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Arthrosis Treatment in Bilbao Without Surgery

SVF therapy and PRP injections for arthrosis in knees, hips and other joints — and a complimentary review of your MRI or X-rays to find the stage

Consultation and review of your scansFree

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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 osteoarthritis
(arthrosis)?

Osteoarthritis, also called arthrosis, is a chronic condition in which the cartilage lining a joint gradually thins and wears away. Cartilage works as a shock absorber; as it breaks down, the bones start to rub against each other, causing pain, stiffness and a smaller range of movement. It is a degenerative rather than an inflammatory disease, although flare-ups with swelling do happen.

  • 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

The doctor decides on suitability once you have been examined and your scans have been reviewed

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: a fever, a cold or flu, or 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

The doctor decides whether the procedure suits you after examining the joint and reviewing X-rays, MRI or ultrasound. Scans you already have can be sent ahead of your visit.

Blood sample for PRP2

Blood sample for PRP

We take a small amount of blood from a vein, which is later used to prepare platelet-rich plasma with growth factors.

Adipose tissue sample3

Adipose tissue sample

Under local anaesthetic, a small portion of adipose tissue (about 30 ml) is taken through a puncture on the abdomen or inner thigh. No stitches are needed.

Processing in a centrifuge4

Processing in a centrifuge

After spinning in a centrifuge, the sample forms layers. The stromal vascular fraction is isolated from them and mixed with the platelet-rich plasma.

Injection into the joint5

Injection into the joint

The doctor injects the prepared material directly into the affected joint, with ultrasound guidance helping place it precisely.

Follow-up6

Follow-up

No crutches, no stay in hospital. The doctor keeps in contact after the procedure and watches 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

Only your own adipose tissue and blood — no synthetic or donor material

Cell therapy (SVF) from your own adipose tissue

The stromal vascular fraction (SVF), a mix of cells that play a part in tissue repair, is obtained by processing a small sample of your adipose tissue. Together with your own plasma, it goes into the affected joint by injection.

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

Its main use is at early and moderate stages of osteoarthritis, to slow the wear of cartilage and lessen friction between the joint surfaces.

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

Plasma rich in platelets and growth factors is separated from a small amount of your blood and injected into the joint. It helps calm inflammation and creates better conditions for tissue repair.

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

For mild osteoarthritis it is often used alone, and with SVF when the effect needs to be stronger.

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

Large and small joints alike. The joint, the technique and the number of injections are chosen by the doctor based on your scans

  • KneeKneePain after walking and climbing stairs, worn cartilage, meniscus problems
  • HipHipEarly hip osteoarthritis, groin pain, limited rotation
  • ShoulderShoulderWear of the joint and nearby tendons, pain when lifting the arm
  • ElbowElbowPain after sports strain or overuse, plus wear of the joint surfaces
  • Hand and wrist jointsHand and wrist jointsPain and stiffness in the small joints of the wrist and fingers
  • AnkleAnklePain and stiffness after sprains and old injuries

Advantages

Why patients choose City Medical Centre

Treatment without surgery — our aim is to keep your own joint, not to replace it

Your own tissue

Your own tissue

Only your own adipose tissue and blood — no synthetic or donor material

No crutches

No crutches

Punctures instead of incisions, local anaesthetic, no long rehabilitation

Second opinion

Second opinion

Send your X-rays, MRI or reports and a doctor will give an independent assessment free of charge

Support after the procedure

Support after the procedure

We remain in touch after the procedure and track the outcome, not merely on the injection day

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

Osteoarthritis treatment prices

Because the cost varies with the joint, the osteoarthritis stage and the method, the doctor names it after the consultation

FAQ

Joint treatment: frequently asked questions

About the conditions

More about these conditions

Other services of our clinic

Everything about arthrosis treatment in Bilbao

For patients from Bilbao, the aim is to keep your own joint as long as possible. The milder the stage, the faster and longer-lasting the effect usually is, and it may reduce the need for regular hyaluronic acid injections.

PRP is often used for mild osteoarthritis, and SVF with PRP when a stronger effect is needed. The method and the number of injections are chosen for each patient in Bilbao after the examination.

