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SVF and PRP for Osteoarthritis in Mannheim

For knees, hips and other joints with arthrosis: SVF cell therapy and PRP. We check the stage from your X-rays or MRI at no cost

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, which doctors also call arthrosis, is a chronic process of cartilage thinning and wearing away inside a joint. The cartilage is there to absorb shock, and as it deteriorates the bones rub together, producing pain, stiffness and reduced mobility. It is degenerative rather than inflammatory, although flares with swelling occur.

  • 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

A doctor examines you, reviews your scans and then decides whether the treatment is suitable

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: fever, flu or a cold, inflamed skin over the joint that is 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

Your joint is examined and your X-rays, MRI or ultrasound are reviewed; then the doctor decides if the procedure suits you. You may send any scans you have before you come.

Blood sample for PRP2

Blood sample for PRP

Blood is taken from a vein in a small amount. Later, platelet-rich plasma containing growth factors is prepared from it.

Adipose tissue sample3

Adipose tissue sample

A puncture on the abdomen or inner thigh, under local anaesthetic, is used to take a small portion of adipose tissue (about 30 ml). No stitches afterwards.

Processing in a centrifuge4

Processing in a centrifuge

In a centrifuge the sample separates into layers; the stromal vascular fraction is isolated and combined 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

Crutches and a hospital stay are not required. The doctor stays in touch after the procedure, following the joint's response.

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

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

Early and moderate osteoarthritis is where it is mostly used — to slow cartilage wear and reduce 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

Your own blood, in a small amount, is processed to separate plasma rich in platelets and growth factors, which goes into the joint to calm inflammation and improve conditions 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

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
  • ShoulderShoulderJoint and tendon wear around it, pain on lifting the arm
  • ElbowElbowWear of the joint surfaces and pain after overuse 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

We work to keep the joint you have instead of replacing it, using treatment without surgery

Your own tissue

Your own tissue

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

No crutches

No crutches

Done through punctures under local anaesthetic, without incisions or long rehabilitation

Second opinion

Second opinion

An independent assessment from a doctor, free of charge — send your X-rays, MRI or reports

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

Pricing depends on which joint, which method and the stage of osteoarthritis; the doctor gives the cost after the consultation

FAQ

Joint treatment: frequently asked questions

About the conditions

More about these conditions

Other services of our clinic

Osteoarthritis in Mannheim: from X-ray to follow-up

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 Mannheim.

Osteoarthritis is chronic, so it needs an ongoing plan rather than a single injection. In Mannheim, the doctor combines SVF or PRP with advice on weight, exercise and load for the joint.

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 Mannheim, the first consultation and review of your scans are free. Leave your name and phone number to book.

Five million joints, one slow process: osteoarthritis in German numbers

Osteoarthritis is rarely a sudden event. Cartilage that cushions the ends of the bones thins over years, and the first signs are easy to wave away: a crunch on the stairs, a stiff knee after sitting, a groin ache when turning the leg outward. Germany's national figures show how common this is. About five million people in the country live with Arthrose. In 2016 around 400,000 hip and knee joint replacements were carried out. Mannheim is a city of 319,536 people (end of 2025), so it is reasonable to assume that many local households are dealing with a worn joint, whether or not anyone talks about it.

It helps to be clear about what the condition is. Osteoarthritis is chronic, degenerative wear of the joint lining. It is not primarily an inflammatory disease, although flare-ups with swelling do happen. The knee (gonarthrosis) and the hip (coxarthrosis) are affected most often because they carry the greatest load. The ankle and the small joints of the hand follow. Doctors usually describe four stages, from early thinning of the cartilage to severe wear. The injection approach described here is most often considered in the early and middle stages. Which stage you are at is decided from your X-ray or MRI, not from how loudly the joint complains.

Mannheim is an urban area with a metropolitan region of roughly 2.4 million people (a 2012 figure). That is a large working population with a wide spread of occupations and ages. The physical demands differ enormously between a warehouse shift, a classroom and a laboratory bench, and so does the way arthrosis shows itself. What the occupations have in common is that the diagnosis usually comes late, once painkillers help only for a short time.

For readers in this situation, the non-surgical option works with your own material. A small blood sample gives platelet-rich plasma (PRP). A small portion of adipose tissue, roughly 30 ml, is processed in a centrifuge to isolate the stromal vascular fraction (SVF). The mixture is injected into the joint under ultrasound guidance. The aim is to ease pain and slow cartilage wear, not to restore a young joint. Nothing donor or synthetic is used.

Damp Rhine winters and stiff mornings

Mannheim sits where the Neckar flows into the Rhine, about 97 m above sea level, in the Upper Rhine Plain, which is described as Germany's warmest region. Summers are warm, with a mean daily maximum of 27.7 °C in July. Winters are mild but damp. In January the mean daily maximum is only 6.0 °C and the mean minimum 0.2 °C, and relative humidity reaches about 84% from November to January, compared with 66% in July. Sunshine falls to 1.4 hours a day in December and January, against 8.3 hours in July.

