Osteoarthritis

Regenerative Treatment Options Beyond Pain Management

Osteoarthritis is the most common form of arthritis. The Centers for Disease Control and Prevention reports that about 33 million American adults have osteoarthritis, and it accounts for nearly half of all arthritis diagnoses. It most often affects the knees, hips, hands, and spine, and it develops when the cartilage that cushions a joint gradually breaks down, leading to pain, stiffness, swelling, and reduced function over time.

Standard care manages the symptoms of osteoarthritis well for many people: activity modification, physical therapy, anti-inflammatory medication, and cortisone injections all have a role. Cortisone in particular is useful for short-term relief, though a 2017 randomized trial in JAMA found that repeated injections did not change the long-term trajectory of the joint. The challenge arrives when these measures stop providing meaningful relief and the only remaining option presented is joint replacement. For patients in that position, regenerative medicine offers a category of treatment worth understanding, along with an honest account of what it can and cannot do.

The honest starting point: regenerative therapy does not regrow a joint that has reached end-stage degeneration. What it can do, for the right patient at the right stage, is reduce pain, improve function, and delay the need for surgery and, for some patients, help them avoid surgery for a meaningful period of time. When treatment helps, the improvement is measured in pain and function rather than cartilage regrowth, and benefits are generally evaluated over several months rather than days. The difference between a good candidate and a poor one is exactly what a thorough evaluation determines.

What Is Happening Inside an Osteoarthritic Joint

Osteoarthritis is more than wear and tear. The cartilage thins and loses its smooth surface, the bone underneath remodels and can form spurs, the joint lining becomes inflamed, and the chemical environment inside the joint shifts toward inflammation. Pain comes from this combination of mechanical change and inflammatory signaling, which is why treatments that address only one part of the picture often produce only partial relief.

This also explains why the same diagnosis behaves so differently from one patient to the next. Two people with knee osteoarthritis on imaging can have very different levels of pain and function, and the right treatment depends on the stage of the disease, the joint involved, and the specific goals of the person living with it.

How It Works

How Regenerative Medicine Approaches Osteoarthritis

Regenerative treatments work by influencing the biological environment of the joint rather than masking symptoms. Two main approaches are used.

Platelet-rich plasma (PRP)

Platelet-rich plasma (PRP) concentrates the growth factors and signaling proteins from a patient’s own blood and delivers them into the joint to modulate inflammation and support tissue health. The evidence for PRP in knee osteoarthritis is among the strongest in regenerative medicine. A 2024 systematic review and meta-analysis in the American Journal of Sports Medicine, analyzing outcomes from 1,993 patients, found that PRP produced significantly higher rates of successful outcomes than hyaluronic acid injection, while cautioning that the individual trial results remain statistically fragile, which is grounds for cautious optimism rather than certainty. Similar findings have been reported in more recent work, including a 2025 review of 15 double-blinded randomized controlled trials involving 1,632 patients with mild-to-moderate knee osteoarthritis. The evidence tends to be strongest in patients with mild-to-moderate osteoarthritis rather than advanced bone-on-bone disease, which is consistent with how candidacy is assessed. One reason is that biologic treatments depend on there being enough remaining joint structure to influence. As osteoarthritis advances, the mechanical changes inside the joint become more severe, which may limit how much symptom improvement can be achieved with regenerative treatment alone.

Cell-based therapy

Cell-based therapy uses cellular preparations, typically bone marrow concentrate (BMC) or adipose-derived cellular preparations, with the goal of influencing inflammation and supporting the joint environment. The evidence here is more mixed and earlier in development. A 2024 meta-analysis of 18 randomized controlled trials found that mesenchymal stem cells were superior to placebo for relieving pain and improving function at 12 months, while other high-quality analyses have found results no different from placebo. A major reason findings differ across studies is that cell source, processing methods, dosing, and patient selection vary substantially between trials, which makes direct comparison difficult. The honest position is that cell-based therapy shows promise for selected patients but has not established the consistent superiority that would make it a default recommendation. It is important to be clear: PRP and cell-based therapies for orthopedic conditions are not FDA-approved, and no responsible provider can promise a specific result. What a good provider can do is match the treatment to the patient and the stage of disease, and say plainly when regenerative care is unlikely to help.

WHO

Which Joints, and Where to Read More

Osteoarthritis affects different joints in different ways, and the evidence and approach vary by location. Vita Nova has detailed guides for the most common areas:

Joint	What to Know
Knee	The most studied joint for regenerative treatment, with the strongest PRP evidence. See the Vita Nova knee pain guide for a full breakdown of options.
Shoulder	Osteoarthritis and rotator cuff-related changes respond differently to regenerative options, and the right approach depends on which is driving the pain. See the Vita Nova shoulder pain resources.
Spine (facet joints)	Facet joint arthritis is a different diagnosis and treatment pathway than disc-related back pain, with its own evidence base. See the Vita Nova back pain guide.
Hip and hands	Less evidence than the knee and typically stricter candidate selection. Research is growing, but results remain less predictable than in the knee, making careful patient selection especially important. Evaluated case by case during consultation.

WHO

Who Is a Candidate

Candidacy for regenerative treatment of osteoarthritis depends on the stage of cartilage loss on imaging, the joint involved, how long symptoms have been present, what has already been tried, overall health, and realistic expectations about the outcome. In general, patients with mild-to-moderate osteoarthritis who have not had lasting relief from conservative care, and who want to explore a biologic option before considering joint replacement, are the most reasonable candidates to evaluate.

Patients with end-stage osteoarthritis, severe deformity, or bone-on-bone joints are usually better served by a surgical evaluation, and a clinic that tells every patient they are a candidate is not providing individualized care. The point of an honest consultation is to determine which path actually fits your joint and your goals.

PRP and cell-based treatments are generally not covered by insurance. Exact costs depend on the joint and the protocol, and are quoted in full at the consultation, before any commitment.

NOTE

A Note on Getting It Right

The strongest advice for anyone weighing osteoarthritis treatment is to seek more than one perspective. A surgeon will evaluate you against the criteria for joint replacement. A regenerative medicine physician will evaluate you against the criteria for biologic and minimally invasive options. Hearing both makes the eventual decision clearer, whichever direction it points.

Expectation

What to Expect from a Vita Nova Consultation

A Vita Nova evaluation is built around a thorough consultation rather than a quick treatment pitch. In practice, that means some patients are told a regenerative option is reasonable to try, and others are told their imaging points toward physical therapy, a surgical evaluation, or continued conservative care instead. Not every consultation results in a recommendation for regenerative treatment. Dr. Mehta and Kate Sherman, PA-C take time to review imaging, prior treatments, symptom history, and functional goals, explain the options in plain language, and set realistic expectations about what regenerative care can and cannot do. The goal of the visit is an honest answer about what fits your specific joint and stage, not a recommendation to proceed regardless.

For Nashville-Area Patients

For patients in Nashville and Franklin, Tennessee living with osteoarthritis that has not responded fully to standard care, Vita Nova Stem Cell Professionals in Franklin offers physician-led evaluations with no obligation to proceed. Dr. Hemal V. Mehta, MD brings fellowship training in interventional spine and pain medicine alongside 25 years of physical medicine and rehabilitation practice, and Kate Sherman, PA-C brings over 20 years of clinical experience with deep orthopedic focus. Together they review your imaging, your history, and your goals, and give you a clear answer about which options fit your case and which do not.

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This page is for informational purposes only and does not constitute medical advice. PRP and cell-based therapies for orthopedic conditions are not FDA-approved. Individual results vary. Consult a qualified physician before making decisions about care.