Notice what the knee is telling you

Notice when the soreness starts

Worn areas in the joint often bring stiffness after sitting and soreness with repeated steps. Weak leg muscles may add strain because they share less work.

An old injury can change how the knee bears weight. Pain that starts in the hip or back can also be felt near the knee.

You aren't expected to find the cause before the exam. Notice the timing, swelling, and movements that have become harder.

Use an exam to sort the cause

A hands-on exam checks movement, strength, swelling, and the exact place that feels tender. Your description tells the provider what happens outside the clinic.

At QC Kinetix, regenerative treatment options mean non-surgical shots prepared with blood or bone marrow. Medical providers, the people who examine you, discuss them after checking your knee.

The exam may find soreness from worn joint areas, the hip, or the back. Sometimes no single cause is clear, and the provider should say so.

Ask what the scan has shown

A scan can show worn areas, how the bones line up, and other changes inside the knee. It cannot measure your soreness on the stairs.

Some knees look badly worn but cause little pain. Others show fewer changes even though walking and sleep are difficult.

Ask which scan finding may explain the soreness and which may not matter. A scan alone doesn't give the full answer.

Choose a result you can judge

Choose one daily activity to follow, such as walking farther or sleeping longer. You can then judge whether the care brought a useful change.

Feeling better doesn't prove that cartilage grew back. Studies have not found reliable cartilage growth after shots prepared from concentrated blood or bone marrow.

Judge care by whether soreness eases and movement improves, making daily life better. Keep the result tied to something you can notice.

Sources

1. FDA states plainly that no stem cell, exosome, stromal vascular fraction, umbilical cord blood, Wharton's jelly or amniotic-fluid product has been approved for the treatment of ANY orthopedic condition - it names osteoarthritis, tendonitis, disc disease, tennis elbow, back pain, hip pain, knee pain, neck pain and shoulder pain individually. The only FDA-approved stem cell products in the United States are cord-blood-derived blood-forming stem cells for disorders of the hematopoietic system, and there are currently no FDA-approved exosome products.

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

2. The RESTORE trial - a participant-, injector- and assessor-blinded RCT of 288 adults aged 50+ with symptomatic medial knee OA (Kellgren-Lawrence 2-3) - compared three weekly intra-articular PRP injections against saline placebo, with co-primary endpoints of 12-month knee pain and medial tibial cartilage volume on MRI. PRP did not beat placebo on either. It is the single best-designed test of the specific claim that PRP changes joint structure, and it was negative.

   Bennell KL, et al. — Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial.. JAMA, 2021. DOI: 10.1001/jama.2021.19415.

3. A four-arm, multicentre, single-blind phase 2/3 randomized trial of 480 knee OA patients (KL II-IV) compared autologous bone marrow aspirate concentrate, autologous adipose stromal vascular fraction and allogeneic umbilical-cord-tissue mesenchymal stromal cells against a corticosteroid injection control. At 12 months NONE of the three orthobiologic injections was superior to another, or to the corticosteroid control, and none of the four groups showed a significant change in MRI osteoarthritis score from baseline. No procedure-related serious adverse events occurred.

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

4. A cross-sectional study contacted 273 of 317 US centres offering direct-to-consumer stem-cell therapy, posing as a 57-year-old man with knee osteoarthritis. The mean advertised price of a unilateral same-day stem-cell knee injection was $5,156 (SD $2,446), and centres claimed a mean clinical efficacy of 82% (SD 9.6%) - a figure with no support in the published evidence. The gap between the quoted number and the trial data is the single most useful thing a patient can be told before a consultation.

   Piuzzi NS, et al. — The Stem-Cell Market for the Treatment of Knee Osteoarthritis: A Patient Perspective.. The journal of knee surgery, 2018. DOI: 10.1055/s-0037-1604443.

5. A dual systematic review compared the RCT evidence on injectable orthobiologics for knee OA with how news media describe it. Of 14 qualifying RCTs, 8 showed significant pain improvement and 10 function improvement, with frequent heterogeneity and risk of bias. Of 124 news articles: 79.0% highlighted benefits, only 29.8% mentioned drawbacks, 37.1% used the term 'stem cell' without specifying the product, 35.5% mentioned commercial entities with no disclosure, and 66.1% were favourable in tone. The authors conclude this disconnect encourages unrealistic expectations.

   Zhang EJX, et al. — Disparities in Evidence and Media Portrayal of Injectable Orthobiologics for Knee Osteoarthritis: A Systematic Review of Randomized Trials and News Media.. Orthopaedic journal of sports medicine, 2026. DOI: 10.1177/23259671261443876.

6. A randomized trial of 90 patients with KL grade 1-3 knee OA found bone marrow aspirate concentrate - the product most often sold as a 'stem cell injection' - was EQUIVALENT to, not better than, PRP through 24 months, with no statistically significant IKDC or WOMAC difference at any time point. Both arms improved from baseline and plateaued at 3 months.

