Regenerative medicine

What does regenerative medicine mean in orthopedics?

Regenerative medicine summarizes treatment approaches that promote the body's self-healing. The aim is not to quickly “stop pain”, but rather to improve tissue quality and function – for example in the case of tendon irritation, early joint wear or muscular injuries.

• Biological: Use of the body's own components (e.g. autologous blood/PRP) and natural healing processes.
• Biophysical: Impulses through forms of energy (e.g. shock waves, electromagnetic fields, lasers).
• Tissue-friendly: outpatient, minimally invasive, can be combined with physiotherapy and training therapy.

Important: Regenerative therapies are not a panacea. They do not replace a necessary operation and have different effects - depending on the diagnosis, stage, tissue, stress and expectation management. We provide individual advice and guide the therapy conservatively after thorough diagnostics.

Who is regenerative medicine suitable for?

Regenerative procedures are an option if complaints are due to structural overload, wear and tear or delayed healing and basic conservative measures are not yet effective enough.

• Joints: Early to moderate osteoarthritis (e.g. knee, hip), cartilage and labrum irritation, irritation.
• Tendons & attachments: tennis and golfer's elbow, achillodynia, patellar tendinopathy, plantar fasciitis, calcific shoulder.
• Muscles & Fascia: Muscle fiber injuries, myofascial trigger points, delayed healing processes.
• Spine & pelvis: Irritation patterns at tendon attachments, myofascial pain, SIJ-related complaints (individual selection).
• Complaints close to the nerves: For certain irritations as part of an overall concept (individual examination).

When is it not suitable? In the case of severely advanced osteoarthritis with significant axial misalignment or instability, acute infections, unclear swellings/tumors, pronounced neurological deficits or if a targeted diagnosis is missing. We'll clarify this together at the appointment.

Procedure at a glance

Depending on the findings, we combine procedures to sensibly add healing stimuli and gradually build up stress. Details can be found on the respective subpages.

• PRP therapy: Preparation of autologous blood to inject plasma rich in growth factors into affected structures. Goal: Initiate/support healing processes. (More under “PRP therapy”)
• Shock wave therapy (ESWT): Focused or radial shock waves to stimulate tissue, especially a. for tendinopathies and calcific shoulder. (More under “Shockwave Therapy (ESWT)”)
• EMTT: Electromagnetic transduction therapy for the biophysical stimulation of metabolic processes. Evidence is still developing. (More under “EMTT”)
• Laser regeneration: Low-level/high-energy laser to modulate inflammation and blood flow. Evidence partly inconsistent. (More under “Laser regeneration”)
• Injection therapies: Targeted injections, e.g. B. with hyaluronic acid in appropriate indications or inflammation-modulating substances. (More under “Injection Therapies”)
• Cell & Metabolic Regeneration: Supporting cellular regeneration through targeted programs and micronutrient strategies. (More under “Cell & Metabolic Regeneration”)
• Traditional Chinese Medicine (TCM): Acupuncture and regulatory medicine as a complementary option for pain relief and functional improvement. (More under “TCM”)
• Neuroregeneration: Selective procedures to support nerve-related healing processes in appropriate cases. (More under “Neuroregeneration”)
• Stem cell therapy: Often experimental in Germany for orthopedic applications and associated with regulatory requirements. Use only after strict indication testing and information. (More under “Stem cell therapy”)

Evidence: What is secured, what is still being developed?

We work guideline-oriented and evidence-based. The study situation varies depending on the procedure and indication.

• Good to moderate evidence: ESWT for plantar fasciitis, tennis elbow and calcified shoulder; PRP for certain tendinopathies and early knee joint wear.
• Heterogeneous data: hyaluronic acid in osteoarthritis; Laser therapies depending on protocol and indication.
• Still limited evidence/experimental: EMTT (depending on application), cell-based stem cell therapies for orthopedic indications.

Therapy success is individual: diagnostic precision, stress control, accompanying therapies (physio/training), sleep, nutrition and psychosocial factors influence the course. We openly discuss the expected effects and alternatives.

Careful diagnostics before any therapy

Before regenerative treatment begins, a precise diagnosis is required. This is the only way to choose the right method at the right time.

• Targeted anamnesis: pain history, sport/everyday life, previous treatments, goals.
• Clinical examination: joint function, tendon/muscle function, statics, gait.
• Imaging: Ultrasound in consultation hours; X-ray/MRI if necessary.
• Optional: laboratory/screening, e.g. B. Inflammatory parameters or vitamin status in selected cases.

Only then will we work with you to determine the approach – conservative, regenerative or (if appropriate) operational co-assessment.

Process in our practice

Typical series (guideline values, vary from person to person): ESWT 3–5 sessions; PRP 1-3 injections; EMTT 6-10 sessions; Laser 4-8 sessions. Intervals depend on findings and tolerability.

Safety, side effects and contraindications

Regenerative processes are considered gentle. However, side effects are possible. We clarify in advance and work according to hygiene standards.

• General (injections): Temporary pain, redness, swelling, hematoma; rarely infection or nerve irritation.
• PRP: autologous blood product; usual irritation reaction possible for 24–72 hours.
• Hyaluronic acid/other injections: Rare intolerance possible.
• ESWT: Temporary tenderness, redness; rarely hematoma.
• EMTT: Sometimes tingling; contraindicated for active implants (e.g. pacemakers).
• Laser: Usually well tolerated; Be careful with photosensitivity; no use on tumors.
• Contraindications (selected): Acute infections, coagulation disorders that have not been controlled; pregnancy depending on the procedure; local skin injuries; Avoid proximity to lungs/nerves during ESWT (depending on region).

Please tell us about any blood thinners, allergies, recent cortisone injections or implants. Together we will choose a safe approach.

Costs and reimbursement

Many regenerative procedures are not regularly included in statutory health insurance (GKV) and are billed as self-pay services (IGeL). Private health insurance companies (PKV) reimburse partially or completely, depending on the tariff.

• Transparency: You will receive a cost estimate in advance according to GOÄ.
• No refund guarantee: Coverage of costs depends on your contract.
• Economically sensible: We only recommend measures with plausible indications.

Combination with physio, training and everyday life

Regeneration needs stimulus and rest – in the right dosage. We combine therapy with active rehabilitation.

• Physiotherapy: mobility, technique, tissue resilience.
• Training: Isometry → eccentric → strength and sport specific.
• Ergonomics & everyday life: Reduce load peaks, take sensible breaks.
• Lifestyle: sleep, stress management, balanced diet, weight management if necessary.
• Sports comeback: step-by-step plan according to symptoms, not according to the calendar.

Self-management: What you can contribute yourself

• Control stress: use pain scale 0–10; Target range 2-4 with practice.
• Warmth/cold depending on the phase: Acute often cold, subacute/chronic often warm - depending on tolerance.
• Gentle mobility daily, targeted strength training 2-3x/week.
• Check shoes/insoles and technique (running, tennis, weight training).
• Medication: Painkillers only after consultation. NSAID breaks are often recommended around PRP - please adjust individually.

Warning signs: Please seek medical advice

• Severe, increasing pain, redness and swelling after injection > 48 hours.
• Fever, chills, weeping sores.
• Newly occurring sensory disturbances, symptoms of paralysis.
• Leg/calf pain with swelling or shortness of breath.

If in doubt, please contact us quickly or seek emergency medical care.

Your location advantage in Hamburg

Our practice is located in Hamburg-Winterhude, Dorotheenstraße 48, 22301 Hamburg. Easily accessible by public transport and bicycle. You can easily get appointments online via Doctolib or by email. We plan your treatment so that work and everyday life are taken into account as best as possible.