MD-Guna injectable collagen preparations are a modern method for soft tissue and joint regeneration based on administering concentrated type I collagen directly around the damaged structure. The Italian Guna range includes a series of preparations dedicated to specific anatomical locations (e.g. MD-Knee, MD-Shoulder, MD-Lumbar, MD-Neck), enabling precise, targeted therapy.

Mechanism of Action

Type I collagen is the main structural protein of connective tissues: tendons, ligaments, joint capsule, intervertebral discs and bone. Under conditions of overload, degeneration and following injury, collagen degrades, weakening tissues and leading to pain and functional limitation.

MD-Guna injectable collagen acts in multiple directions:

  • MECHANICAL-STRUCTURAL EFFECT – exogenous collagen forms a temporary matrix for regeneration of damaged fibres
  • BIOSTIMULATORY EFFECT – stimulates the patient’s fibroblasts to produce new collagen (anabolic effect)
  • ANTI-INFLAMMATORY EFFECT – reduces local inflammation around the tendon/ligament
  • BIOMECHANICAL EFFECT – stabilises the structure of the joint capsule, ligaments and tendons, reducing micro-injuries
  • REGENERATIVE EFFECT – long-term improvement in tissue quality (effect develops over 4–12 weeks)

Indications

  • Tendinopathies – tennis elbow, golfer’s elbow, jumper’s knee, Achilles tendon
  • Degenerative disease of the knee, hip and shoulder joints (as a complement to HA)
  • Low back pain of ligamentous origin (sacroiliac ligaments, lumbar ligaments)
  • Neck pain of ligamentous origin
  • Joint instability following ligamentous injuries (e.g. collateral knee ligament)
  • Enthesopathies (chronic inflammatory conditions at tendon insertions)
  • Painful shoulder syndrome, joint capsule fibrosis
  • Supporting rehabilitation after sports injuries
  • Patients in whom steroids are to be avoided (repeated steroid injections are inadvisable)

Procedure Sequence

  • Qualifying consultation, diagnostic ultrasound assessment of the structure (if in doubt).
  • Selection of the appropriate MD-Guna preparation depending on location (MD-Knee, MD-Shoulder, MD-Tissue, MD-Neural, MD-Lumbar, MD-Neck, MD-Small Joints).
  • Skin disinfection, local anaesthesia (optional).
  • Under ultrasound guidance (for deep structures) or by palpation (for superficial ones), introduction of a fine 27–30G needle.
  • Slow administration of 2 ml of the collagen preparation, typically divided into several points around the symptomatic structure.
  • Brief massage of the injection area.
  • Cycle: 1 injection per week for 3–6 weeks; after the cycle typically 1 maintenance injection every 1–3 months.

Effects

  • First relief: 1–3 weeks after the first injection
  • Full effect: 8–12 weeks after completing the cycle
  • Duration of effect: 4–12 months
  • Gradual improvement in tendon/ligament function and strength
  • Pain reduction and increased range of motion
  • Best results in combination with physiotherapy and an exercise programme

Possible Side Effects

  • Transient pain at the injection site (1–2 days)
  • Minor subcutaneous haematoma
  • Very rarely: allergic reaction (the preparation contains collagen derived from porcine sources – patients are informed)
  • No risk of chondrotoxicity (unlike steroids)
  • Safe for repeated use

FAQ

How does MD-Guna differ from PRP?

 PRP (platelet-rich plasma) uses growth factors from the patient’s own blood; MD-Guna administers high-quality exogenous collagen. Both preparations act regeneratively but in different ways. PRP is more anabolic (stronger stimulation of proliferation); MD-Guna acts more rapidly at a structural level (ready-made collagen matrix). We often combine both therapies for a synergistic effect.

How many MD-Guna doses are needed?

The standard cycle is 3–6 doses (once weekly). In patients with advanced degenerative changes we use up to 6–8 doses. After the cycle we recommend maintenance injections every 1–3 months.