Joint pain is one of the most common and debilitating health concerns affecting millions worldwide. Whether it stems from osteoarthritis, injury, or chronic overuse, the damage to cartilage and connective tissues can significantly reduce mobility and quality of life. In recent years, cellular therapy has emerged as a promising alternative to conventional treatments like medications, steroid injections, and even surgery. But how does it work, and does the science back the hype? Let’s dive into the mechanisms, evidence, and potential of cellular therapy to repair damaged joints.
What is Cellular Therapy?
Cellular therapy, often referred to as regenerative medicine, involves using a patient’s own cells to repair or regenerate damaged tissues. In the context of joint repair, the most common types of cellular therapy include:
Stem cell therapy: Typically using mesenchymal stem cells (MSCs) derived from bone marrow, adipose tissue, or umbilical cords.
Platelet-rich plasma (PRP): A concentrate of platelets derived from the patient’s own blood, rich in growth factors that stimulate healing.
The Science Behind Joint Damage
To understand how cellular therapy might work, it’s helpful to know what happens when joints are damaged. Healthy joints are cushioned by cartilage, a smooth and slippery tissue that enables frictionless movement. However, cartilage has a limited ability to heal because it lacks a blood supply. When it wears down due to injury or disease, the body struggles to regenerate the lost tissue.
This leads to symptoms like:
Pain and stiffness
Swelling
Reduced range of motion
Bone-on-bone grinding in advanced cases
Traditional treatments typically aim to manage symptoms rather than repair tissue. This is where cellular therapy seeks to make a game-changing impact—by stimulating the body to heal itself.
How Cellular Therapy Works
1. Stem Cell Therapy
Mesenchymal stem cells (MSCs) are multipotent, meaning they can differentiate into various cell types, including chondrocytes, the cells responsible for producing cartilage. When injected into the joint, these stem cells are believed to:
Reduce inflammation
Stimulate the repair of cartilage
Recruit other healing cells to the area
Modulate immune responses
Moreover, stem cells secrete bioactive molecules (cytokines and growth factors) that contribute to the repair environment. It’s not just about replacing cells—it’s about kick-starting the body’s healing process.
2. Platelet-Rich Plasma (PRP)
PRP therapy involves drawing a patient’s blood, centrifuging it to concentrate the platelets, and injecting it into the injured joint. Platelets are a natural source of growth factors, including:
Platelet-derived growth factor (PDGF)
Transforming growth factor-beta (TGF-β)
Vascular endothelial growth factor (VEGF)
These molecules can stimulate tissue repair, reduce inflammation, and improve pain. While PRP doesn’t contain stem cells, it can enhance the microenvironment to support natural regeneration.
What Does the Research Say?
Stem Cells: Promising but Preliminary
Numerous animal and early human studies have shown that stem cell injections can:
Reduce joint pain
Improve function
Slow cartilage degeneration
In some cases, regenerate cartilage
A 2020 meta-analysis published in The American Journal of Sports Medicine found that patients receiving MSC therapy for knee osteoarthritis showed significant improvements in pain and function compared to controls. However, these benefits vary based on factors like cell source, dosage, and disease severity.
Still, it’s important to note that most studies are small and short-term. Large-scale, randomized controlled trials (RCTs) are still needed to validate the long-term safety and effectiveness of stem cell therapy.
PRP: Growing Clinical Support
PRP has a more robust clinical foundation, particularly in treating mild to moderate osteoarthritis. Studies have shown that PRP is more effective than hyaluronic acid injections (another common joint treatment) in reducing pain and improving joint function.
In 2021, the Journal of Orthopaedic Research published a study indicating that PRP was effective in reducing knee pain for up to 12 months in osteoarthritis patients. While results are modest, PRP is considered relatively low-risk and widely used by sports medicine physicians.
Risks and Limitations
While cellular therapy holds enormous promise, it’s not without risks or limitations:
Lack of standardization: There is no universal protocol for dosage, preparation, or delivery.
Variable outcomes: Some patients experience dramatic improvement, while others see little to no benefit.
Regulatory status: The FDA tightly regulates stem cell therapies, and many offerings at clinics are not approved or lack scientific validation.
