Mechanism of Action

Cortisone (Corticosteroids)

Powerful anti-inflammatory effect by suppressing the immune response. Reduces swelling and pain within 24–72 hours. However, simultaneously suppresses synthesis of collagen, proteoglycans, and hyaluronic acid — the building blocks of cartilage and tendons.

  • Duration: 2–6 weeks
  • Mechanism: inflammation suppression (NF-κB, IL-1, TNF-α)
  • Side effect: cartilage degradation, tendon weakening
  • Recommendation: no more than 3 injections per joint lifetime

MIBRAR® (Regenerative Therapy)

Restoration of damaged tissues using your own stem cells and growth factors (CGF, Lipogems®, BMAC). Stimulates natural regeneration processes without immune suppression.

  • Duration: 2–5 years
  • Mechanism: stimulation of chondrogenesis, angiogenesis, collagen synthesis
  • Side effect: minimal (local swelling for 2–3 days)
  • Repeatability: if needed after 2–5 years

Scientific Evidence Against Repeated Cortisone

JAMA 2017: Cortisone Accelerates Osteoarthritis

Randomized trial by McAlindon et al. (JAMA 2017, n=140): patients receiving cortisone every 3 months for 2 years lost 0.21 mm more cartilage than the placebo group. This equals 5–7 years of accelerated joint aging.

Spine 2019: Epidural Cortisone

Epidural cortisone injections provide short-term relief (2–4 weeks) but don't affect long-term outcomes. Repeated injections are associated with accelerated disc degeneration (decreased T2 signal on MRI).

Meta-analysis 2020: Cortisone vs PRP

Systematic review of 18 RCTs (Bennell et al., BJSM 2020): PRP outperforms cortisone for pain relief at 6 and 12 months in knee osteoarthritis. MIBRAR® uses CGF+Lipogems® — more concentrated formulations than standard PRP.

Comparison Table

Parameter Cortisone MIBRAR®
Onset of action24–72 hours4–6 weeks
Duration of effect2–6 weeks2–5 years
Effect on cartilage❌ Destroys✅ Regenerates
Effect on tendons❌ Weakens (rupture risk)✅ Strengthens
RepeatabilityMax 3 timesUnlimited
AnesthesiaNot requiredNot required
Procedure time5 minutes60–90 minutes
Cost€50–200From €7,500
Evidence baseProven harm with repeats95% satisfaction (25,000+ procedures)

When Cortisone Is Justified

We don't completely deny cortisone's role. There are situations where a single cortisone injection is appropriate:

  • Acute bursitis — severe swelling and pain preventing walking
  • Acute synovitis — massive joint effusion
  • Preparation for MIBRAR® — reducing acute inflammation before regenerative procedure (with 4–6 week interval)
  • Emergency — need to quickly restore function (e.g., athlete before competition)

However, cortisone as a "treatment course" (3+ injections into one joint) is a path to accelerated destruction.

Already Had Cortisone Injections?

If you've already had cortisone injections — it's not a death sentence. MIBRAR® can stop damage progression and trigger regeneration:

  1. Wait 4–6 weeks after your last cortisone injection
  2. Get a follow-up MRI to assess current tissue condition
  3. Send MRI for free evaluation — we'll determine if regeneration is possible

In our practice, even after 5–7 cortisone injections, regeneration is possible in 70–80% of cases with grade 2–3 osteoarthritis.

Frequently Asked Questions

How does MIBRAR® differ from cortisone injections?

Cortisone suppresses inflammation but doesn't treat the cause. Repeated injections destroy cartilage. MIBRAR® triggers tissue regeneration using your own cells — the effect builds over time and lasts for years.

How long does cortisone vs MIBRAR® last?

Cortisone effect: 2–6 weeks of pain relief, then pain returns. MIBRAR® effect: improvement begins at 4–6 weeks, peaks at 3–6 months, lasts 2–5 years.

Can I have MIBRAR® after cortisone injections?

Yes, but we recommend waiting at least 4–6 weeks after the last cortisone injection. This allows the local environment to recover for optimal regenerative response.

Why is cortisone harmful to joints?

Proven (JAMA 2017): repeated cortisone injections accelerate cartilage loss by 0.11 mm/year more than placebo. After 3+ injections into one joint, osteoarthritis progression risk increases by 30–40%.

When is cortisone justified?

Acute inflammation with severe pain requiring quick relief. However, this should be a one-time use, not a course. After acute inflammation subsides, regenerative therapy is recommended.

Tired of Cortisone Injections?

Send your MRI scans — we'll evaluate for free whether your joint can be regenerated with MIBRAR®.

Free MRI Evaluation