The cost of osteoarthritis treatment depends on the joint, the stage and the method, so the price is set at the consultation. For patients from Bilbao, the first consultation and review of your scans are free. Leave your name and phone number to book.

Grey winters and stiff joints: what Bilbao's weather record shows

Bilbao has an oceanic climate. The 1991-2020 normals put January and February at highs of 13.5 °C and 14.2 °C and lows of 5.3 °C and 5.1 °C. That is cool rather than freezing, and snow falls on only 1.7 days a year. The winter is damp and dim instead. Annual precipitation is 1,158 mm over 124.4 days, November is the wettest month at 171 mm, and December and January get only 81 hours of sun each. Average humidity is 71 %, and the very fine drizzle people call sirimiri belongs to the picture.

None of this wears cartilage down. Osteoarthritis is a slow, chronic thinning of the lining of the joint, and it develops over years. Many people with a worn knee or hip nonetheless say the joint feels stiffer and more reluctant after rest in the cold months. If that sounds familiar, it is worth noting when the stiffness appears, how long it lasts, and whether the joint hurts at rest or only on movement. These details help the doctor tell osteoarthritis from an inflammatory joint condition. In osteoarthritis the pain is aching, comes with movement, and brings crunching and stiffness after rest. In arthritis there is pain at rest and at night, swelling, redness and warmth.

The summer figures are the other half of the picture. August and July are the warmest months, with highs of 26.3 °C and 25.4 °C, and they are also the driest, at 52-53 mm of rain. A dry, mild stretch is a practical window for building the habits that help a joint. These are swimming, water aerobics, cycling, Nordic walking and yoga, all of which are gentle on the joint surfaces. Running on hard surfaces, jumping and heavy lifting are the activities to avoid.

If you notice that your symptoms follow the seasons, say so when you write to the coordinator. The doctor will ask about it at the online consultation. It does not change the diagnosis, which still rests on your scans, but it adds to the history.

More than half the adults above normal weight: the load behind knee and hip wear

The Spanish National Statistics Institute's 2020 European Health Survey gives a clear background. Osteoarthritis is the third most common diagnosed chronic problem among people aged 15 and over, reported by 14.4 %. Only high blood pressure (19.0 %) and high cholesterol (15.3 %) rank higher, and low back pain stands at 13.7 %. In other words, joint wear is not a rare complaint that happens to a few people. It is among the most common long-term conditions in the country.

The same survey describes body weight. Obesity affects 16.0 % of adults (16.5 % of men and 15.5 % of women), overweight 37.6 %, and 53.6 % are above the weight considered normal. Weight matters here because knees and hips carry the greatest load, and they are the joints most often affected by gonarthrosis and coxarthrosis. The ankle and the small joints of the hand follow. The treatment described for this condition says plainly that how long an effect lasts depends on the stage, on body weight, on activity and on other factors, and that no one can promise a fixed result.

Weight control is therefore part of any sensible plan. It is not a condition for being heard. The doctor will not turn you away over it. Early diagnosis, weight control, exercise and cooperation with a doctor all make a real difference to how the condition develops.

For people whose weight is high enough to be a health problem in itself, the Spanish public system has its own rules. Its common portfolio of services includes an adjustable gastric band for adults with a body mass index above 40 kg/m2, or above 35 with a significant associated condition, once conservative alternatives such as diet, exercise and behaviour change have failed. That is a separate matter from joint treatment. The coordinator can tell you what we do and do not cover, so you do not have to decide anything alone.

Hills, stairs and a working day on your feet

Bilbao is compact, with an official area of about 40.65 km2 and a mean altitude of only 19 m. The city sits in a river valley, 16 km south of the Bay of Biscay, and it is ringed by two small mountain chains of roughly 400 m. The highest point is Mount Ganeta at 689 m. The Nervión and Ibaizábal rivers join at Basauri to form the Bilbao estuary, about 15 km long.

A flat valley floor with steep slopes around it means that many daily routes mix level walking with climbs and descents. For a knee with worn cartilage, descents and steps are often where the trouble shows first. The description of knee problems in our treatment programme mentions cartilage wear with meniscus trouble and pain on stairs or after walking. If your knee complains on a steep street or a long staircase, that is useful detail for the doctor.

