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Stem Cell Therapy for Osteoarthritis Pain: What the Evidence Shows, Who It Helps, and What to Expect
13 Yearsin practice
Physician-Led Careevery visit
Denver + 7 LocationsCO, TX, AZ, NE, OK
Key takeaways
- Osteoarthritis (OA) is wear and inflammation in a joint, not just “bone on bone.” Pain depends on much more than what your X-ray shows.
- If joint pain is holding you back from the hiking, golf, or pickleball you love, stem cell therapy may help. Many patients with moderate OA experience less pain and better movement, and we’ll tell you honestly whether you’re a good candidate.
- Candidacy matters more than anything else. We turn away patients whose joints are too far gone, and we’ll tell you so.
- It works best alongside strength training, weight management, and a smart activity plan.
A note from the doctor
Why I wrote this page
Most patients who come to see me have already done their homework. They’ve tried the anti-inflammatories, the physical therapy, maybe a cortisone shot or two. They are active people in their 40s, 50s, and 60s who aren’t ready to give up hiking, golf, skiing, or simply getting through a workday without pain. And they’ve been handed a lot of confusing information.
My goal here is to give you the full picture, so you can decide whether regenerative treatment is worth a conversation.
The Basics
What is osteoarthritis?
Osteoarthritis is the most common form of arthritis. It develops when the cartilage that cushions the ends of your bones thins and the tissues around the joint become irritated. Over time, the joint lining can become inflamed, the underlying bone can change, and the muscles around the joint can weaken as you move less to avoid pain.
OA is not simply “wear and tear.” It is an active process involving the whole joint, including cartilage, bone, the synovial lining, ligaments, and surrounding muscle. That is part of why treatment aimed only at cartilage often falls short.
Common early signs:
- Stiffness after sitting or in the morning, usually easing within 30 minutes
- Aching after activity that lingers into the evening
- A joint that feels less trusting on stairs or uneven ground
- Swelling, a grinding or catching sensation, or reduced range of motion
OA most often affects the knees, hips, hands, spine, shoulders, and ankles.
Reading your imaging
What does your X-ray or MRI actually mean?
Many patients are told they are “bone on bone” and assume surgery is the only path. In reality, imaging and pain don’t always match. Some people with severe-looking X-rays have manageable symptoms, and some with mild changes are in significant pain.
Doctors often grade knee OA using the Kellgren-Lawrence scale:
Grade 0
Normal
No OA changes
Grade 1
Doubtful narrowing, possible tiny bone spur
Lifestyle, strengthening, monitoring
Grade 2
Definite bone spurs, possible mild narrowing
Conservative care; regenerative options may be considered
Grade 3
Moderate narrowing, multiple bone spurs, some bone changes
Regenerative therapy may reduce pain and help you stay active, and surgery can remain a later step if necessary.
Grade 4
Severe narrowing, large spurs, significant bone deformity
Replacement may be your best option, but many patients at this stage choose to explore other routes first. Regenerative therapy may bring some pain relief and improved function, and we'll give you an honest read on whether it's worth trying.
Your grade is one factor, not a verdict. We also consider your symptoms, function, alignment, weight, activity level, and goals.
Compare
Your options, compared honestly
No single treatment is right for everyone. Here is how the main options compare.
| Option | What it does | Typical duration | Main limitations |
|---|---|---|---|
| Physical therapy and strengthening | Improves joint support and mechanics | Ongoing | Requires consistency; may not be enough alone |
| Oral NSAIDs / topical pain relievers | Reduce pain and inflammation | Hours | Long-term NSAID use can affect stomach, kidneys, and heart |
| Corticosteroid injection | Powerful short-term anti-inflammatory | Weeks to a few months | Repeated injections may be associated with additional cartilage loss |
| Hyaluronic acid injection | Lubricant and cushion | Several months, variable | Evidence is mixed; insurance coverage varies |
| Stem cell therapy | Goes beyond pain relief. Stem Cells placed directly into the joint release growth factors and signaling proteins that calm inflammation, support the surrounding tissue, and create the conditions the joint needs to function and recover. | Variable | Not FDA-approved for OA, Not covered by insurance |
| Joint replacement | Replaces the damaged joint | Often 15+ years | Major surgery, recovery time, not reversible |
If your joint is severely damaged and surgery is clearly indicated, I will tell you that and refer you to an orthopedic surgeon. Joint replacement is an excellent operation for the right patient.
