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Osteoarthritis Treatment in Constanta: Steps and Results

PRP and SVF cell therapy for the knee, hip and other arthritic joints, plus a free X-ray or MRI review to see which stage you are at

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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)?

Arthrosis (osteoarthritis) means slow, chronic wear of the cartilage lining the joint. Healthy cartilage softens impact; when it thins, the bones rub on each other and the joint hurts, stiffens and moves less. Although flare-ups with swelling happen, this is a degenerative disease rather than an inflammatory one.

  • 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

It is up to the doctor, after examining you and reviewing your scans, to decide whether the treatment fits

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 raised temperature, a cold or flu, inflamed skin above the target joint

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 checks the joint, studies your X-rays, MRI or ultrasound and decides if this procedure fits your case. If scans are already done, send them before the visit.

Blood sample for PRP2

Blood sample for PRP

A small amount of blood is taken from a vein. Platelet-rich plasma with growth factors is later prepared from it.

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

Layers form as the sample is spun in a centrifuge. The stromal vascular fraction is isolated and blended with the platelet-rich plasma.

Injection into the joint5

Injection into the joint

Ultrasound guidance allows the prepared material to be injected directly and precisely into the affected joint.

Follow-up6

Follow-up

No crutches and no hospital stay. The doctor stays in touch after the procedure and follows how the 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 material from your body — blood and adipose tissue — no donor or synthetic products

Cell therapy (SVF) from your own adipose tissue

First a small sample of adipose tissue is processed to isolate the stromal vascular fraction (SVF) — cells involved in tissue repair. This fraction, combined with your plasma, is then injected into the affected joint.

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

The typical indication is early or moderate osteoarthritis: the aim is slower cartilage wear and less friction between the surfaces of the joint.

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

The joint receives an injection of plasma rich in platelets and growth factors, prepared from a small amount of your blood. It helps reduce inflammation and creates a better setting for tissue repair.

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

It is often used for mild osteoarthritis, and together with SVF when a stronger effect is needed.

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

We treat large and small joints; the doctor picks the joint, method and injection count once your scans are reviewed

  • KneeKneeCartilage wear, meniscus problems, pain on stairs and after walking
  • HipHipEarly hip osteoarthritis, groin pain, limited rotation
  • ShoulderShoulderPain while raising the arm and wear of the joint and its tendons
  • ElbowElbowWear of joint surfaces, pain after heavy use or sports strain
  • Hand and wrist jointsHand and wrist jointsFinger and wrist small joints affected by pain and stiffness
  • AnkleAnklePain and stiffness after sprains and old injuries

Advantages

Why patients choose City Medical Centre

Our focus is saving your own joint, not replacing it — through treatment without surgery

Your own tissue

Your own tissue

Only material from your body — blood and adipose tissue — no donor or synthetic products

No crutches

No crutches

Punctures, not incisions; local anaesthetic; no prolonged rehabilitation

Second opinion

Second opinion

Your X-rays, MRI or reports are assessed independently by a doctor at no charge once you send them

Support after the procedure

Support after the procedure

We follow the result and keep in touch after the procedure, not only on 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

Osteoarthritis treatment prices

After the consultation the doctor names the cost, which depends on the joint, the stage of osteoarthritis and the method

FAQ

Joint treatment: frequently asked questions

About the conditions

More about these conditions

Other services of our clinic

Osteoarthritis treatment in Constanta: what you should know

Osteoarthritis is not the same as arthritis. Arthrosis is wear of the cartilage; arthritis is inflammation with pain at rest, swelling and warmth. The approach differs, so the diagnosis comes first for everyone in Constanta.

Osteoarthritis treatment in Constanta is not done with cancer, acute infections, blood clotting disorders, during pregnancy or during a flare-up of a serious chronic illness. The doctor checks this at the consultation.

Do not wait until the joint is destroyed. Book a free consultation in Constanta: early and moderate osteoarthritis responds best to treatment. The price is set individually.

Cartilage wear and a city of 263,688 people

Osteoarthritis is the slow, chronic wearing of the cartilage lining a joint. Healthy cartilage softens impact. When it thins, the bone ends rub against each other, and the joint hurts, stiffens and moves less. It is a degenerative disease, not an inflammatory one, although flare-ups with swelling do happen. The knees (gonarthrosis) and hips (coxarthrosis) are affected most, because they carry the greatest load. The ankle and the small joints of the hand follow.

