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Orthobiologics - biologic injections, honestly sold.

PRP, bone-marrow concentrate, Lipogems, hyaluronic acid and nStride for arthritic joints and stubborn tendons. Ultrasound-guided, consultant-delivered - and with the evidence, including its limits, explained before you spend a pound.

See indicative pricing
A radiographer guides a patient onto the bed of an advanced 3 Tesla MRI scanner in a London imaging suite

Indicative pricing

What orthobiologic injections cost privately in the UK.

Indicative ranges across UK MSK clinics.

In short

£500–£900, in and out in under an hour.

Procedure Indicative range
Single PRP injection (knee, hip, shoulder, tendon) £500–£900
PRP course of three injections £1,200–£2,500
Bone-marrow aspirate concentrate (BMAC) £3,000–£6,000
Microfragmented adipose tissue (Lipogems) £3,000–£6,000
nStride autologous protein solution (APS) £2,000–£3,500
Hyaluronic acid injection £300–£600
Consultant MSK consultation only £200–£350

Prices vary by clinic, by the consultant, by the preparation system used, and by whether imaging and consultation are bundled in. BMAC and Lipogems are always the top of the range because they involve a tissue harvest.

The problem

A field full of promise - and a market full of overselling.

Orthobiologics is where genuine science and aggressive marketing collide. “Regenerative” clinics sell £6,000 stem-cell packages on thin evidence. The two are worth separating before you consent.

  • Is an injection the right answer at all?

    For many patients a structured physiotherapy block, weight management or bracing does more than any injection. That is worth knowing before a needle is recommended.

  • Match the product to the evidence

    PRP for knee OA and tendinopathy has trial support. Cartilage-regrowing stem-cell claims do not. You deserve to know which shelf your treatment sits on.

  • Ultrasound guidance, or it doesn’t count

    Blind injections miss the joint or tendon in a surprising share of cases.

When it helps

When an orthobiologic is worth considering.

The situations most often seen, plus the one red flag that means hospital urgently rather than an injection appointment.

  • Knee osteoarthritis, mild to moderate

    The best-evidenced indication for PRP - pain relief and function gains for many patients with early to moderate knee OA, typically lasting 6–12 months.

  • Tennis or golfer’s elbow

    Chronic lateral or medial epicondylitis that hasn’t settled with physiotherapy - PRP has reasonable evidence here and avoids the tendon-weakening risk of repeated steroid.

  • Patellar and Achilles tendinopathy

    Stubborn jumper’s knee or mid-portion Achilles pain, alongside - never instead of - a proper loading programme.

  • Plantar fasciitis that won’t settle

    Heel pain persisting beyond 6–12 months of stretching, orthotics and shockwave - PRP is a reasonable next step before surgery is discussed.

  • Hip and shoulder osteoarthritis

    Evidence is weaker than for the knee, but injection under ultrasound can be worth a trial when surgery isn’t wanted or isn’t yet indicated.

  • Delaying or avoiding joint replacement

    For some patients not ready for a knee or hip replacement, a biologic injection can buy meaningful time - with the honest caveat that it treats symptoms, not the X-ray.

  • Steroid injections no longer helping

    When cortisone relief has become shorter-lived with each round, a biologic alternative avoids the cartilage and tendon concerns of repeated steroid.

  • Red flag: hot, swollen joint with fever

    A hot, red, exquisitely painful joint with fever may be septic arthritis - an emergency needing same-day hospital care, never an injection clinic booking.

Injection options

Five products, very different evidence bases.

What each option involves, roughly what it costs, and - most importantly - how strong the evidence behind it actually is.

  • Platelet-rich plasma (PRP)

    Your own blood, centrifuged to concentrate platelets and growth factors, injected into the joint or tendon. The best-evidenced orthobiologic - particularly for knee OA and tendinopathy.

  • Leucocyte-rich vs leucocyte-poor PRP

    Preparations differ. Leucocyte-poor is generally preferred for joints; leucocyte-rich is sometimes used for tendons. A good clinic tells you which system it uses and why.

  • Bone-marrow aspirate concentrate (BMAC)

    Marrow drawn from the pelvis under local anaesthetic, concentrated and injected. Contains a small number of mesenchymal cells - but it is not a “stem-cell cure”, whatever the marketing says.

  • Microfragmented adipose tissue (Lipogems)

    A mini liposuction of abdominal fat, processed and injected into the joint. Early evidence in knee OA is promising but not definitive; NICE classes it as a procedure needing special arrangements.

  • nStride APS

    Autologous protein solution - blood processed to concentrate anti-inflammatory proteins, as a single knee OA injection. Some trial data suggest benefit lasting up to three years; more evidence is needed.

  • Hyaluronic acid (viscosupplementation)

    A gel injection to lubricate the joint. Cheap and safe, but NICE advises against routine use in knee OA because average benefit over placebo is small. Some individuals still find it helps.

  • Combination and staged approaches

    Some consultants combine PRP with hyaluronic acid, or stage biologics alongside a structured rehab block. The rehab is not optional - it does much of the work.

  • What is not supported by evidence

    Unlicensed “stem-cell therapy”, culture-expanded cells, or injections sold as regrowing cartilage. No orthobiologic has been shown to regenerate a worn joint, and clinics claiming otherwise are overselling.

Safety and recovery

What to expect afterwards - honestly.

Orthobiologic injections are low-risk outpatient procedures. The things worth planning are the expectations, the NSAID pause, and the rehab that does half the work.

  • Local anaesthetic, in a clean procedure room

    These are outpatient injections under local anaesthetic - no general anaesthetic, no hospital stay. You walk in and walk out the same day.

  • Because it’s your own tissue, reactions are rare

    PRP, BMAC and Lipogems all use your own blood, marrow or fat, so allergic reactions are very rare. A post-injection flare of pain and swelling for 2–5 days is common and expected.