How it may help
How regenerative therapy may help
What that may mean for you:
- Less pain with walking, stairs, and activity, and for some patients, little or no pain at all
- Less morning stiffness
- Better range of motion, with some patients regaining full motion
- Less reliance on pain medication, and for some patients, no medication at all
- More confidence in the joint, and more freedom to do what you enjoy
Results vary. Not every patient responds, and outcomes depend on the joint, the stage of arthritis, and the individual.
Regenerative therapy uses your body’s own healing biology, delivered by cells called mesenchymal stem cells (MSCs), placed directly into or near the painful joint. These cells act like project managers for repair.
They release growth factors and anti-inflammatory proteins that may calm irritation, support surrounding tissue growth, and create a healthier environment inside the joint.
For many patients, that means less pain, easier movement, and more likely getting back to the activities that matter to them.
What it does not mean:
- A promise to regrow cartilage and get a new joint
- A guarantee you'll avoid joint replacement
- A permanent fix
The Research
What does the research say?
Here is the honest summary. Several randomized trials and meta analyses report that MSC injections improve pain, stiffness, and function in knee OA. A 2025 meta-analysis of randomized trials found improvements with stronger effects in some studies using adipose derived cells and higher doses.
Studies differ in cell type, dose, preparation, injection technique, and patient selection, which makes results hard to compare. Evidence for hips, shoulders, and hands is thinner than for knees.
What that means in practice: some patients with moderate OA report meaningful improvement. Others do not. Anyone who tells you the outcome is guaranteed is not being straight with you.
Candidacy
Who is a good candidate?
The patients who tend to do best:
- Mild to moderate OA (roughly Kellgren-Lawrence grade 2 to 3) with remaining joint space
- Pain that persists despite conservative care
- Good alignment and a healthy weight, or willingness to work on it
- Realistic expectations: less pain and better function, not a new joint
- Willingness to follow a strengthening plan
When we may recommend against treatment:
- Severe, end-stage OA with collapsed joint space or major deformity
- Active infection in or near the joint
- Active cancer or recent cancer treatment
We do say no. If we don't think you're likely to benefit, we'll explain why and point you toward a better option.
Every Joint
Joint by joint
Knees
The most studied joint, and where the evidence is strongest. Knees are well suited to ultrasound-guided injection.
Hips
Hips sit deeper, so injections are image-guided. Hip OA is commonly treated, though the research base is smaller than for knees.
Shoulders
The glenohumeral joint and rotator cuff are often involved together. We assess whether pain is from arthritis, a cuff tear, or both, because that changes the plan.
Hands and thumbs
Thumb-base arthritis is common in people in their 50s and 60s.
Ankles and feet
Often follows an old injury. We commonly see patients for Plantar Fasciitis, Arthritis, Achilles Tendinitis & Tendinopathy.
Spine
Facet joint arthritis and disc degeneration are different problems with different options. See our Back Pain page.
More Conditions
Orthopedic conditions we see
Regenerative options may be considered for selected patients with these orthopedic conditions.
Meniscus tears
Torn cartilage cushions in the knee, common with age and twisting sports.
ACL, MCL and other ligament injuries
Partial tears and sprains that leave a joint feeling unstable.
Rotator cuff tears and tendinopathy
Shoulder tendon injuries, often alongside shoulder arthritis.
Labral tears
Hip and shoulder socket cartilage tears.
Cartilage defects
Focal cartilage damage and chondromalacia.
Tendinitis and tendinopathy
Tennis and golfer's elbow, patellar and Achilles tendons.
Bursitis
Inflamed cushioning sacs at the hip, shoulder, elbow, and knee.
Plantar fasciitis and ankle sprains
Common foot and ankle conditions in active adults.
