Orthopedic Stem Cell (MSC) Options: Who, How, What to Expect

For patients seeking non-surgical options, mesenchymal stem cell (MSC) procedures are a frequent question. This guide summarises when MSCs may be considered—especially in early cartilage injuries and select tendon/meniscus conditions—without hype. Your personal plan is set after clinical assessment and imaging.

What are MSCs?

Mesenchymal stem/stromal cells are prepared from sources such as adipose tissue or bone marrow. In practice, orthopaedics commonly uses a patient’s own tissue processed into a concentrated cell suspension that is applied to a target site.

When might they be considered?

In carefully selected cases: early–mid cartilage lesions (knee, hip, shoulder), some meniscal tears, specific tendon problems and early stages of avascular necrosis. Widespread end-stage cartilage loss is typically not a good indication.

How is the procedure performed?

Tissue harvesting: Under sterile conditions, adipose tissue (abdomen/flanks) or bone marrow (iliac crest) is collected and processed (centrifugation/filtration) to obtain an MSC-rich concentrate. In some scenarios, lab preparation and surgical placement with a matrix/scaffold may be used.

Application: The material is injected intra-articularly or near the target tissue under ultrasound/fluoroscopy guidance. The plan is individualised with physiotherapy, load management and activity modifications.

Who is not a good candidate?

Active cancer, bleeding/clotting disorders, active infection, or advanced end-stage osteoarthritis often make MSCs unsuitable. Suitability is determined by your clinician after examination and imaging.

Realistic expectations: what does the evidence say?

Research on MSCs is ongoing. Some small studies report symptom improvement in selected patients, yet the size and durability of benefit vary and are not guaranteed. Several major guidelines caution against routine use in osteoarthritis due to limited high-quality evidence. Decisions should balance patient selection with expectation management.

Safety

Local pain/swelling can occur; infection is uncommon but possible. Rarely, undesired tissue responses have been reported. As with any procedure, an individualised risk–benefit discussion is essential.

Why a comprehensive plan matters

MSCs are not a miracle fix. The best outcomes come from combining physiotherapy, strength–balance training, and weight/activity management—and, when appropriate, other non-prosthetic treatments.