Treatment choices depend on the joint and the soreness

Strength and pacing reduce strain on the joint

Stronger muscles help share the work done by a sore joint. A therapist can teach safe exercises and raise the effort over time. You can also break a long task into shorter periods.

For some people, a cane or brace makes walking easier. Medicine may help if it's safe with your other drugs. These choices remain useful even when other care is being discussed.

PRP is a shot made from your own blood

A platelet-rich plasma, or PRP, shot uses plasma, the liquid in your blood, with extra platelets, tiny blood parts that help bleeding stop. The office spins blood from your arm to separate and gather those platelets. A clinician gives the fluid inside the joint or beside the sore tissue, as the exam directs.

Concentrated PRP puts more platelets into the same amount of plasma. More isn't always better, and no single exam result proves that higher is better. QC Kinetix may offer either kind after checking where you hurt, how the joint moves, and how much wear an X-ray shows. The clinician can explain why that amount was chosen and what risks apply.

Surgery alternatives still require an honest comparison

Joint preservation means using care that may help you put off surgery. Knee or hip surgery alternatives can include non-surgical care and changes in activity. Their fit depends on how worn the joint is and how much function you've lost.

Severe wear may still call for a surgical opinion. Getting that opinion doesn't force you to have an operation. It gives you another clear choice to compare.

Sources

1. In a 480-patient, four-arm, multicenter randomized phase 2/3 trial, none of three orthobiologic cell injections - autologous bone marrow aspirate concentrate, autologous adipose stromal vascular fraction, or allogeneic umbilical cord tissue-derived mesenchymal stromal cells - was superior to any other, or to a corticosteroid injection control, on pain at 12 months.

   Mautner K, et al. — Cell-based versus corticosteroid injections for knee pain in osteoarthritis: a randomized phase 3 trial. Nat Med, 2023. DOI: 10.1038/s41591-023-02632-w.

2. FDA states in its consumer alert that the only FDA-approved stem cell products in the United States are blood-forming stem cells derived from umbilical cord blood, approved for disorders of the blood-forming system, and that NONE of these products - stem cells, stromal vascular fraction, umbilical cord blood, Wharton's jelly or amniotic fluid - has been approved for the treatment of any orthopedic condition, including osteoarthritis, tendonitis, disc disease, tennis elbow, back pain, hip pain, knee pain, neck pain or shoulder pain.

   US Food and Drug Administration, Center for Biologics Evaluation and Research — Consumer Alert on Regenerative Medicine Products Including Stem Cells and Exosomes. , 2020.

3. The 2018 AAOS/NIH consensus work group recommended that minimally manipulated mixed cell preparations be called CELL THERAPY rather than stem cell therapy, and that their untested and uncharacterised nature be clearly communicated to patients and the public, because stem cells have properties these preparations do not meet.

   Chu CR, et al. — Optimizing Clinical Use of Biologics in Orthopaedic Surgery: Consensus Recommendations From the 2018 AAOS/NIH U-13 Conference. J Am Acad Orthop Surg, 2019. DOI: 10.5435/JAAOS-D-18-00305.

4. In 96 patients, concentrated bone marrow aspirate contained a mean of 26.3 million nucleated cells per mL but only about 1,422 colony-forming units of connective tissue progenitors, and the nucleated cell count had negligible predictive value for how many progenitor cells were actually present (r-squared 0.28).

   Muench LN, et al. — Nucleated Cell Count Has Negligible Predictive Value for the Number of Colony-Forming Units for Connective Tissue Progenitor Cells (Stem Cells) in Bone Marrow Aspirate Harvested From the Proximal Humerus During Arthroscopic Rotator Cuff Repair. Arthroscopy, 2021. DOI: 10.1016/j.arthro.2021.01.064.

5. On 27 September 2024 the Ninth Circuit held in United States v. California Stem Cell Treatment Center that stromal vascular fraction produced by enzymatically digesting a patient's own fat IS a drug under the Federal Food, Drug, and Cosmetic Act, and that the same surgical procedure exception does not apply because the removed fat and the implanted SVF are not the same thing. The district court's ruling for the clinics was reversed.

   United States Court of Appeals for the Ninth Circuit — United States v. California Stem Cell Treatment Center, Inc., No. 22-56014 (9th Cir. Sept. 27, 2024). , 2024.

6. On 2 June 2021 the Eleventh Circuit affirmed an injunction against US Stem Cell Clinic in United States v. US Stem Cell Clinic, LLC, holding the clinic's adipose stem cell procedure fell outside BOTH the same surgical procedure exception and the 361 HCT/P exception - the latter because the clinic intended the cells to perform functions beyond the basic functions they performed before the procedure, which is the definition of non-homologous use.

   United States Court of Appeals for the Eleventh Circuit — United States v. US Stem Cell Clinic, LLC, No. 19-13276 (11th Cir. June 2, 2021). , 2021.

7. A 2025 meta-analysis of 73 double-blind placebo-controlled injection trials in 5,895 knee osteoarthritis patients found placebo responder rates above 50 percent at 1, 3 and 6 months, declining by 12 months - which is why any uncontrolled 'our patients improved' claim from a clinic is uninterpretable.

   Previtali D, et al. — Placebo response to intra-articular injections in knee osteoarthritis: magnitude, evolution over time, and influencing factors. A systematic review and meta-analysis with meta-regression. EFORT Open Rev, 2025. DOI: 10.1530/EOR-2025-0022.

8. The OARSI non-surgical management guideline evaluated 60 interventions with GRADE methodology and built its recommendations around core treatments - structured exercise, weight management and self-management education - for every patient with knee osteoarthritis, regardless of what else is added.

   Bannuru RR, et al. — OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage, 2019. DOI: 10.1016/j.joca.2019.06.011.