What can you try before joint surgery?

What can help at home?

Briefly avoiding whatever starts your ache may calm the joint. Complete rest often isn't needed. Gentle exercise can strengthen nearby muscles without asking too much at once.

A cane may take some weight off the joint, while a brace can support it. Some people take medicine or rub medicine over the sore area. Your doctor can check whether either is safe with the medicines you take.

Choose one daily task to judge whether the care is helping. You might notice sleep, a short walk, or the stairs. Compare what you could do and how the joint felt later.

What does orthobiologics mean, and what is PRP?

Orthobiologics is the clinic word for joint care made from blood, bone marrow, or fat. Platelet-rich plasma (PRP) is one such choice, made from blood the clinic takes from your arm. Staff spin that blood to collect the platelet-rich part and place it into the sore joint.

Concentrated PRP is made from your blood in the same basic way. It has more platelets than the clinic's other PRP choice. You can ask why one is being offered and what difference to expect.

These regenerative treatments are intended to help the body repair a joint, but the name isn't a promise. You can keep up easy strength work while weighing knee or hip surgery alternatives. At QC Kinetix, medical providers—the staff members at the clinic who examine joints—can offer PRP or concentrated PRP after talking with you about the daily task you would most like to do again with greater comfort.

Sources

1. The AAOS third-edition clinical practice guideline for non-arthroplasty management of knee osteoarthritis is the orthopedic profession's own GRADE-style appraisal of the same options a regenerative clinic sells; it is the benchmark against which any 'regenerative' claim on this topic should be read, and it rates the strongest support for exercise, weight loss and self-management rather than for injectables.

   Brophy RH, et al. — AAOS Clinical Practice Guideline Summary: Management of Osteoarthritis of the Knee (Nonarthroplasty), Third Edition.. The Journal of the American Academy of Orthopaedic Surgeons, 2022. DOI: 10.5435/JAAOS-D-21-01233.

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 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.

5. 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.

6. 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.

7. 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.

8. 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.

9. The AAOS clinical practice guideline summary on SURGICAL management of knee osteoarthritis - the other end of the ladder, and the honest comparator for anyone told a biologic injection will let them avoid an operation.

   Srivastava AK, et al. — American Academy of Orthopaedic Surgeons Clinical Practice Guideline Summary of Surgical Management of Osteoarthritis of the Knee.. The Journal of the American Academy of Orthopaedic Surgeons, 2023. DOI: 10.5435/JAAOS-D-23-00338.

10. 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.