Does it work? Start with your joint and your goal

An easier daily task is a useful sign of relief

Soreness can ease and return even without new care. One good week after a procedure may still feel welcome. It doesn't show whether the change will last. Choose one or two tasks before care begins, then watch those same tasks.

For a knee, you might track rising from a chair. For a hip, watch how you put on a shoe. For a shoulder, notice reaching overhead or sleeping on that side. Write down what you can do before and after care.

Your own daily tasks show whether the relief matters to you.

Results only apply to the procedure that was studied

Marrow is the soft tissue inside your bones. To make bone marrow concentrate, a clinician puts a needle through skin over the pelvis near your lower back. Liquid marrow is drawn out and spun so certain parts gather together. Another needle puts the concentrated liquid into the aching joint.

Cells grown in a lab are increased over days or weeks, not prepared during one office visit. A result for those cells doesn't answer whether marrow concentrate will help your knee.

The letters PRP mean platelet-rich plasma. A clinic takes blood from you, then uses a spinning machine. Blood parts called platelets collect in a smaller amount of liquid. Concentrated PRP holds more platelets in the amount used. More platelets don't prove better relief or greater safety.

Compare results only after you confirm that the exact procedure matches.

A fair answer allows for little or no relief

An office procedure can't promise a certain result. Some people improve, while others don't feel much change. Relief varies with the cause and amount of joint wear. Have the clinic give you exact dates for checking progress. Relief has lasted when the same daily task stays easier at later checks.

Before starting, ask what happens if the first procedure doesn't help. Later care might include more exercise, another opinion, or surgery advice. That question doesn't schedule a second procedure; it tells you which choices will remain.

That is the straight answer to “does it work?”

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. A 2025 systematic review and meta-analysis of 8 randomized trials in 502 patients found intra-articular mesenchymal stem cells improved WOMAC scores versus control at 6 months (MD 7.44, 95% CI 1.45-13.42) and 12 months (MD 10.31, 95% CI 0.96-19.67), with wide confidence intervals and a small pooled sample.

   Cao M, et al. — Efficacy and safety of mesenchymal stem cells in knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Stem Cell Res Ther, 2025. DOI: 10.1186/s13287-025-04252-2.

3. A phase III double-blind placebo-controlled trial in 261 patients with Kellgren-Lawrence grade 3 knee osteoarthritis tested a single injection of autologous culture-expanded adipose-derived mesenchymal stem cells - a product that cannot legally be sold outside a clinical trial in the United States because culture expansion is more than minimal manipulation.

   Kim KI, et al. — Clinical Efficacy and Safety of the Intra-articular Injection of Autologous Adipose-Derived Mesenchymal Stem Cells for Knee Osteoarthritis: A Phase III, Randomized, Double-Blind, Placebo-Controlled Trial. Am J Sports Med, 2023. DOI: 10.1177/03635465231179223.

4. A phase 3 placebo-controlled trial of 146 patients using allogeneic bone marrow-derived MSCs (25 million cells) plus hyaluronic acid reported significant WOMAC improvement versus placebo at 6 and 12 months, with a roughly 24 percent relative change - one of the more favourable trials, and it used a culture-expanded product administered with hyaluronic acid rather than a same-day clinic preparation.

   Gupta PK, et al. — Efficacy and Safety of Stempeucel in Osteoarthritis of the Knee: A Phase 3 Randomized, Double-Blind, Multicenter, Placebo-Controlled Study. Am J Sports Med, 2023. DOI: 10.1177/03635465231180323.

5. A 2023 appraisal of 15 randomized and 11 non-randomized trials of culture-expanded MSCs for knee osteoarthritis found function improved relative to control in 11 of 15 RCTs and cartilage protection or repair reported in 18 of 21 imaging studies, but noted the total sample of 610 patients limits any definitive conclusion.

   Copp G, et al. — Culture-expanded mesenchymal stromal cell therapy: does it work in knee osteoarthritis? A pathway to clinical success. Cell Mol Immunol, 2023. DOI: 10.1038/s41423-023-01020-1.

6. A meta-analysis of 14 placebo cohorts across 13 Level I trials in 1,076 knee osteoarthritis patients found that intra-articular saline - the placebo - produced pain and function improvements exceeding the minimal clinically important difference at 3 and 6 months.

   Saltzman BM, et al. — The Therapeutic Effect of Intra-articular Normal Saline Injections for Knee Osteoarthritis: A Meta-analysis of Evidence Level 1 Studies. Am J Sports Med, 2017. DOI: 10.1177/0363546516680607.

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. 21 CFR 1271.10(a) sets the four criteria a human cell or tissue product must meet to be regulated SOLELY under section 361 of the Public Health Service Act: it must be minimally manipulated; intended for homologous use only, as reflected by labeling and advertising; not combined with another article beyond water, crystalloids or a preserving agent; and either have no systemic effect and not depend on the metabolic activity of living cells, or else be for autologous use, use in a close blood relative, or reproductive use.

   US Code of Federal Regulations, Title 21 — 21 CFR 1271.10 - Are my HCT/P's regulated solely under section 361 of the PHS Act. , 2004.

9. 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.