   Anz AW, et al. — Bone Marrow Aspirate Concentrate Is Equivalent to Platelet-Rich Plasma for the Treatment of Knee Osteoarthritis at 2 Years: A Prospective Randomized Trial.. The American journal of sports medicine, 2022. DOI: 10.1177/03635465211072554.

7. A Level-1a systematic review of 87 randomized PRP-for-knee-OA trials (7,925 patients, 8,118 knees) scored them against the 23-item MIBO reporting checklist. The overall MIBO score was 72%, 71% of studies scored below 80%, and reporting was worst on exactly the items that define the product: whole-blood characteristics (20%), platelet recovery rate (22%), PRP analysis (30%), PRP activation (47%). Adherence did not improve after MIBO was published. Much of the PRP literature does not say what was actually injected.

   Nakagawa HF, et al. — Systematic Review of Randomized Controlled Trials Evaluating the Use of Platelet-Rich Plasma for Knee Osteoarthritis: Adherence to Minimum Information for Studies Evaluating Biologics in Orthopaedics.. The American journal of sports medicine, 2025. DOI: 10.1177/03635465241249996.

8. A 2026 systematic review and meta-analysis of 28 randomized trials of intra-articular mesenchymal stem cell-based therapies in knee OA found significant improvements in several pain and function measures (delta-VAS MD -1.67; KOOS pain MD 15.37) but NO significant difference in WOMAC, KOOS quality of life or the Lequesne index, and MRI-based WORMS scores were non-significant - indicating no consistent structural benefit. Its own conclusion: these therapies serve a primarily SYMPTOM-modifying rather than STRUCTURE-modifying role, with higher frequencies of local reactions to weigh against the symptomatic benefit.

   Awad G, et al. — Efficacy and safety of intra-articular mesenchymal stem cell-based therapies in knee osteoarthritis: A systematic review and meta-analysis of randomized controlled trials.. Clinical rheumatology, 2026. DOI: 10.1007/s10067-026-08042-w.

9. A GRADE-rated systematic review and meta-analysis of 16 randomized trials (807 participants) found that MSC therapy for chronic knee OA pain PROBABLY RESULTS IN LITTLE TO NO DIFFERENCE in pain relief at 3-6 months (WMD -0.74 cm on a 10 cm VAS against a minimally important difference of 1.5 cm) or physical functioning (WMD 2.23 on the SF-36 100-point subscale against a 10-point MID), both moderate certainty; at 12 months pain was again probably little-to-no-different (WMD -0.73 cm). The measured effect is real but sits BELOW the threshold at which a patient would notice it.

   Sadeghirad B, et al. — Mesenchymal stem cells for chronic knee pain secondary to osteoarthritis: A systematic review and meta-analysis of randomized trials.. Osteoarthritis and cartilage, 2024. DOI: 10.1016/j.joca.2024.04.021.

10. FORWARD, the longest disease-modifying osteoarthritis drug trial reported to date, gave intra-articular sprifermin (a recombinant FGF-18) or placebo to knee OA patients and followed 378 of them for 5 years. Sprifermin produced a significant, sustained dose-response INCREASE in total femorotibial cartilage thickness versus placebo - and WOMAC pain improved about 50% from baseline in ALL groups, including placebo. It is the cleanest demonstration in the literature that adding measurable cartilage and relieving pain are two different results, and that one does not deliver the other.

    Eckstein F, et al. — Long-term structural and symptomatic effects of intra-articular sprifermin in patients with knee osteoarthritis: 5-year results from the FORWARD study.. Annals of the rheumatic diseases, 2021. DOI: 10.1136/annrheumdis-2020-219181.

11. A systematic review of the discordance between clinical and radiographic knee osteoarthritis: many people with severe-looking x-rays have little pain, and many with disabling pain have modest radiographic change. This is the reason a post-treatment scan is a poor proxy for how someone feels, in either direction.

    Bedson J, et al. — The discordance between clinical and radiographic knee osteoarthritis: a systematic search and summary of the literature.. BMC musculoskeletal disorders, 2008. DOI: 10.1186/1471-2474-9-116.

12. The Cochrane review of exercise for knee osteoarthritis found high-quality evidence that land-based therapeutic exercise provides short-term benefit in pain and physical function, sustained for at least 2-6 months after the programme ends, with mild transient soreness the only reported adverse effect across 45 trials. It is the best-evidenced treatment for this condition and it costs nothing per injection.

    Fransen M, et al. — Exercise for osteoarthritis of the knee.. The Cochrane database of systematic reviews, 2015. DOI: 10.1002/14651858.CD004376.pub3.

13. A randomized trial in the New England Journal of Medicine compared physical therapy against intra-articular glucocorticoid injection for knee osteoarthritis and found physical therapy produced better WOMAC outcomes at one year. When a clinic offers an injection, the comparator that matters is not 'nothing' - it is a course of supervised exercise.

    Deyle GD, et al. — Physical Therapy versus Glucocorticoid Injection for Osteoarthritis of the Knee.. The New England journal of medicine, 2020. DOI: 10.1056/NEJMoa1905877.