Try the care that fits your knee now

Try strength and lighter loads first

Stronger leg muscles can make standing, stairs, and longer walks easier. Several short sessions may suit the knee better than one hard workout.

Change an activity before giving it up. Walk a shorter distance, use a rail, or allow more rest between games.

This care may help even when a scan looks the same. It isn't merely something to do while waiting for treatment.

Ask how PRP is prepared

PRP is short for platelet-rich plasma, a knee shot made after a sample of your blood is spun and concentrated. Clinics don't all prepare the shot in the same way.

Why does that matter? A study of one PRP mixture may not tell you how a different mixture works.

Ask how the blood is spun and which part goes back into the knee. The clinic should give you a clear answer before you choose care.

Some studies suggest that PRP may ease soreness or movement, but they don't show how much your knee will improve. In one study, people did not know whether they received PRP or a salt-water shot.

PRP did no better in that comparison, and reliable cartilage growth has not been shown. At Chandler, QC Kinetix offers regenerative treatments, meaning non-surgical shots prepared from either blood or bone marrow.

Ask about side effects, time after the shot, full cost, and the chance of no relief. Those are the treatment limits that matter to your choice.

Ask what orthobiologics contain

Orthobiologics is the medical name for joint shots using blood or material drawn from bone marrow. Each option may contain something different.

Joint preservation means trying to keep the knee moving and delay surgery. It doesn't mean that a shot has rebuilt worn cartilage.

Ask what will be in the shot, how the clinic prepares it, and who gives it. The answer should name the material and the expected change in soreness or movement.

Discuss surgery when daily life stays hard

Knee surgery alternatives include strength work, braces, medicine, and non-surgical shots. They may help delay surgery when they ease soreness enough for daily life.

Badly worn joints, a bent-looking knee, or soreness at rest may warrant seeing a surgeon. Replacement removes damaged joint surfaces and puts an implant in their place.

Surgery isn't a personal failure, and waiting isn't always helpful. Ask which choice matches what the knee now keeps you from doing.

Sources

1. The 2019 ACR/Arthritis Foundation guideline makes STRONG recommendations for exercise, weight loss in people with overweight or obesity, self-efficacy and self-management programs, tai chi, cane use, tibiofemoral bracing, topical NSAIDs, oral NSAIDs and intra-articular glucocorticoid injection in knee OA. Notably it does NOT strongly recommend any biologic injectable.

   Kolasinski SL, et al. — 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee.. Arthritis & rheumatology (Hoboken, N.J.), 2020. DOI: 10.1002/art.41142.

2. OARSI 2019 designates arthritis education plus structured land-based exercise (with or without dietary weight management) as CORE treatments for knee OA and strongly recommends topical NSAIDs (Level 1A), while strongly recommending AGAINST oral and transdermal opioids (Level 5). The treatments with the strongest evidence in this condition remain the least dramatic ones.

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

3. 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.

4. In a 2-year RCT, intra-articular triamcinolone given every 12 weeks for knee OA produced significantly GREATER cartilage volume loss than saline, with no significant pain benefit. The most widely used joint injection in medicine is itself associated with structural harm on repeat dosing - relevant context when a clinic frames a biologic as 'the alternative to steroid shots'.

   McAlindon TE, et al. — Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial.. JAMA, 2017. DOI: 10.1001/jama.2017.5283.

5. 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.

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 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.

8. 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.

9. 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.

10. A CDC-led national public health investigation identified culture-confirmed bacterial infections in 20 patients (median age 63) across 8 US states who received umbilical cord blood-derived products marketed as stem cell treatment for pain, osteoarthritis, rheumatoid arthritis and injury. ALL BUT ONE REQUIRED HOSPITALISATION. Of unopened, undistributed product vials sampled, 65% (22 of 34) were contaminated with at least one of 16 bacterial species, mostly enteric; whole-genome sequencing linked an Arizona patient isolate to product administered in Florida.

    Hartnett KP, et al. — Investigation of Bacterial Infections Among Patients Treated With Umbilical Cord Blood-Derived Products Marketed as Stem Cell Therapies.. JAMA network open, 2021. DOI: 10.1001/jamanetworkopen.2021.28615.