Gambling establishments raise concern over potential hip and knee ailments
In the medical field of Individual Health Services (IGeL), a growing concern has been raised by the chairperson of the Medical Service of the Health Funds, Stefan Gronemeyer. On August 19, 2025, the Medizinische Dienst Bund (Medical Service Federation) demanded that medical practices be required to regularly offer independently created, scientifically based assessments and information about IGeL.
One of the most prominent IGeL services is the use of hyaluronic acid injections for knee or hip joint arthritis, offered at self-pay services at the doctor's office. These injections, while popular due to the widespread prevalence of arthritis and the lack of a curative therapy, have been a subject of debate.
Out of 60 examined IGeL services, 31 were negatively assessed, with only 3 showing a tendency towards a positive assessment. The potential harm of these injections includes joint inflammation, heart problems, and minimal and clinically insignificant pain reduction. The harm, according to the Medical Service of the Health Funds, outweighs the benefits.
Gronemeyer urges settled physicians to present facts instead of advertising in waiting rooms and criticizes promises of benefit through practice flyers and TV. He also demands two new regulations to contain IGeL. One of these regulations is that IGeL should not be provided on the same day they are offered, allowing time for consideration.
Every year, statutory health insured individuals spend at least 2.4 billion euros on IGeL services. The cost of these hyaluronic acid injections varies, with each treatment cycle costing between approximately 220 and 300 euros. However, prices can go up to 500 euros or more.
Despite the high cost, many insured people believe that these services are no longer offered by insurers. However, this is incorrect, according to Gronemeyer. Unlike hyaluronic acid injections, several treatments that aim to relieve pain and improve mobility are covered by health insurers, up to joint replacement in severe cases of arthritis.
The demand for these hyaluronic acid injections is high, with orthopedics, ophthalmology, and gynecology being among the most profitable specialties in the IGeL market. However, Gronemeyer stresses that more regulation is needed to ensure the safety and efficacy of these treatments for patients.
For 26 services, the result was inconclusive due to insufficient studies. This highlights the need for more research and scientific evidence to support the use of these treatments. As the debate continues, it is clear that the health and wellbeing of patients must be the top priority.
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