Three Generations of Injection Therapy

1st Generation: Hyaluronic Acid (Viscosupplementation)

Hyaluronic acid (HA) is a natural component of synovial fluid. HA injection into the joint improves lubrication and cushioning. Does not affect cartilage — symptomatic effect only. Duration: 3-6 months. Needs to be repeated 2-3 times per year.

Mechanism: viscoelastic lubrication + mild anti-inflammatory effect.

2nd Generation: PRP (Platelet-Rich Plasma)

Platelets with growth factors (PDGF, TGF-beta, VEGF) are isolated from the patient's blood. Stimulates healing, reduces inflammation. Superior to HA in effectiveness. However: no stem cells, no scaffold for regeneration, low growth factor concentration.

Mechanism: growth factors stimulate repair.

3rd Generation: MIBRAR® (CGF + Lipogems®)

Two-component system: CGF (Concentrated Growth Factors) — 10x more growth factors than PRP, in a fibrin scaffold + Lipogems® — microfragmented adipose tissue with mesenchymal stem cells, pericytes, and extracellular matrix.

Mechanism: true regeneration — stem cells form new tissue (cartilage, tendon, disc).

Comparative Table

Parameter	Hyaluronic Acid	PRP	MIBRAR®
Source	Synthetic preparation	Patient's blood	Patient's blood + adipose tissue
Stem cells	No	No	Yes (Lipogems®)
Growth factors	No	Basic level	10x more (CGF)
Scaffold	No	No	Yes (fibrin matrix CGF)
Mechanism	Lubrication	Repair stimulation	Tissue regeneration
Effect on cartilage	Does not restore	Minimal	Regeneration (new chondrocytes)
Effect duration	3-6 months	6-12 months	Lifelong
Number of procedures	3-5 times per year	3-5 procedures	1-2 procedures
Effectiveness in osteoarthritis	50-60%	65-75%	88-95%
Use for tendons	Not used	Moderately effective	Highly effective
Use for discs	Not used	Not used	Highly effective

Why PRP is Insufficient

No stem cells

PRP contains only platelets and growth factors. Stimulates existing cells but does not supply new ones. In cases of significant damage to native cells, insufficient for regeneration.

No scaffold

PRP — liquid that is quickly absorbed. No structural scaffold for organized tissue growth. CGF — fibrin gel that remains in the injury area for weeks, providing gradual release of growth factors.

Low concentration

Standard PRP: platelet concentration 2-5 times higher than blood. CGF: 10 times higher + fibrin + leukocytes with additional growth factors.

Limited indications

PRP is not used for intervertebral discs (no regeneration). MIBRAR® is effective for discogenic pathology — unique opportunity to restore the disc.

Why hyaluronic acid does not treat

Only symptomatic effect

HA improves gliding of joint surfaces, reduces pain for 3-6 months. But cartilage continues to deteriorate. With each course, the effect becomes shorter — because there is less cartilage.

No regeneration

Cochrane meta-analysis (2006): HA does not outperform placebo in terms of structural cartilage changes. Clinical effect — due to lubrication and moderate anti-inflammatory action.

Lifelong dependence

2-3 courses per year, each course 3-5 injections. Total cost over 10 years is comparable to the cost of one MIBRAR® procedure, which provides long-term results.

Stop «lubricating» — start restoring

MIBRAR® — the only method that regenerates cartilage at the cellular level.

Book a consultation

Questions about methods

How does MIBRAR® differ from PRP?

PRP — only platelets and growth factors. MIBRAR® = CGF (10x more growth factors + fibrin scaffold) + Lipogems® (stem cells + extracellular matrix). MIBRAR® regenerates tissue, PRP only stimulates.

Does hyaluronic acid help with osteoarthritis?

Temporarily. Lubricates the joint for 3-6 months, but does not restore cartilage. MIBRAR® regenerates cartilage at the cellular level — long-term result.

How many procedures are needed?

Hyaluronic acid: 3-5 injections, 2-3 times a year lifelong. PRP: 3-5 procedures. MIBRAR®: 1-2 procedures with lifelong effect due to full tissue regeneration.

Can methods be combined?

PRP and HA do not add benefits to MIBRAR®. MIBRAR® includes all advantages of PRP (growth factors) + stem cells + scaffold. Additional HA or PRP injections are not needed.