Chronic knee problems are rising sharply among young and middle-aged Indians. This troubling trend is pushing many toward non-surgical solutions like Platelet-Rich Plasma injections and stem cell therapy. These treatments are widely promoted across clinics and advertisements. But how effective are they really? Senior orthopaedic surgeon Dr. A V Gurava Reddy provides crucial insights. He serves as an executive council member at Kaloji Narayana Rao University of Health Sciences in Telangana.
How Widespread Is Knee Pain in Younger Indians?
A study from rural South India discovered radiographic osteoarthritis in almost 29% of people above 40 years old. A meta-analysis of 14 community studies revealed that nearly 47% of Indians aged 60 and above suffer from knee osteoarthritis. Hospital data from Hyderabad shows women form nearly two-thirds of diagnosed cases. A sharp rise occurs after age 45.
These trends clearly indicate that knee degeneration is no longer exclusive to old age. Lifestyle changes, obesity, and lack of muscle conditioning contribute significantly. A growing number of sports and work-related injuries are also pushing younger and middle-aged people into chronic knee pain.
Why Do Women Develop Knee Problems Earlier?
After menopause, the natural decline in estrogen affects tissues that cushion joints. This makes them more vulnerable to wear and tear. Many Indian women tend to have lower physical activity levels. This leads to weaker thigh and hip muscles.
When these muscles are under-conditioned, the body's movement patterns change. More load falls directly on the knees. Vitamin D deficiency is widespread among Indian women. This also affects bone strength and joint health. Besides, women often postpone seeking treatment. They frequently prioritize family over their own health. By the time they visit a doctor, the disease has already progressed.
What Exactly Is PRP Therapy?
Many patients are drawn to non-surgical options like Platelet-Rich Plasma therapy. PRP is prepared from a person's own blood. Once the sample is centrifuged, the platelets become concentrated. These platelets are rich in natural growth factors. They reduce inflammation and support tissue healing.
PRP works well in soft-tissue injuries. Conditions like tennis elbow, plantar fasciitis, and patellar tendon irritation respond positively. These are situations where tissue has degenerated but is not structurally destroyed. The biological boost helps people recover better.
Does PRP Work for Knee Osteoarthritis?
No, it does not work the same way. In osteoarthritis, cartilage gradually wears away. Structural damage advances over time. Research shows that PRP does not regenerate cartilage or reverse this damage.
In early osteoarthritis, it may offer temporary relief. Patients usually experience a few months of reduced pain and slightly better function. But in moderate or advanced stages, PRP's effect is minimal. Significant cartilage loss and joint deformity limit its benefits.
The American Association of Hip and Knee Surgeons does not recommend PRP for knee arthritis. The National Institute for Health and Care Excellence and the Australian Orthopaedic Association share this position.
Clinics Claim PRP Can Delay Knee Replacement
Some centres promote PRP as a miracle osteoarthritis cure. This misleads vulnerable patients and is unethical. PRP cannot halt osteoarthritis progression. It doesn't correct alignment problems. It cannot undo bone-on-bone contact. It absolutely cannot rebuild cartilage.
The best it can do is offer symptomatic relief in early disease. Once the joint is severely damaged, knee replacement becomes the only long-lasting solution. Patients should not think of PRP as an alternative to surgery. It is not.
What About Stem Cell Therapy Efficacy?
Stem cell therapy is marketed even more aggressively than PRP now. True stem cell therapy involves lab-cultured stem cells. These are expanded and differentiated in controlled conditions. That is not what most Indian clinics offer.
Instead, they use bone marrow aspirate concentrate or fat-derived cell mixtures. These are not pure stem cells. Their ability to repair cartilage or bone has not been proven. No form of stem cell therapy is approved by the US FDA for osteoarthritis or avascular necrosis.
The science of stem cells is promising. But commercial treatments available today remain experimental. They show no consistent long-term benefit.
Is PRP Therapy Safe? What About Costs?
PRP is generally safe as it's prepared from a patient's own blood. However, infections, localised pain, and swelling can occur. Risks increase when unapproved biologics or poorly processed cell mixtures are used. Patients must undergo such procedures only in regulated and well-equipped centres.
A basic PRP session costs between Rs 25,000 and Rs 40,000. Advanced PRP can cost between Rs 50,000 and Rs 1 lakh. Clinics frequently sell three-session packages. These range from Rs 75,000 to Rs 3 lakh. Premium combinations marketed as 'Super PRP' or 'Stem-PRP' can go up to Rs 1.5-3 lakh.
What Actually Helps Most People with Knee Pain?
The most reliable improvements still come from fundamental lifestyle changes. Weight control is crucial. Physiotherapy strengthens quadriceps and hip muscles. Improving flexibility and correcting gait and posture provide significant relief. Modifying high-impact activities also helps.
These approaches have a much stronger evidence base than any injectable therapy. Even in early osteoarthritis, lifestyle change and physiotherapy remain the cornerstone of treatment. Patients should focus on these proven methods before considering expensive regenerative therapies.