Constanta had 263,688 residents at the 2021 census, down from 283,872 in 2011. The metropolitan area counted 425,916 people in 2011, which is 61% of Constanta County. These figures describe the population, not the incidence of joint disease, and we do not claim a local rate of osteoarthritis. What they do show is that this is the fourth-largest city in Romania and the capital of the county in Northern Dobruja, with a large pool of adults of working age and older. For this group, a question such as "is this stiffness just tiredness, or is it cartilage?" is a practical one.

Treatment works best early or at a moderate stage, before the joint surfaces are badly worn. That is why an early opinion matters more than the exact year of birth on a passport. Typical signs of osteoarthritis are aching pain on movement, crunching, and stiffness after rest. If you recognise this, send your existing X-ray, MRI or ultrasound to the coordinator on WhatsApp or Telegram. A doctor reviews the scans free of charge and tells you which stage they show. Doctors usually describe four stages, from early thinning of the cartilage to severe wear. Injection treatment is most often considered in the early and middle stages.

In advanced cases the doctor will say frankly if a joint replacement is the more realistic option. When the joint space has almost disappeared, a lasting effect from injections cannot be expected. An honest answer like this is part of the free consultation.

Body weight, physical work and the sports ground

Several things speed up cartilage wear: body weight, activity and the stage of the condition. These also decide how long the effect of treatment lasts from person to person. This is why the doctor asks about your job, your sport and your weight before talking about a plan.

Constanta's economy is tied to its port. The port covers 39.26 km² and stretches about 30 km, and it is described as the largest on the Black Sea. A working day in a port, in a warehouse, on a vessel or in transport can mean standing for long hours, kneeling, lifting and climbing. These are loads that the knees, hips and ankles take daily. Desk work has its own side: hours of sitting followed by the first steps, when stiffness is most noticeable. We cannot state how many local workers have joint problems, but we can say which kind of load the doctor will ask about.

Sport matters too. The city has FCV Farul Constanta in Liga I, RC Farul in the rugby Divizia Nationala and HCD Constanta in handball. The service text lists "high load on the joints — sport or physical work" among the situations where treatment is considered. It also lists recovery after injuries and surgery, and meniscus pathology and injury among the conditions treated. So a person who played football, rugby or handball years ago and now has a knee that aches on stairs can send the scans of both the old injury and the current state.

The advice on movement is not "stop". Suitable activity builds the muscles that unload the joint, feeds the cartilage better and keeps you moving. The service text suggests swimming, water aerobics, cycling, Nordic walking or yoga. It advises avoiding running on hard surfaces, jumping, heavy lifting and sudden movements. In a city with a 13 km beach, swimming and water exercise are easy to picture as part of a routine, but the doctor sets the exact programme after seeing the joint.

Controlling weight, exercise and cooperation with a doctor make a real difference. Untreated osteoarthritis usually gets worse. Pain turns constant, movement is increasingly limited, the joint can deform and walking may become difficult. That is why we suggest sending scans sooner rather than waiting.

Damp winters, stiff mornings and the sea air

The climate of Constanta is humid subtropical (Cfa). For 1991–2020, the January mean high is 4.7 °C and the mean low is -1.2 °C. July and August have a mean high of 27.9 °C and a low of about 19.7–19.9 °C. The annual mean high is 16.4 °C. The record extremes are 38.5 °C and -25.0 °C. Relative humidity averages 82% over the year and reaches 88% in December, against 76% in July. December also has only 86 hours of sunshine, compared with 331 in July, out of 2,314 hours a year. About 22 days a year are snowy, mostly in January (7.83) and February (5.25).

We do not claim that damp air causes osteoarthritis. The cause is cartilage wear. But these numbers describe the months in which many people become more aware of their joints, and the service text gives a useful way to read the signs. Stiffness after rest is typical of osteoarthritis. Pain at rest and at night, swelling, redness and warmth point instead towards arthritis, an inflammatory disease. Morning stiffness lasting more than 30 minutes is also a typical sign of arthritis. A cold, wet January can blur this distinction, so a diagnosis is the first step. Causes of arthritis include autoimmune conditions such as rheumatoid arthritis, infections, gout and psoriasis, and the treatment approach is different.