None of these numbers cause osteoarthritis, and the weather does not change the state of the cartilage. Even so, many people with joint wear describe the cold, grey months as the hardest. Stiffness after rest is a typical osteoarthritis sign. When days are short and people move less, the joint tends to feel worse simply because it is used less. Avoiding movement in winter is a trap: suitable activity builds the muscles that unload the joint and helps feed the cartilage. Swimming, water aerobics, cycling, Nordic walking and yoga suit most people with osteoarthritis. Running on hard surfaces, jumping, heavy lifting and sudden movements are best avoided.

There is also a practical side to timing. With 153 rainy days a year and 578 mm of precipitation, the river-plain climate offers many wet days that tempt people to stay indoors. After an injection, the doctor describes a rough course. In the first week the joint may ache a little more, which is an expected reaction. By about one month the pain usually eases. Around three months, mobility and activity improve, and the full effect develops at about six months. Seen against the calendar, an injection in autumn would reach its early improvement around the darkest weeks of December and January and its fuller effect in spring. This is not a promise of a result, since duration differs from person to person and depends on the stage, body weight and activity. It does mean the plan can be matched to the months in which you want to move more.

Do not read the weather as a diagnostic tool. Pain at rest and at night, swelling, redness and warmth over the joint, and morning stiffness lasting more than 30 minutes point towards arthritis, an inflammatory condition, rather than osteoarthritis. The treatment approach differs, so a proper diagnosis is the first step, whatever the season.

Campus, fairground and desk: how everyday load reaches the knee

Mannheim's rhythm gives some useful examples of load. Universität Mannheim had 11,933 students in the winter semester 2023/24. Young adults are not the typical osteoarthritis group, but the university also employs many people who sit for long periods, and young athletes and anyone with an old injury can develop wear early. Recovery after injuries and surgery is one of the situations in which doctors consider this treatment, and an ankle that never quite recovered from a sprain is a common starting point for later wear. The ankle is among the joints that can be treated.

Large public events add another kind of strain. The Maimarkt begins on the last Saturday in April and runs for eleven days. It was first recorded in 1613, and the source gives between 250,000 and about 350,000 visitors a year. The Mannheimer Mess fair is held twice a year, in spring and autumn. For people who work at stands, set up halls or simply spend long days walking on hard floors, those weeks mean many hours on their feet. A knee that copes with an office day may complain after eleven days of standing and walking. If you are planning an injection and have such a period coming, ask the doctor how to schedule it. Plan ahead, because the first week can bring a little extra aching.

Body weight is the other big variable. In Germany, measured data from the DEGS survey of 2008–2011 found obesity in 23.3% of men and 23.9% of women, while self-reported survey data gave lower values (15.7% of men and 13.8% of women in the 2009 Mikrozensus). The gap shows that people often underestimate their own weight. For the knees and hips, every extra kilogram means extra load on every step. The treatment text names body weight as one of the factors that determine how long an effect lasts. Controlling weight, exercising and cooperating with a doctor are the three things that make a real difference, in addition to any injection.

Physical work and sport are named as reasons the treatment may suit you. Heavy load on the joints, whether from a trade or from training, can lead to earlier wear. If you have pain, crunching or stiffness and painkillers help only briefly, the sensible step is to have the joint assessed rather than to wait until walking becomes difficult. Untreated osteoarthritis usually gets worse: the pain becomes constant, movement is more and more limited, and the joint can deform.

From scans to injection: how the process starts online

Because the first consultation is online, a Mannheim resident can start without arranging anything. Coordinators answer round the clock, 24/7, on WhatsApp and Telegram, and the reply normally comes within 15 minutes. The consultation and the review of your scans are free and carry no obligation to book anything.

What helps most is sending the material you already have. 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. German patients often already have imaging from an orthopaedic or family-doctor appointment, and these results can be reviewed by the doctor without charge. You can also use this route purely as a second opinion on your scans.

The doctor then decides whether the method suits you. Conditions that argue against it include cancer, pregnancy, blood clotting disorders, acute infections (including infection in or near the joint) and a flare-up of a serious chronic illness. Temporary reasons to wait are a raised temperature, a cold or flu, and inflamed skin over the target joint. So if you catch a winter cold, tell the coordinator, because it can mean postponing.

If the plan goes ahead, the procedure follows the steps in the treatment plan: blood is taken from a vein, a small adipose tissue sample is taken under local anaesthetic through a puncture on the abdomen or inner thigh, and no stitches are needed. The samples are spun in a centrifuge, the SVF is isolated and blended with the PRP, and the material is injected into the affected joint under ultrasound. The whole procedure takes one day, with no crutches and no hospital stay. Afterwards the doctor stays in contact and follows how the joint responds.