The same is true of load at work and in sport. A high load on the joints, whether from sport or from physical work, is one of the situations in which the treatment is considered. Recovery after injuries and surgery is another. Pain, crunching or stiffness in a joint, or painkillers that help only for a short time, are listed as reasons to ask for a review.

A mixed list of joints can be assessed. The knee is the most common, but the hip (early osteoarthritis, groin pain, limited rotation), the shoulder (pain as the arm goes up), the elbow, the hand and wrist, and the ankle (after sprains and old injuries) are all treated. The doctor determines the joint, the method and the number of injections after looking at your scans.

Some conditions rule the treatment out, at least for now. Cancer, pregnancy, blood clotting disorders, acute infections (including infection in or near the joint) and a flare-up of a serious chronic illness are the permanent reasons. Temporary ones are a raised temperature, a cold or flu, and inflamed skin above the target joint. Tell the coordinator about any of these straight away.

Waiting lists in Spain and the case for a second opinion

The national health system publishes its waiting-time figures, and they are worth reading with your own situation in mind. At the end of 2025, the average wait for a first specialist consultation across the system was 102 days, with 84.42 of every 1,000 people on a list. Traumatology had the longest consultation wait of any specialty, at 132 days.

For joint replacement the numbers are as follows. Hip prosthesis: average wait 98 days, with 13.7 % exceeding the maximum period of 180 days. Knee prosthesis: 105 days, with 15.9 % beyond that limit. Across the whole system the average surgical wait was 121 days, and 21.6 % of patients had waited more than six months. A later correction note exists for these national figures, because of data from Castilla-La Mancha.

The Basque Country looks better than the national average. There were 24,069 patients on structural surgical waiting lists, which is 10.81 per 1,000 inhabitants, and the average wait was 64 days, one of the shortest in the system. In Traumatology there were 6,638 patients waiting for surgery, with an average of 78 days.

These figures describe the public system. They say nothing about the quality of its doctors, and we are not suggesting that anyone avoids it. What they show is that a person with a painful joint may spend weeks or months between a first consultation and any operation. During that time a second, independent look at the X-ray or MRI can be useful.

That is what the free review offers. Send your reports, X-rays or MRI, and a doctor will independently assess them at no charge. The doctor will tell you the stage and say whether treatment without surgery suits you. If the joint is already too damaged, you will hear that frankly: in that case a joint replacement is the more realistic option, and the doctor will say so. The review does not oblige you to book anything, and it does not replace the care you already receive. It can help you put better questions to your own specialist.

How the online route works if you live in Bilbao

The consultation is online, and the coordinators answer round the clock on WhatsApp and Telegram. The first reply normally comes within 15 minutes. You do not need a stack of paperwork. Send what you have: an X-ray, an MRI, an ultrasound report, or blood test results. An X-ray remains the main method and shows the stage. An MRI gives a detailed picture of cartilage and soft tissues, an ultrasound shows inflammation and fluid in the joint, and blood tests help rule out inflammatory diseases.

Doctors usually describe four stages of knee osteoarthritis, from early thinning of the cartilage to severe wear. The injection treatment is most often considered in the early and middle stages. Our programme uses two methods, both from your own tissue, with nothing donor or synthetic:

- **PRP** is platelet-rich plasma separated from a small blood sample taken from a vein. It is often used for mild osteoarthritis.

- **SVF** is the stromal vascular fraction, isolated from roughly 30 ml of adipose tissue collected under local anaesthetic through a puncture on the abdomen or inner thigh, with no stitches. It is blended with the plasma and used chiefly in early and moderate stages.

Both are injected into the joint under ultrasound guidance, and the whole procedure is done in one day. There are no crutches and no hospital stay.

The doctor quotes the cost only after the consultation, because it depends on the joint, the method and the stage. The consultation and scan review are free.