  • Infection risk is low but real

    Joint infection after injection occurs in well under 1 in 1,000 cases with sterile technique. A joint that becomes hot, red and increasingly painful with fever needs same-day review, not a wait-and-see.

  • BMAC and Lipogems harvest sites ache

    Bone-marrow aspiration leaves a bruised, achy pelvis for a week or so; the Lipogems liposuction site bruises similarly. Both settle on their own.

  • It is not a cure - and not cartilage regrowth

    No orthobiologic has been shown to regenerate cartilage or reverse arthritis on imaging. What good evidence shows is symptom relief - often meaningful, usually temporary.

  • Expect months, not decades

    Where PRP works for knee OA, benefit typically lasts 6–12 months. Some patients get longer, some get nothing. Repeat courses are possible but each is a fresh decision, not a subscription.

  • Stop anti-inflammatories around PRP

    NSAIDs like ibuprofen are usually paused for a week before and 2–4 weeks after PRP, as they may blunt the platelet response. Paracetamol is fine. Ask for exact instructions in writing.

  • Rehab does half the work

    For tendinopathy in particular, the loading programme around the injection matters as much as the injection. An injection without rehab is money half-spent.

  • Red flags after injection

    Fever, a hot swollen joint, spreading redness, or pain that escalates rather than settles after day 5 needs the same-day team or A&E, not a routine call.

Reading your procedure note

Your procedure note in four parts. Read the last one first.

Whichever biologic was used - PRP, BMAC, Lipogems or nStride - the note the consultant sends you keeps to the same shape.

A UK consultant sports-medicine doctor reviewing a patient’s injection procedure notes

A quiet reminder

MSK language is precise and can read coldly - ask your care team to explain anything that is unclear.

If you would like someone to talk you through the procedure note and the rehab plan before your review, ask the clinician who wrote it.

  1. 01 Header

    Diagnosis, grade and product used

    What was treated and why - the OA grade or tendinopathy diagnosis - plus exactly which biologic was injected, the preparation system, and the volume delivered.

  2. 02 Technique

    Guidance, approach and harvest

    Confirmation of ultrasound guidance, the needle approach used, and for BMAC or Lipogems, the harvest site and how the tissue was processed.

  3. 03 Findings

    What the ultrasound showed

    The state of the joint or tendon on the day - effusion, synovitis, tendon thickening or tears - which sets the baseline for judging your response.

  4. 04 Impression

    Rehab plan, review date, plan B

    Read this first: the loading programme, when you’ll be reviewed, what response would justify a repeat, and what the next step is if the injection doesn’t deliver.

Recognised by major UK insurers

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Be aware: most UK insurers class PRP, BMAC, Lipogems and nStride as unproven and do not cover them, though the consultation and imaging are sometimes funded.

Frequently asked

Common questions about orthobiologics.

Quick answers on evidence, stem-cell claims, how many injections, cost and recovery.

  • Does PRP actually work?

    For knee osteoarthritis and some tendinopathies - tennis elbow, patellar tendinopathy - PRP has reasonable evidence of symptom benefit, and many patients get meaningful relief for 6–12 months. It is not a cure, it does not regrow cartilage, and trial results are mixed: some well-designed studies show little advantage over placebo. It is worth seeing the honest odds before you spend anything.

  • Is this stem-cell therapy?

    Not in the way it is often sold. BMAC and Lipogems contain small numbers of mesenchymal cells, but there is no good evidence they regenerate cartilage, and UK-regulated clinics cannot lawfully offer culture-expanded stem-cell treatments for joints outside a trial. Any clinic promising to “regrow your cartilage with stem cells” is overselling - and that is exactly the kind of clinic to be wary of.

  • Which orthobiologic is right for me?

    It depends on the joint, the diagnosis and the budget. PRP is the usual first choice for knee OA and tendinopathy - best evidence, lowest cost. Hyaluronic acid is cheap and safe but with small average benefit. BMAC, Lipogems and nStride are options for knee OA when PRP hasn’t helped or a single-injection approach is preferred, at a higher price and with a thinner evidence base. The consultation settles it.

  • How many injections will I need?

    For knee OA, many consultants recommend a course of three PRP injections 2–4 weeks apart, as the trial evidence for courses is somewhat stronger than for single shots. Tendinopathy is often treated with one or two. BMAC, Lipogems and nStride are single-visit treatments. Nobody should be sold an open-ended subscription of injections.

  • How much do orthobiologic injections cost privately in the UK?

    Roughly £500–£900 for a single PRP injection and £1,200–£2,500 for a course of three. Hyaluronic acid is £300–£600. BMAC and Lipogems run £3,000–£6,000, and nStride around £2,000–£3,500. A consultant consultation is £200–£350.

  • Can I get PRP or stem-cell injections on the NHS?

    Rarely. NICE does not recommend routine PRP or stem-cell injections for osteoarthritis outside research settings, and advises against routine hyaluronic acid for knee OA, so NHS availability is largely limited to trials and a few tendinopathy services. In practice, orthobiologics in the UK are almost entirely private - which is precisely why honest, independent advice matters.

  • What is recovery like?

    You walk out the same day. Expect a sore, sometimes swollen joint for 2–5 days - a flare is normal after PRP. Relative rest for 48–72 hours, then a graded return guided by your physiotherapist. Most people are back at a desk the next day and back to sport in 2–6 weeks depending on the tissue treated. BMAC and Lipogems add a week of harvest-site aching.

  • Will insurance cover it?

    Usually not. Most UK insurers class PRP, BMAC, Lipogems and nStride as unproven and exclude them, though a few policies part-fund the consultation and imaging. Hyaluronic acid is occasionally covered.

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