PRP for Hip & Knee Arthritis: A Surgeon’s Honest Guide

If you have hip or knee arthritis and want to stay active, you've probably come across platelet-rich plasma (PRP) as a regenerative option. I offer PRP injections in my practice, and for the right patient I'm a genuine believer in them. I also believe in being straight with people about what PRP can and can't do. So this isn't a generic overview — it's an honest look at how I actually use PRP, who tends to benefit, what to expect, and how it compares with cortisone and with joint replacement.

What PRP actually is

PRP is made from your own blood. We draw a small sample, spin it in a centrifuge to concentrate the platelets — the cells that carry the growth factors and signaling proteins your body uses to manage inflammation — and inject that concentrate directly into the arthritic hip or knee. It's a biologic, regenerative approach that works with your own physiology, done in a single visit. Because it uses your own blood, a platelet-rich plasma injection is a lower-risk treatment with minimal downtime; the most common effect is some temporary soreness at the injection site.

My approach to PRP

Here's how I actually use PRP in practice — not the brochure version.

Who I recommend it for. I most commonly recommend PRP for active patients with mild-to-moderate hip or knee arthritis — people who are still moving well, want to stay that way, and aren't ready for (or don't yet need) surgery. If staying active is central to your life and your arthritis is in that earlier-to-middle range, you're exactly the kind of patient I have this conversation with.

As a way to delay surgery. For the right patient, PRP can be an excellent option before joint replacement. By calming inflammation and easing pain, it can help you stay active and put off surgery — sometimes for years. I see PRP as a thoughtful step on the continuum of care, not a competitor to replacement.

When I'll steer you away from it. If your arthritis is advanced — essentially bone-on-bone — I'll tell you honestly that PRP is unlikely to give you the relief you're hoping for. At that stage, a hip replacement or knee replacement is usually the more dependable answer. I'd much rather have that honest conversation than take your money for an injection that won't deliver.

Who benefits most — and who doesn't

Patient selection is everything with PRP. It's the difference between a patient who's thrilled and one who feels they wasted their money — and the biggest factor is how much arthritis you have. The more cartilage you still have, the more PRP has to work with.

The patients who do best are active, generally healthy, have arthritis that hasn't yet reached the severe end of the spectrum, and come in with clear, realistic goals about staying mobile. If that's you, PRP is well worth a conversation.

What to expect — timeline and results

PRP is not a quick fix, and I set that expectation upfront:

It's not permanent — arthritis is a progressive condition, and PRP doesn't change that. But a good response can buy meaningful time, and some patients choose to repeat it periodically to maintain the benefit.

PRP vs. cortisone injections

One of the most common questions I get is whether to do PRP or a cortisone injection. They're different tools that solve different problems:

The bottom line: cortisone is faster and covered by insurance, but the relief is usually shorter and repeated steroid shots have real downsides over time. PRP is slower to kick in and out-of-pocket, but for the right patient the benefit tends to last longer and works with your own biology. Many of my active patients use cortisone to break a flare and PRP as a more durable, regenerative strategy — and hyaluronic acid (gel) injections are a third option, especially for the knee. The right mix sits within your overall nonsurgical plan.

PRP vs. joint replacement

Patients also ask whether PRP can help them avoid a knee replacement or hip replacement. The honest answer depends entirely on your arthritis:

• Mild-to-moderate arthritis — PRP can genuinely help you delay replacement, sometimes for years, by keeping you comfortable and active.
• Advanced, bone-on-bone arthritis — PRP is not a substitute for replacement. No injection rebuilds a joint that's worn out, and a modern, muscle-sparing replacement is what reliably restores comfort and function.

PRP and replacement aren't competitors — they're different points on the same continuum. The aim is always to use the least invasive thing that actually works for where your joint is today. If you're weighing this, our guides on the signs you may need a knee replacement and a hip replacement are a useful gut check.

Insurance and cost

On the practical side: PRP is considered elective and is not covered by insurance — it's an out-of-pocket cost. We give you clear pricing in advance, with no surprises. By contrast, cortisone and, in many cases, hyaluronic acid (gel) injections are typically covered — and we'll talk through the economics honestly so the decision is an informed one.

Is PRP right for you?

Most of the patients I see for this are deciding between a few options — PRP, cortisone, gel injections, or, when the time is right, hip or knee replacement. The honest truth is that the best choice depends on your arthritis severity, your activity level, and your goals — and that's exactly what an evaluation is for.

Request an evaluation with Dr. Harb to find out whether PRP — or another option — is the right move for your hip or knee. You can also read more about hip osteoarthritis and knee osteoarthritis to understand where your joint stands.