Orthobiologics Mesa: joint care made from blood or other body material

Why has this joint started aching?

Cartilage covers each bone end so the joint can move smoothly. Arthritis can wear this cover and make movement stiff or sore. Past damage can alter how weight passes through the joint, while tendons can ache after repeated work.

An X-ray can reveal wear, though it can't show how much you hurt. A worn joint may cause little trouble during an easy day. A joint with less wear may still ache after a long outing. Your daily limits tell the clinician what the X-ray cannot.

What may calm the soreness at home?

Ease back from the movement that caused the flare, though you don't need to stay still all day. Gentle motion can keep stiffness from building. A cool pack may calm swelling after activity.

Regular exercise strengthens supporting muscles, so begin with movement you can control without sharp pain. Notice the joint after supper and once more when you wake. If the ache keeps climbing, reduce the effort or stop.

What can you try before surgery?

Home care and physical therapy often come before a clinic procedure. Medicine may ease soreness, but a clinician must check your other drugs. Surgery may still help with severe wear, though hearing that opinion doesn't mean you've agreed to it.

Regenerative treatments use material from your body in hopes of easing soreness. To make platelet-rich plasma, or PRP, staff spin your blood until more platelets collect in one portion. Platelets are small blood parts involved in healing. Concentrated PRP has more platelets than standard PRP, but more doesn't prove better relief or greater risk.

Sources

1. The ESSKA-ORBIT European consensus on blood-derived orthobiologics graded 28 question-statement sets; only 9 of 28 had high-level scientific support. Three statements reached grade A: that there is enough preclinical and clinical evidence to support PRP use in knee OA; that clinical evidence shows effectiveness in MILD TO MODERATE knee OA (KL grade 3 or lower); and that PRP provides a longer effect than the short-term effect of corticosteroid with a safer profile. The panel regarded PRP as a valid and possible first-line injectable option for KL grades 1-3.

   Laver L, et al. — The use of injectable orthobiologics for knee osteoarthritis: A European ESSKA-ORBIT consensus. Part 1-Blood-derived products (platelet-rich plasma).. Knee Surgery, Sports Traumatology, Arthroscopy, 2024. DOI: 10.1002/ksa.12077.

2. The companion ESSKA-ORBIT consensus on cell-based therapy (77 experts, 22 countries, 27 statements) found only 5 of 27 statements reached recommendation level A or B; 22 were rated C or D. It concluded that cell-based therapy shows clinical benefit in pain and function up to 12 months for KL grades 1-3 with some benefit in selected KL 4, but that because of limited high-quality studies and NO clear superiority over other injectables it should be considered a SECOND-LINE option, after other non-operative treatment fails.

   de Girolamo L, et al. — The use of injectable orthobiologics for knee osteoarthritis: A formal ESSKA-ORBIT consensus. Part 2-Cell-based therapy.. Knee Surgery, Sports Traumatology, Arthroscopy, 2025. DOI: 10.1002/ksa.70001.

3. RESTORE, the largest and most rigorously blinded placebo-controlled PRP trial in knee OA (n=288, participant-, injector- and assessor-blinded), gave three weekly injections of a commercial leukocyte-poor PRP or saline. At 12 months the change in knee pain was -2.1 vs -1.8 points (difference -0.4; 95% CI -0.9 to 0.2; P=.17) and the change in medial tibial cartilage volume was -1.4% vs -1.2% (difference -0.2%; P=.81). Twenty-nine of 31 prespecified secondary outcomes showed no between-group difference. The authors concluded the findings do not support the use of PRP for knee OA.

   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.

4. FDA states verbatim of stem cell products, stromal vascular fraction (adipose-derived cells), umbilical cord blood, Wharton's jelly, amniotic fluid and exosome products: 'None of these products have been approved for the treatment of any orthopedic condition, such as osteoarthritis, tendonitis, disc disease, tennis elbow, back pain, hip pain, knee pain, neck pain, or shoulder pain.' The only FDA-approved stem cell products in the United States are blood-forming (hematopoietic progenitor) cells derived from umbilical cord blood, approved only for disorders of blood production, and there are currently NO FDA-approved exosome products.

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