Your visit
What treatment looks like at Cendant
1Consultation and review
We review your history, prior treatments, imaging, and goals. If you send recent X-rays or MRI ahead of time, we can give you a preliminary view before you travel or schedule.
2Exam and candidacy decision
A physical exam, a look at your imaging, and a frank conversation about whether treatment makes sense.
3Procedure
- A plan chosen for your joint. There is no one-size-fits-all protocol here. Your physician selects the biologics that best fit your joint, your stage of arthritis, and your goals.
- Cell collection, if applicable. When your own cells are part of the plan, we collect bone marrow aspirate (BMAC) from the iliac crest. Your physician thoroughly numbs the area with lidocaine, and you also receive nitrous oxide to help you stay relaxed and comfortable. The collection takes just several minutes, and most patients tolerate it very well.
- Lab preparation. Your sample is prepared in our lab, where the tissue is processed and the stem cells are isolated and concentrated for injection.
- Image-guided injection. Your physician places the prepared cells into or near the joint using ultrasound guidance. Imaging helps get the cells where they are intended to go. To keep you comfortable, we use lidocaine, nitrous oxide, or both, depending on your joint and your needs.
4Recovery
You walk out the same day. We want you using your joint, because staying active helps preserve the muscle strength that supports it. Many patients have no restrictions at all. Others are asked to hold off on high-stress activity for up to two months, depending on how active they want to be. Common examples are lateral movements like tennis and demanding skiing such as moguls. Athletes are generally asked to slow down for a couple of months while the joint settles. Your physician will give you a plan that fits your joint and your goals.
5Rehab and follow-up
The six months after your procedure are the most important window, so we stay involved. We follow up with you during that time to check your progress and make sure you're moving in the right direction. If it would help, your physician may also prescribe a strengthening plan tailored to your joint and your goals.
In their own words
Patient stories
Rich
Read the transcript
My tennis was restricted. I could not play. When I would play a match and I'd go home, there was pain. I couldn't sleep, so I started looking at options. I found Cendant and here I am.
It's a walk-in process. You walk in, you walk out within an hour and a half to two hours. They take the stem cells from your stomach. They process them and reinject them into your knees.
The regeneration of cells at critical points of where you're having problems was very attractive to me. It made sense. And I was back playing tennis within 60 days. After a match, I wasn't having any problems. So I'd go home and I'm leery. How am I gonna wake up? And when I'd wake up, it was zero.
Individual results vary. Rich shared his own experience.
Karl
Read the transcript
Well, I finally reached the point where some of the things I really enjoy doing, like big game hunting, hiking around the mountains of Colorado, fishing, and skiing, I just couldn't do without extreme pain. So I finally decided I had to do something. I stumbled into this stem cell concept and decided that this was for me.
Then you go in, and the nice thing is they give you a couple shots up the knees, which is pretty much painless. And then you do the procedure, and it takes an hour and a half, and basically you walk out. Home you go.
I can't imagine why anybody wouldn't want to try this before they'd want to have knee replacement, which is a serious, serious surgical procedure.
Individual results vary. Karl shared his own experience.
Next step
How can we help you?
Send us a few details, or call 720-338-4491. A care coordinator will contact you within 2 hours.
Timeline
A realistic timeline
What many patients experience (individual results vary).
- Days 1–3
Soreness, swelling, or warmth at the injection site is common
- Weeks 1–2
Return to normal activity; low-impact movement encouraged
- Weeks 4–8
Common for patients to begin noticing changes; some don't yet
- Months 3–6
Patients often feel the most noticeable gains here, with less pain, easier movement, and more confidence in the joint.
- Months 6–12
Follow-up assessment; decide whether further care is needed
Safety
Safety, side effects, and FDA status
Common, short-lived effects
Soreness, swelling, stiffness, or mild warmth at the injection site.
Rare but serious risks
Any injection carries a small risk of infection. Allergic reactions and bleeding are rare.
FDA status, plainly
The FDA has not approved stem cell injections for osteoarthritis.
Cost
How much does it cost?