The normals have shifted. Compared with 1961–1990, when the annual mean high was 15.2 °C, precipitation 396 mm and sunshine 2,265.8 hours, the 1991–2020 period is warmer and wetter. Annual precipitation is now 467.1 mm over 59.5 days with at least 1 mm. May (44.8 mm) and October (44.4 mm) are the wettest months, and February is the driest (25.9 mm). For planning, this has a simple meaning. Autumn and winter are a sensible time to arrange an online consultation, because nothing about it depends on the weather outside. You do not need to leave the house for the consultation itself.

The summer season is different. Mamaia, a district of Constanta, lies on a strip of land 8 km long and 300 m wide between the Black Sea and Lake Siutghiol. The beach season runs from mid-June to early September, and a 2 km gondola lift has operated since 2004. Walking on sand, long days on your feet and queues all put extra demands on a painful knee or ankle. If you want your joint in better shape before the season, the timetable below shows why it is worth starting in good time.

What to expect after the injection

The procedure is done in one day. The service text describes it in steps. A small amount of blood is taken from a vein, and platelet-rich plasma (PRP) with growth factors is prepared from it. Under local anaesthetic, the doctor collects a small portion of adipose tissue, roughly 30 ml, through a puncture on the abdomen or inner thigh, and stitches are not needed. The sample is spun in a centrifuge, the stromal vascular fraction (SVF) is isolated and blended with the plasma. The material is then injected directly into the affected joint under ultrasound guidance. Your own blood and adipose tissue are the only materials used, with nothing donor or synthetic. There are no crutches and no hospital stay.

The timeline is described as an average, for guidance only:

- About 1 week: the joint may ache a little more. This is an expected reaction.

- About 1 month: the pain usually eases.

- About 3 months: mobility and activity improve.

- About 6 months: the full effect develops.

Many patients notice early changes 2–3 weeks after the procedure. The result can last from several months to several years, depending on the individual. No one can promise a fixed result. Because osteoarthritis is chronic, it needs an ongoing plan rather than a one-off injection. Generally, the milder the stage, the faster and longer-lasting the effect, which may cut the need for regular hyaluronic acid injections.

For some people the treatment is not suitable. These are cancer, pregnancy, blood clotting disorders, acute infections (including infection in or near the joint), and a flare-up of a serious chronic illness. Temporary contraindications are a raised temperature, a cold or flu, and inflamed skin above the target joint. In a damp Constanta winter, a cold or flu is not rare, so tell the coordinator about any such illness when you choose a date. Nothing is lost by postponing.

Some coordinators' typical questions are about the combination of methods. PRP is often used for mild osteoarthritis. SVF with PRP is chosen when a stronger effect is needed, mainly in early and moderate stages. The doctor decides the joint, the method and the number of injections after looking at your scans.

Romanian health insurance and the cost question

Romania's social health insurance is run by CNAS, the Casa Nationala de Asigurari de Sanatate. It is the national authority managing the system and a basic package of services: medical services, medicines, sanitary materials and medical devices. Free procedures require a health card showing paid insurance. EU citizens and uninsured Romanians receive free emergency care. Since April 2019, insured people have been allowed to pay the difference between the tariffs of private providers and the fund's fees.

We cannot tell you whether CNAS or a particular insurance plan will cover an online consultation or PRP and SVF treatment, and we do not make such promises. Our sources do not contain a list of osteoarthritis procedures reimbursed by the fund. They do show a pattern: CNAS does not fully reimburse some procedures, as the example of bariatric operations shows, and it has begun introducing co-payments for certain services that are not strictly medically necessary. The system is described as hospital-centric, with a shortage of healthcare workers. For a person with a painful knee, this may mean that questions about cover, referrals and waiting should be put directly to the family doctor and the insurer.

Out-of-pocket payments made up about 21% of total health expenditure, against an EU average of 15%. This is dated data from local records, so treat it as background, not as a current figure. The cost of our treatment is not fixed in advance. The doctor quotes it after the consultation, because it depends on the joint, the method and the stage of osteoarthritis. The consultation and the review of your scans are free and carry no obligation.

Preparing your scans and planning around the calendar

A good consultation begins with documents. An X-ray remains the main method and shows the stage. MRI gives a detailed picture of cartilage and soft tissues. Ultrasound shows inflammation and fluid in the joint, and blood tests help rule out inflammatory diseases. Photographs of reports and the images themselves can be sent to the coordinator by WhatsApp or Telegram, and the reply is quick. If you do not have recent scans, say so, and the coordinator will explain which ones the doctor will want to see.