Cost: These treatments are often expensive and not covered by insurance.
Patients should exercise caution and consult with a specialist experienced in regenerative medicine before undergoing any procedure.
The Future of Cellular Therapy
Research is advancing rapidly, and future developments may include:
Gene-edited stem cells that are more effective at cartilage regeneration
Personalized medicine approaches using a patient’s unique cellular profile
Combined therapies, such as PRP with stem cells or scaffolds that support new tissue growth
Clinical trials are ongoing, and within the next decade, cellular therapies may become a routine part of managing joint degeneration, potentially delaying or even eliminating the need for joint replacement surgery.
Conclusion: Hype or Hope?
Cellular therapy is not a miracle cure, but it does represent a hopeful shift toward treating the root cause of joint pain rather than just the symptoms. The science is encouraging—especially for PRP and stem cell therapies—but we are still in the early stages of understanding who benefits most, how treatments should be delivered, and what long-term outcomes will look like.
For those suffering from joint pain and exploring alternatives to surgery, cellular therapy may offer a science-backed, minimally invasive option worth discussing with a medical professional. As research continues, we’re likely to see cellular therapy play an increasingly important role in the future of orthopedic and sports medicine.
Join us on our free Facebook Live Series called “Ask the Docs”. In this session, you can ask SDOMG Physicians everything you want to know about rotator cuff tendon tears and the cellular treatments available to help.
Dr. Christopher Rogers was honored to speak at the April 2021 La Jolla Golden Triangle Rotary Club meeting. Topics of the lecture included a history of stem cell therapy in San Diego and an update on FDA-approved clinical trials for knee osteoarthritis. To see a copy of the lecture, visit the San Diego Orthobiologics Medical Group YouTube channel or view the video linked below!
Turmeric, a spice from South Asia derived from the Curcuma longa root, has been used as a medicine for nearly 4000 years.Recent studies have shown that turmeric may help to relieve joint pain caused by arthritis because the active ingredient, curcumin, is now known to have anti-inflammatory properties. Curcumin has been shown to have similar efficacy to diclofenac, a non-steroidal anti-inflammatory drug, with fewer side effects.Similar improvements in pain severity and function were seen with curcumin and diclofenac in a randomized, controlled clinical study of 139 patients with knee osteoarthritis. Nineteen patients in the diclofenac group (and none in the curcumin group) required anti-ulcer medications at 28 day followup [1].
Turmeric for Joint Pain Relief
Curcumin has also been shown to have a strong antioxidant capacity.In a randomized double-blind placebo-controlled trial, patients with mild-to-moderate knee osteoarthritis were given the curcuminoidand were compared to a group that received a placebo for 6 weeks. [2]Researchers measured the levels of enzymes known to influence inflammation (e.g. superoxide dismutase (SOD) and malondialdehyde (MDA)). The treatment group showed significant changes in these enzymes suggesting that short-term supplementation with curcumin decreases oxidative stress.
Another randomized, double-blind, placebo-controlled trial of low or high dose bio-optimized Curcuma longa in 150 patients with knee osteoarthritis measured serum biomarkers of cartilage degradation (sColl2-1). [3] The high dose extract showed a transient but non-significant decrease in the cartilage degradation biomarkers. Moreover, pain improvement in the low- and high-dose extracts was better than in the placebo group after 90 days of treatment.
The effects of topical curcumin 5% ointment on osteoarthritis knee pain in patients older than 70 years was studied in a double-blind, randomized placebo-controlled trial.[4]Subjects applied either the ointment or a placebo (Vaseline) twice a day for 6 weeks.The pain intensity was significantly lower in the group receiving the curcumin ointment than in the placebo group suggesting that this treatment may be considered for older adults with knee osteoarthritis.
[1]Shep D, Khanwelkar C, Gade P, Karad S.Safety and efficacy of curcumin versus diclofenac in knee osteoarthritis: a randomized open-label parallel-arm study.Trial 2019; 20:214.
[2]Panahi Y, Alishiri GH, Parvin S, Sahebkar A. Mitigation of systemic oxidative stress by curcuminoids in osteoarthritis: results of a randomized controlled trial. J Dietary Suppl. 2016;13(2):209–20.