Timing after the procedure is given as an average. In the first week the joint may ache a little more, which is an expected reaction. Around one month the pain usually eases, and by about three months mobility and activity improve. The full effect develops over about six months. Some patients notice early changes at 2-3 weeks. The effect can last several months to several years, depending on the individual, and because osteoarthritis is chronic it needs an ongoing plan, not a one-off injection.

Planning around the calendar in a city with a long festival week

Bilbao's calendar has fixed points. Aste Nagusia, the Semana Grande, runs for nine days from the first Saturday after 15 August. It starts with the chupinazo from the Teatro Arriaga. The week falls in the driest, warmest part of the year, when many people spend long hours on their feet.

If you have a painful hip or knee, it is reasonable to think about such dates when you agree on a plan with the doctor. The doctor will explain what activity is sensible in the first days after the procedure and what to avoid, in line with your joint and your individual features. Do not rely on a generic timetable. Early reaction, relief and recovery all vary, and the doctor confirms them at the consultation.

The university is a different rhythm. The University of the Basque Country has its Bizkaia campus at Leioa, 11 km from the centre, and students and staff move between the two. Whatever your routine, whether a desk, a campus, a workshop or a stand-up job, mention it. The load you put on your joints each day is part of the history.

After the procedure the doctor keeps in touch and follows how the joint responds. Contact does not stop on the day of the injection.

Does the cold, damp Bilbao winter make osteoarthritis worse?

The weather does not cause osteoarthritis, which is slow wear of the cartilage. Some people notice more stiffness after rest in the cooler months, when January and February highs are 13.5 °C and 14.2 °C and humidity averages 71 %. Keep a note of when the stiffness appears and how long it lasts, and share it with the doctor at the online consultation. The diagnosis itself rests on your X-ray or MRI.

How common is osteoarthritis in Spain?

The 2020 European Health Survey by the national statistics institute lists osteoarthritis as the third most common diagnosed chronic problem among people aged 15 and over, at 14.4 %. Only high blood pressure (19.0 %) and high cholesterol (15.3 %) rank higher. It is a widespread condition, so joint pain is worth checking early.

Does my weight affect whether the treatment is suitable?

Weight is not a reason to be turned away. It does affect the load on knees and hips, and the length of any effect depends on the stage, body weight, activity and other factors. In Spain 53.6 % of adults are above normal weight according to the same survey. The doctor will discuss weight control, exercise and a realistic plan after seeing your scans.

Public waiting times for a hip or knee replacement are long in some regions. Can I get an opinion in the meantime?

Yes. Nationally, the average wait is 98 days for a hip prosthesis and 105 days for a knee prosthesis, and in the Basque Country the overall surgical average is 64 days. Whatever your place on a list, you can send your X-rays or MRI and a doctor will review them free of charge. You will hear the stage of the osteoarthritis and whether a non-surgical plan is appropriate. If the joint is badly damaged, the doctor will say that a replacement is more realistic.

My knee hurts mostly on stairs and slopes. Is that relevant?

It is, because pain on stairs or after walking is a typical complaint with cartilage wear and meniscus problems in the knee. Bilbao lies in a valley ringed by hills of about 400 m, so slopes and steps are part of many daily routes. Describe which movements hurt and when. It helps the doctor decide which joint and method to consider.

Which documents should I send, and how?

Send whatever you already have, as photos or files, by WhatsApp or Telegram. X-rays, MRI, ultrasound reports and blood test results are all useful. The coordinator replies round the clock, normally within 15 minutes, and passes everything to the doctor for a free review.

Can I plan the procedure around summer or a festival week?

You can raise it at the consultation. The doctor will explain the expected reaction, with the joint possibly aching a little more in the first week, and what activity is sensible afterwards. Pain usually eases around one month, mobility improves by about three months, and the full effect develops over about six. Timing depends on your joint and your individual features.

Does public health coverage in Spain apply to this treatment?

The Spanish common portfolio of services is set out in Royal Decree 1030/2006. It excludes techniques whose purpose is mere aesthetic or cosmetic improvement, but it covers many treatments for disease. We cannot tell you what your regional service will fund for injections into the joint. Ask your public provider. The consultation with us and the review of your scans are free, and the doctor quotes any treatment cost only after the consultation.