Stem Cell for Knee Osteoarthritis: Evidence Review (2023)

If you are looking for up-to-date summary evidence on stem cell treatment for knees, you've come to the right place.

Globally, stem cell therapy is being touted as a miracle cure for everything from wrinkles to spinal repair. However, there is also a lot of misinformation out there. Even among medical groups, the recommendations are conflicting, lacking in depth and out-dated. 

Most consumers are interested in stem cell treatment for knee pain because it's a non-surgical option as opposed to knee replacement surgery. 

Due to the large burden of disease attributable to knee osteoarthritis, it is important that consumers, healthcare providers and policy‐makers have the most up‐to‐date summary of the evidence for this intervention so they can make informed decisions.

The stages of osteoarthritis, as demonstrated in the knee joint

Some doctors and media channels argue that there is very little evidence to support the use of stem cells to treat orthopaedic conditions. As with most cutting edge treatment, research and experiment is part of a continuous improvement process.

As of April 2023, there are more than 450 scientific publications related to the use of stem cells in treating knee orthopaedic conditions alone. More than 100 studies have been launched to investigate the benefits of stem cell therapy and knee osteoarthritis. You can review the status of these trials on clinicaltrials.gov.

Stem Cell Therapy for Knee Osteoarthritis Evidence and Reviews

There are many customer reviews on Google reviews, Facebook and Vitals.com. Most of them are subjective and could be potentially biased. Although individual customer reviews are useful, it's difficult to analyse all of them individually and to draw a conclusion based on those reviews. Most government agencies and researchers conduct reviews on studies that are published on peer-reviewed journals by doing searches on PubMed.

Some doctors and media channels argue that there is very little evidence to support the use of stem cells to treat orthopaedic conditions. However, there are more than 400 publications related to the use of stem cells in treating knee orthopaedic conditions alone. There are currently more than 100 studies on stem cell treatment for knee osteoarthritis alone, under the U.S. Clinical Trial Registry.

A review of 19 studies (Kenneth 2019), published in 2019 concluded that Mesenchymal Stem Cell therapies in the treatment of knee OsteoArthritis are safe and have shown promising results. Allogeneic (source from different individuals) MSCs offer theoretical advantages over autologous (source from self) MSCs, especially in ease of use and consistency of product, but there are concerns regarding cell viability and vitality, as well as the body's response to non-autologous products. 

A systematic review (Yubo 2017) of 11 RCTs (randomised controlled trials) concluded that MSCs (mesenchymal stem cells) transplantation treatment was shown to be safe and has great potential as an efficacious clinical therapy for patients with knee Osteoarthritis.

Regenexx, the largest provider of stem cell therapy for orthopaedic conditions in the United States alone, have treated 30,000 patients with stem cell therapy for various joint conditions including knee pain. According to Regenexx, common regenerative medicine treatments used in common orthopedic problems have better research evidence than orthopedic surgery.

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Several other comparative studies have demonstrated good evidence in the treatment of osteoarthritis. However, there are several approaches and cell lines used. More well-designed and randomised controlled trials are needed to evaluate the best approach and universal consensus. As studies continue, the methods, forms and combinations of stem cell preparations are improving, and outcomes are expected to improve as well.

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Related: Orthopedic Stem Cell Type and Extra Cellular Matrix Research Summary (1997 - 2021)

Stem Cell Therapy Cost for Knees

Patients are paying around $5K-$10K in the United States for knee stem cell treatment where clinics are largely claiming 70-100% success.

Image via DVC Stem

How much does stem cell treatment cost in general?

On average, patients can expect to spend around $5,000 to $20,000 or more on stem cell therapies. In general, orthopedic treatments are less expensive, while treatments for chronic and complex conditions are more expensive. Most of those paying lower stem cell treatment costs under $5,000 were pursuing treatment for orthopedic or musculoskeletal conditions. (Source)

A patient paid $6,500 for a stem cell treatment on one knee in 2014, which was completed at the National Spine and Pain Center in Fairfax, VA. (Source)

In general, orthopedic treatments are less expensive, while treatments for chronic and complex conditions are more expensive. In contrast, most of the individuals who paid higher treatment costs were getting treated for systemic or more complex conditions, such as diabetes, multiple sclerosis (MS), neurodegenerative diseases (such as Alzheimer’s disease or dementia), psoriatic arthritis, or autism.

So why is stem cell therapy so expensive?

The short answer to that question is that the stem cell field is still highly specialized and complicated. For example, stem cell treatment for leukemia will require a hemato-oncologist; which is a sub-specialty within the specialty area of hematology.

Further, the capital and operating expenditure to source, expand stem cells and maintain high quality standards within a stem cell lab are high.

However, due to its demand, novelty and popularity; there are many un-ethical providers that are taking advantage of the demand. Many countries have taken steps to regulate the stem cell industry in order to protect the consumers. 

Other than hematological stem cells, most of the stem cell treatments have not been adopted by the mainstream and insurance companies. Additionally, the field is further restricted by older laws in the United States. That means that there are very few sources for stem cells, labs that are equipped to process stem cells, and reputable clinics that provide the treatments, most of which are located outside the US. Just as with an expensive food or item of clothing, the problem is with availability and production cost.

Stem Cell Therapy Dose for Knee Osteoarthritis

For allogeneic UC-MSC (Umbilical cord - Mesenchymal Stem Cells), a 25-million cell dose may be the most effective among the doses tested for pain reduction (Arthritis Res Ther. 2016). That said, please discuss the optimal treatment with your knee specialist as there might be other factors that might need to be personalised to your situation.

Where do I find out whether stem cell therapy for my knee is an option?

Regenexx has over 70 clinic locations in the United States offering non-surgical Regenexx solutions for musculoskeletal pain.

Key Takeaway

Certain patients are likely to benefit from stem cells instead of knee replacement surgery depending on their age and severity of disease, since joint replacement has its own risks. That said, stage 4 or severe knee osteoarthritis is unlikely to benefit from stem cells. You should consult your doctor and come to a decision together.

Other alternatives include supplements, PRP (platelet rich plasma), physical therapy and weight loss might help as well. The Mayo Clinic and others are using approaches beyond stem cells. They are also testing approaches using cartilage cells called chondrocytes instead of stem cells, which also show promise.

Related: 

• Best Stem Cell Treatments

• Best joint supplement for knees

• 9 Best Ways for Treating Knee Arthritis

• Stem Cell Knee vs Total Knee Replacement