[3]Henrotin Y, Malaise M, Wittoek R, Vlam K, et al.Bio-optimized Curcuma longa extract is efficient on knee osteoarthritis pain: a double-blind multi center randomized placebo controlled three-arm study.Arthritis Research and Therapy 2019; 21, 179.
[4]Jamali N, Adib-Hajbaghery M, Soleimani A.The effect of curcumin ointment on knee pain in older adults with osteoarthritis: a randomized placebo trial.BMC Complementary Medicine and Therapies, 2020, 20:305.
Join our free webinar to learn about PRP, an innovative non-surgical treatment option for osteoarthritis and other orthopedic conditions.
Dr. Mary Ambach specializes in non-surgical orthopedics, regenerative therapies, and interventional pain management. As a key thought leader in the field of Regenerative Medicine, Dr. Ambach conducts research, trains physicians, and lectures at international medical conferences.
Dr. Christopher Rogers is one of the world’s leading experts in orthopedic regenerative medicine and a renowned speaker at national medical conferences. He has developed new approaches for the treatment of tendon injuries, osteoarthritis, and disc degeneration which provide a safe and viable alternative to surgery.
You may have seen stories in the news about the potential of cell therapy to treat severe cases of COVID-19. One story in particular mentioned positive results of an experimental study of stem cells with the patient mortality rate decreasing from 85 percent to 15 percent.[i] Stem cell therapy has been shown to have regenerative, anti-inflammatory and immunomodulating properties. Although this patient sample was very small, this is yet another reminder that cell therapy has moved to the forefront of medicine.
Bone marrow transplantation for blood diseases has been in use for more than 40 years[ii], but more recently has been used to treat orthopedic injuries including joint degeneration and pain.
Why Do My Joints Hurt?
It is not uncommon to experience pain in the shoulders, elbows, knees or hips. Sometimes even the toe joints can hurt. Whether big or small, painful joints can make daily activities difficult and significantly impact your quality of life.
Pain in the joints may result from several different conditions. These include:
· Osteoarthritis: a condition that develops when the cartilage in the joints begins to break down. It often occurs as a result of trauma, aging, obesity or genetic factors.
· Tears or sprains to soft tissues surrounding the joint such as muscles, tendons and ligaments.
· Chronic inflammation due to autoimmune diseases such as lupus or rheumatoid arthritis.
The good news is that cell therapies that use a patient’s own blood, bone marrow or adipose (fat tissue) have proven to be effective at treating joint pain without surgery or extended rehabilitation.
Fat Cells or Bone Marrow Cells?
Cell therapy is derived from two major sources of cells, adipose (fat) cells and bone marrow cells. Each can be easily obtained in the clinic, but the two offer different healing properties.
Adipose-derived cells are taken from the abdomen, flank or thighs. These cells can repair and replace damaged or injured tissue. The specialized healing cells are called pericytes and they direct other cells to form new blood vessels, awaken stem cells and stimulate the growth of new tissues such as cartilage, bone and tendon. They also secrete powerful anti-inflammatory and pain relieving molecules.
Bone marrow cells can be used for injury recovery and more rapid healing. That’s because bone marrow contains cells that have the ability to improve circulation, decrease inflammation and regenerate healthy tendons, ligaments and cartilage.
How Effective is Cell Based Therapy?
Like all medical treatments, outcomes are significantly impacted by several factors, including:
· The extent of the damage being treated.
· The patient’s overall health prior to the procedure.
· How the orthobiologics are prepared for treatment.
· For many patients, however, using adipose and bone marrow cells to treat orthopedic injuries is highly effective and does not present many of the risks associated with traditional invasive surgery.
The procedure is performed on an out-patient basis in the physician’s office. Most patients require only a single treatment and many are able to resume their normal activities within days.
San Diego Orthobiologics Medical Group is one of only six clinics in the U.S. to participate in a first-of- its-kind FDA-approved clinical trial to treat knee osteoarthritis using a patient’s own fat-derived stem cells.
Drs. Christopher Rogers and Mary Ambach of San Diego Orthobiologics Medical Group were chosen based on their extensive experience with cell therapy to treat orthopedic conditions.
