is the one the insurer organises: a general practitioner, a referral to a rheumatologist, blood tests, imaging and the prescribed medication. A systemic disease such as rheumatoid arthritis belongs with the rheumatologist, and regenerative injections do not replace that care.

The online consultation adds an independent opinion, not a substitute. PRP and SVF injections do not cure rheumatoid arthritis. Once an acute flare has settled, the doctor can assess whether joint injections might ease local symptoms. For psoriatic arthritis the aim is long remission, which means keeping inflammation in check and preventing joint deformity, with regenerative injections as one possible part of the plan.

On coverage, be realistic and ask directly. This text does not say whether your insurer will take on the cost of PRP or SVF. Contact your fund and ask whether it applies to your diagnosis, and ask the coordinator what written documentation the doctor can provide after the consultation. The consultation and review of scans is free and carries no obligation to book anything. The price of treatment depends on the joint, the method and the type of arthritis, and is given after the consultation.

Joint disease is common. About five million people in Germany have osteoarthritis, and about 400,000 hip and knee replacements were performed in 2016. If a joint is already badly damaged, replacement may be the more realistic option, and the doctor will say so honestly after seeing your scans. After an uncomplicated hip replacement, the inpatient stay is usually about six to eight days in most clinics, with follow-up rehabilitation arranged during that stay. Those figures are useful context for a decision that is yours: the aim of the injections is to keep your own joint working and possibly postpone replacement, not to promise that it can be avoided.

Putting your file together for a video consultation

The consultation is online, and coordinators answer 24/7 on WhatsApp and Telegram, with a reply within 15 minutes. The more complete your file, the more the doctor can say in the first conversation. Send what you already have: X-rays, MRI or ultrasound images or reports, and recent blood test results. If you have no scans, the coordinator will tell you which would be useful, and the doctor will say after reviewing them whether treatment without surgery suits you.

Besides imaging, gather the practical details. List your diagnosis as it was given to you, the date you first noticed symptoms and which joints are affected. List all current medications, including anything your rheumatologist has prescribed, and note any injections you have already had. Mention previous injuries and operations, because a long-past injury can be the cause of the inflammation. Add your diary, even if it is only two or three weeks long.

Think about contraindications before the call. The procedure is not done with cancer, pregnancy, blood clotting disorders, acute infections (including infection in or near the joint) or a flare-up of a serious chronic illness. There are also temporary reasons to wait: a fever, a cold or flu, or any skin inflammation over the joint planned for treatment. If you have had a recent infection or any skin problem near the joint, say so at the start. The doctor will postpone treatment or suggest another option.

Choose a quiet spot with a good connection and a camera angle that shows the joint. Wear clothing that lets you expose the knee, hand, shoulder or ankle, and be ready to show how far you can bend, rotate or raise it. Being able to demonstrate morning stiffness or the movement that hurts adds real information. Keep your spouse or a relative nearby if you want them to hear the explanation, and have the diary and questions in front of you.

What the weeks after an injection look like

If the doctor decides that PRP or SVF suits you, the sequence is concrete. PRP is prepared from a small quantity of blood taken from a vein. For SVF, roughly 30 ml of adipose tissue is taken under local anaesthetic through a single puncture on the abdomen or inner thigh, without stitches. The sample is spun in a centrifuge, the stromal vascular fraction is isolated and combined with the platelet-rich plasma, and the material is injected into the joint under ultrasound guidance. Everything is your own blood and tissue, and the whole procedure is done in one day. There are no crutches and no hospital stay.

The timeline given for guidance is gradual. At about one week the joint may ache a little more, which is an expected reaction. At about one month the pain usually eases, at about three months mobility and activity improve, and at about six months the full effect develops. These are averaged figures, and how long the effect lasts differs from person to person. It depends on the stage of the condition, body weight, activity and other factors, and nobody can promise a fixed result.

Your diary becomes more valuable after the procedure. Keep the same entries, so that the one-week ache is recorded as expected and not mistaken for a new flare. Compare the one-month and three-month notes with your baseline: morning stiffness, night pain, swelling, ability to walk on the slopes of the Teutoburger Wald or to grip with the hand. The doctor stays in touch after the procedure and follows how the joint responds, so these records give the follow-up conversation something concrete to work from.

For people who like to be active, the city offers a long outdoor option in the Hermannsweg, a 156 km hiking trail along the Teutoburg Forest ridges, and a bike racing track, the Radrennbahn Bielefeld. These are mentioned only as reference points for how much load a joint might face. Ask the doctor what level of activity is sensible for your joint and your stage, and do not decide it by yourself during a flare.

Does Bielefeld's damp, cool climate make arthritis flares more likely?

The records show a wet climate: 822 mm of precipitation a year over 194 rainy days, with December and January the wettest months, and a January mean of 2.7 °C. Whether this affects your joints is individual. Some people notice a link and others do not. The reliable way to find out is to log joint symptoms next to the weather over several months, and the doctor can then look at the pattern with you during the consultation.

Winters here have very little sun. Should I tell the doctor about seasonal changes in my joints?

Yes. Average sunshine falls to about 1.1 to 1.2 hours a day in December and January, against 7.8 hours in June. Less daylight often means less activity, which can change stiffness and pain. Record the month, how active you were and how long the morning stiffness lasted, using the 30-minute mark as your reference. Seasonal notes help the doctor judge how stable your joint is before suggesting a moment for treatment.

Will my statutory health insurance cover PRP or SVF injections?

About 92% of people in Germany are in statutory health insurance, but this does not tell us whether a specific fund pays for these injections. Ask your insurer about your diagnosis and the method. The consultation and scan review are free, and the price of treatment is given by the doctor afterwards. Ask the coordinator what written summary can be provided for you to take to your insurer.

I already see a rheumatologist. Do I have to stop that care?

No. PRP and SVF work alongside a rheumatologist's care for a systemic disease and do not replace it. Rheumatoid arthritis is treated by the rheumatologist, and the injections do not cure it. After an acute flare has settled, the doctor can assess whether joint injections may ease local symptoms. Send your current medication list so the doctor sees the whole picture.

How soon after a flare can the treatment be considered?

Not during a severe flare or an active joint infection. The doctor waits until the acute flare has calmed, because the injections are meant to act on local inflammation and tissue repair. A fever, cold, flu or skin inflammation over the joint also means waiting. Your diary showing the dates of the last flare and when the joint became quiet helps the doctor choose the moment.

Which scans should I send, and what if I have none?

Send X-rays, MRI or ultrasound images or reports, plus recent blood test results if you have them. If you have nothing, tell the coordinator, who will say which imaging would be useful. The doctor reviews what you send free of charge and tells you whether treatment without surgery suits you. A second opinion on existing scans is possible at any time.

If my joint is already badly worn, is replacement the only option?

Not necessarily at an early or moderate stage, where injections combined with exercise therapy and physiotherapy can reduce pain and improve movement. If the joint is already badly damaged, replacement may be more realistic, and the doctor says so honestly after seeing the scans. In Germany about 400,000 hip and knee replacements were performed in 2016, and a hip replacement usually means an inpatient stay of about six to eight days.

Can I carry on hiking or cycling around Bielefeld after an injection?

Ask the doctor for advice specific to your joint. After the procedure there are no crutches and no hospital stay, but the joint may ache a little more in the first week, which is expected. Improvement in mobility and activity is described at about three months, and the full effect at about six months. Increase activity gradually and record how the joint responds.