Three injections — cortisone, hyaluronic acid (HA), and platelet-rich plasma (PRP) — are commonly offered for knee pain. They work very differently, suit different patients, and cost very different amounts. Here's the honest comparison.
Cortisone (corticosteroid)
Mechanism: powerful anti-inflammatory. Suppresses inflammation rapidly.
Best for: severe flare-ups of knee osteoarthritis, particularly when conservative care alone isn't controlling symptoms.
Onset: 1-3 days. Duration: typically 6-12 weeks.
Limitations: limited to 2-3 injections per year per knee — frequent use accelerates cartilage damage. Not a long-term strategy.
Cost in Egypt 2026: EGP 500-1,500 per injection.
Hyaluronic acid (HA / viscosupplementation)
Mechanism: replaces or supplements the natural lubricating fluid in the joint. Reduces friction between cartilage surfaces.
Best for: moderate knee OA where conservative treatment isn't quite enough, but it's too early for surgery.
Onset: 2-4 weeks. Duration: 6-12 months per course of 3 injections.
Limitations: less effective for advanced bone-on-bone OA. Cost-benefit improves with appropriate patient selection.
Cost in Egypt 2026: EGP 3,000-8,000 per injection course (3 injections).
PRP (Platelet-rich plasma)
Mechanism: concentrated growth factors from your own blood injected into the joint. Stimulates healing and reduces inflammation through biological pathways.
Best for: mild-to-moderate knee OA in active patients (40-65 typically), and certain soft-tissue conditions (tendinopathy).
Onset: 4-6 weeks. Duration: 6-12+ months, varies more than HA.
Limitations: evidence is improving but still mixed. Doesn't help severe bone-on-bone OA. Variable preparation quality between clinics affects results.
Cost in Egypt 2026: EGP 3,000-7,000 per injection. Typical course is 1-3 injections.
Side-by-side comparison
Speed of relief: cortisone fastest (1-3 days) > HA (2-4 weeks) ≈ PRP (4-6 weeks).
Duration: HA and PRP both 6-12 months > cortisone 6-12 weeks.
Long-term safety: HA and PRP much safer than cortisone for chronic use.
Best for advanced OA: cortisone (short-term relief) > HA > PRP.
Best for mild-to-moderate OA in active patients: PRP > HA > cortisone.
Choosing the right injection
Active patient under 65 with mild-to-moderate knee OA: PRP is usually first-line. Often combined with HA for amplified effect.
Moderate-to-advanced OA, not yet ready for surgery: HA course is the typical choice.
Severe pain flare-up: cortisone for short-term relief. Plan longer-term strategy after the flare-up settles.
Patient considering surgery but wanting to delay: HA or PRP can buy 6-18 months, sometimes more.
I tell patients: these injections are tools, not magic. The patients who do best combine them with strengthening exercises and weight management. An injection alone produces modest results; an injection plus 6 weeks of targeted PT often transforms function. — Dr. Mohamed Masoud, Bone Art Clinic
Frequently Asked Questions
Are knee injections painful?
Local anesthetic is used first. The injection itself feels like brief pressure. Most patients report it as 2-3 out of 10 in discomfort. The injection process takes 5-10 minutes total.
Can I combine cortisone, HA, and PRP?
Not all at once. Cortisone is short-term; HA and PRP are longer-acting. Common combinations: cortisone first (for acute flare-up), then HA or PRP 4-6 weeks later for sustained benefit.
How long do PRP injection effects last?
Most patients experience meaningful relief lasting 6-12 months. Some get 18+ months. Effect varies more than HA. Repeated annual courses are common for ongoing benefit.
Does insurance cover PRP or HA injections in Egypt?
HA injections are often partially covered by major Egyptian insurers when indicated. PRP is rarely covered (still considered emerging by many insurers). Cortisone is widely covered. Verify with your insurer first.