Treatment at Cendant typically ranges from $5,000 to $8,500 for a single joint or spine case. Multi-joint cases typically range from $9,000 to $13,500.
Typical price ranges
Single joint or spine$5,000 – $8,500
Multi-joint$9,000 – $13,500
$0$3,500$7,000$10,500$14,000
Your plan is built around your joint and your goals, so your final cost depends on three things:
- The biologics you and your physician select for your case
- The amount of biologic needed
- The number of injection sites
You’ll know your cost before you commit. After your consultation and exam, we give you a clear recommendation and a price for your plan.
A few things worth knowing:
- Most insurance, including Medicare, does not cover regenerative cell therapy for OA.
- Many patients pay with HSA or FSA funds.
- We offer financing options.
Cost should never be the only way you compare clinics. Which brings me to the next section.
Be an informed patient
How to choose any regenerative clinic: questions to ask
Whether you choose us or someone else, ask these:
- 1
Who is the Physician performing the procedure, and what is their training?
- 2
What exactly are you injecting, and where does it come from?
- 3
How are the cells processed?
- 4
Is the procedure image-guided?
- 5
What outcomes should I realistically expect for my joint and grade of OA?
- 6
What happens if it doesn't work?
- 7
What follow-up is included, and what costs extra?
- 8
Will you tell me if I'm not a good candidate?
Be cautious of any clinic that guarantees results or can't clearly answer the questions above.
FAQ
Frequently Asked Questions
Q: Can stem cell therapy cure osteoarthritis?
A: No. It does not cure OA or regrow a worn-out joint. For many patients with OA, it may reduce or eliminate pain and improve function.
Q: Will it help me avoid knee replacement?
A: It can. Many Cendant patients have avoided knee and other joint replacements after treatment. Some have postponed surgery for a meaningful stretch of time, and some experience only modest relief. We can't promise which group you'll fall into, and we'll give you an honest read on your odds after reviewing your imaging and examining your joint. If your joint is severely damaged, replacement may still be the better choice, and we'll tell you so.
Q: How long does it take to work?
A: Most patients who improve do so gradually over three to six months, not overnight.
Q: Is it safe?
A: Most side effects are mild and temporary. Serious complications, such as joint infection, are uncommon but possible.
Q: Can I treat both knees at once?
A: Yes, it's common to treat more than one joint during the procedure.
Q: Can I get treated if I've had a cortisone shot recently?
A: We generally wait 6–8 weeks after a cortisone injection.
Q: What if I'm bone on bone?
A: We commonly treat patients who are "bone on bone." Many report improvement, but the chances are lower. We'll tell you honestly after reviewing your imaging.
Q: What should I do next?
A: Send us your recent imaging and a note about your symptoms. We'll review them and tell you candidly whether a visit makes sense.
References
- Whittle SL, et al. Stem cell injections for osteoarthritis of the knee. Cochrane Database of Systematic Reviews. 2025. PubMed
- Cao M, et al. Efficacy and safety of mesenchymal stem cells in knee osteoarthritis: systematic review and meta-analysis of RCTs. Stem Cell Research & Therapy. 2025;16:122. PubMed
- Wang J, et al. Mesenchymal stem cell-based therapy for osteoarthritis: systematic review and meta-analysis. Front Cell Dev Biol. 2026. PubMed
- Chen X, et al. Transplantation of three mesenchymal stem cells for knee osteoarthritis: network meta-analysis. J Orthop Surg Res. 2024;19:366. Article
- Messier SP, et al. Weight loss reduces knee-joint loads in overweight and obese older adults with knee osteoarthritis. Arthritis & Rheumatism. 2005;52(7):2026–2032. Article
This page is for general education and is not medical advice. Results vary, and no outcome is guaranteed. Regenerative treatments for osteoarthritis are not FDA-approved. Talk with a qualified physician about your situation.
Patient Testimonials
Please see the comments and personal video testimonies on our website to see our patients’ experience and their personal journey to wellness with Cendant.
Please see the comments and personal video testimonies on our website to see our patients’ experience and their personal journey to wellness with Cendant.
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