Three very different tools, matched to the diagnosis. Done under ultrasound in-clinic, with a full pre- and post-procedure protocol.
Joint injection is one of the most misunderstood procedures in orthopedic practice. PRP, hyaluronic acid, and corticosteroid are often lumped together as "pain shots," but they work on completely different biological pathways, have different evidence bases, and suit different patients. A good injection decision starts with a diagnosis and a Kellgren-Lawrence grade, not a price list.
At Myntrava, injections are performed by PRC-licensed orthopedic specialists, most of whom are Fellows of the Philippine College of Surgeons and the Philippine Orthopaedic Association. We work under DOH AO 2021-0013 standards for out-patient procedures and use real-time ultrasound guidance for every knee, shoulder, and hip injection — accuracy rates for unguided knee injections in the literature sit around 55–65%, versus >95% with ultrasound. That difference matters when the drug is a ₱12,000 vial of PRP.
Platelet-Rich Plasma (PRP) is autologous — we draw 20 mL of your blood, centrifuge it to concentrate the platelets, and inject the plasma back into the joint. The growth factors (PDGF, TGF-β, VEGF) are thought to modulate the inflammatory environment and support cartilage homeostasis. Best evidence is in Kellgren-Lawrence II–III knee OA in patients under 65 who are not yet surgical candidates.
Hyaluronic acid (HA), or viscosupplementation, replaces the high-molecular-weight hyaluronan that is depleted in arthritic synovial fluid. It improves lubrication and shock absorption. We use Orthovisc and Synvisc-One depending on the joint — typically a three-injection series at weekly intervals for the knee, or a single shot for the hip. Corticosteroid (triamcinolone or methylprednisolone) is the quick anti-inflammatory — fast onset, 4–12 weeks of relief, best for acute flares and inflammatory arthropathies. Limited to 3 injections per joint per year.
If the only tool you have is a steroid, every knee looks like it needs one. That's not orthopedics — that's pain dispensing. — Dr. Miguel Aguinaldo
Most patients here arrive after a proper consultation with a Kellgren-Lawrence grade and a WOMAC score. If you are still deciding whether injection is appropriate, this article on PRP evidence in knee OA lays out what the current trials actually say. Many injection patients also enrol in our structured osteoarthritis program, which combines viscosupplementation with physiotherapy for a 10–14 week block.
We confirm diagnosis, Kellgren-Lawrence grade, allergies, anticoagulant use, and recent infections. Blood pressure recorded. Consent signed per DOH AO 2021-0013.
For PRP: 20 mL venous draw, 15-minute centrifuge. For HA/steroid: vial checked with patient. Skin prepped with chlorhexidine, sterile drape.
Needle tracked in real time to the intra-articular space — suprapatellar recess, glenohumeral joint, or anterior hip capsule — confirmed before delivery.
Slow injection, needle withdrawal, pressure dressing. We observe 10 minutes for vasovagal response or acute reaction. Most patients walk out unaided.
Activity restrictions for 48–72 hours, analgesia plan, red-flag symptoms (fever, increasing swelling) to watch for, follow-up scheduled.
Injection without rehab is half a treatment. We book you into physical rehabilitation at 1–2 weeks post-injection to consolidate the window.
Partially, and it varies. Corticosteroid is usually covered under most HMO plans (Maxicare, Medicard, Intellicare). HA and PRP are typically out-of-pocket or reimbursable depending on your rider. We pre-verify with your HMO before the procedure.
Most patients rate it 2–3 on the VAS pain scale during needle insertion, lower with ultrasound guidance because we avoid repeated passes. Local anaesthetic is mixed in for HA and steroid. PRP can ache for 24–48 hours as the growth factors activate — that is expected.
Same day for desk-based work. For physically demanding work, take 2 days off after corticosteroid and 3–5 days after PRP. Avoid the jeepney commute on injection day if you can — uneven steps are not kind to a freshly injected knee.
Not a price question. PRP has better evidence for younger knees with KL II OA and for tendinopathies. HA is better tolerated, better-studied over 12 months, and often the pragmatic first line in KL III. We make that call during your consultation, not over the phone.
Steroid: 48–72 hours. HA: 2–4 weeks, peak at 8–12 weeks. PRP: 4–6 weeks, peak at 3 months. Patience matters — judging PRP at week 2 is the commonest reason people wrongly declare it "didn't work."
Yes, and we strongly prefer that combination. Evidence consistently shows injection plus structured rehab outperforms either alone. See our recovery note on combining injection with rehab.
Book a 45-minute consultation first. We grade the joint, discuss options, and only then decide whether PRP, HA, or corticosteroid is right — if any.
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