PRP on its own is often used for mild osteoarthritis. SVF together with PRP is used when a stronger effect is needed. Which joint, which method and how many injections are decisions the doctor makes after looking at your scans.

Coverage, waiting and the replacement question

Roughly 92% of the German population is covered by statutory health insurance, and about 88% of the working population is insured through statutory funds and about 11% privately (2024). Anyone living in Mannheim is therefore very likely to have a standard insurance route for ordinary orthopaedic care, such as examinations and imaging. Whether a particular insurer reimburses an injection treatment with your own cells is a separate question. This text does not claim that it does. The doctor quotes the cost after the consultation, because it depends on the joint, the method and the stage. It is sensible to ask your insurer in writing what applies to your tariff, and the coordinator can explain what the doctor can provide in the way of documentation.

German rules also draw a line between medically indicated care and procedures done at the patient's own request. After a medically not indicated procedure, insured persons may have to share in the costs of resulting complications, and insurers may restrict benefits under § 52 SGB V. This discussion concerns elective cosmetic interventions, not osteoarthritis, but it shows why it is worth asking your insurer before you decide, so you know where you stand.

On waiting times, a 2010 Commonwealth Fund survey found that 70% of Germans reported waiting less than one month for elective surgery. That is an old figure and says nothing about your own case. If a replacement is the realistic option, the inpatient stay after an uncomplicated hip replacement lasts about six to eight days in most clinics, with follow-up rehabilitation (Anschlussheilbehandlung) arranged during the stay. The injection route is different: no operation, no hospital stay and no prolonged rehabilitation.

The honest framing is that these are two points on one line. Many people want to keep their own joint for as long as they reasonably can, and some want to postpone a replacement. The doctor will say frankly when a joint is already so worn that replacement is more realistic. This applies especially when the joint space has almost disappeared in the most advanced stage, where a lasting effect cannot be expected. For avascular necrosis, SVF may be considered only at early stages (1–2) to support the blood supply to the femoral head. At later stages an operation is usually required.

Does the damp winter in Mannheim make osteoarthritis worse?

The weather does not wear down cartilage, but many people notice more stiffness in the cold, humid months. In Mannheim the January mean maximum is 6.0 °C, and relative humidity reaches about 84% from November to January. Short days also mean less movement, and stiffness after rest is a typical osteoarthritis sign. Regular suitable exercise such as swimming, cycling or Nordic walking helps, and a doctor can advise on timing.

Can I send scans I already have from a German doctor's appointment?

Yes. X-rays, MRI, ultrasound and blood test results can be sent to the coordinator on WhatsApp or Telegram, and the doctor reviews them free of charge. The review establishes the stage of osteoarthritis and whether a non-surgical plan is sensible. You can also use it purely as a second opinion.

Will my statutory health insurance pay for this treatment?

This cannot be answered in general. About 92% of people in Germany are covered by statutory insurance, but whether an injection with your own cells is reimbursed depends on your insurer and tariff. The doctor quotes the cost after the consultation. Ask your insurer in writing and keep the reply with your documents.

How should I plan around the Maimarkt or the Mess fair?

Those events mean long days on your feet. The Maimarkt lasts eleven days from the last Saturday in April, and the Mess is held in spring and autumn. In the first week after an injection the joint may ache a little more, which is expected. Tell the coordinator about your work calendar so the doctor can suggest suitable timing, and take any cold or fever into account, since those can mean postponing.

I work on my feet or do a lot of sport. Is that a reason to wait?

High load on the joints, from sport or physical work, is listed among the situations in which the treatment may suit you. After the injection, the doctor advises on activity. In general, swimming, cycling and Nordic walking are better than running on hard surfaces, jumping or heavy lifting. Your plan depends on the joint and the stage.

Does body weight change what I can expect?

Yes. How long an effect lasts depends on the stage of the condition, body weight, activity and other factors, and nobody can promise a fixed result. Extra weight loads the knees and hips with every step, so controlling weight is part of a sensible plan alongside any injection.

When would joint replacement be more realistic than injections?

When the joint is already badly destroyed, especially at the most advanced stage where the joint space has almost disappeared. In Germany about 400,000 hip and knee replacements were done in 2016, and a hip replacement typically means about six to eight days as an inpatient. The doctor will tell you frankly after seeing your scans whether replacement is more realistic.

How quickly can I start the process from Mannheim?

The first step is a free online consultation. Coordinators are available 24/7 on WhatsApp and Telegram and usually reply within 15 minutes. You send your scans, the doctor reviews them, and only then is a plan proposed. There is no obligation to book.