Think about the calendar as well. Romania has 15 non-working public days, including 1–2 January, 24 January, Orthodox Easter from Friday to Monday, 1 May, 1 June, Pentecost on Sunday and Monday, 15 August, 30 November, 1 December and 25–26 December. Orthodox Easter Sunday in 2027 falls on 2 May, so the long weekend runs around that date. Because the consultation is online and coordinators reply round the clock, 24/7, a public holiday does not block the first step. Choose a day when you can rest after the procedure and when you are free of fever or a cold.

Ovidius University of Constanta, founded in 1961, has about 15,000 students and 16 faculties, including Medicine and Pharmacy. That says something about the city's rhythm but nothing about our treatment, so we mention it only for context. Students and staff with sports injuries who want a second opinion on an MRI can use the same free review as anyone else.

Finally, remember that the figures here are averages and the plan depends on your joint and individual features. The doctor confirms them at the consultation.

Does the cold, humid winter in Constanta make osteoarthritis worse?

The cause of osteoarthritis is the wear of cartilage, not the weather, and we cannot say that the climate worsens it. What the climate data show is that January has a mean high of 4.7 °C and a mean low of -1.2 °C, and December humidity averages 88%. In those months it is easier to notice stiffness after rest, which is a typical sign of osteoarthritis. If the pain is present at rest and at night, or the joint is swollen, red and warm, that points to arthritis instead, so a diagnosis is the first step.

When in the year is it sensible to arrange the consultation and the procedure?

The online consultation can be done at any time, since you do not leave home for it. For the procedure itself, choose a date without fever, cold, flu or inflamed skin above the joint, because these are temporary contraindications. Autumn and winter are wetter and colder in Constanta, and colds are more likely then, so keep a little flexibility in the date. Many people also like to finish the first weeks of recovery before the beach season, which runs from mid-June to early September. The full effect develops over about six months.

Will Romanian health insurance (CNAS) pay for PRP or SVF treatment?

We cannot promise it, and we have no confirmed list of such procedures covered by the fund. CNAS manages the basic package of services, and free procedures require a health card showing paid insurance. Since April 2019, insured people may pay the difference between private tariffs and the fund's fees. The fund has also started co-payments for some services that are not strictly medically necessary. Ask your family doctor and the insurer about your own situation. The consultation and review of your scans with us are free, and the doctor quotes the cost of treatment after it.

I worked in the port or on my feet for years. Is that relevant to my knees and hips?

Yes, it is relevant for the conversation. Body weight, activity and the stage of the condition affect how fast the cartilage wears and how long the effect of treatment lasts. The doctor will ask about the kind of load: standing, kneeling, lifting, climbing or long sitting. The service text lists high load on the joints through sport or physical work among the situations where treatment is considered. We cannot give a local rate of joint disease among port workers, because we have no such data.

I played football, rugby or handball in my youth. Should I send old scans too?

Yes. Recovery after injuries and surgery, and meniscus pathology and injury, are among the conditions treated. Old reports, X-rays or MRI help the doctor see the history of the joint next to the current picture. Send what you have, and the coordinator will say what else might be useful. The review is free and does not commit you to treatment.

Can I keep up with exercise and sea swimming while preparing?

Suitable activity is recommended. It builds the muscles that unload the joint and keeps you moving. The service text names swimming, water aerobics, cycling, Nordic walking and yoga. It advises avoiding running on hard surfaces, jumping, heavy lifting and sudden movements. The doctor gives a personal programme after the consultation. If a joint swells or becomes hot, say so, because that may need a different approach.

Will a public holiday delay my consultation?

No. Coordinators answer round the clock, 24/7, on WhatsApp and Telegram, including during Romanian public holidays. Orthodox Easter in 2027 is on 2 May, with non-working days from Friday to Monday around it. You can send scans during these days and agree a date for the procedure afterwards.

How many injections and how many joints will I need?

This is decided by the doctor after looking at your scans, not in advance. The joint, the method and the number of injections depend on the stage and the joint. The doctor describes the plan at the consultation. PRP is often used for mild osteoarthritis, and SVF with PRP when a stronger effect is needed. The whole procedure is done in one day.