Stem cell therapy is not an “alternative” to surgery. However, for mild to moderate knee osteoarthritis it may serve as a joint-preserving option that helps reduce inflammation, slow cartilage breakdown, and postpone surgery. The earlier you learn about it, the more options you may have.
* Results vary from person to person and depend on the type and progression of the condition.
Your knee hurts. Stairs have become difficult. Your doctor says, “It may be time to consider surgery.” At that moment, it is natural to feel overwhelmed with anxiety.
In orthopedics, the concept of preserving your own joints for as long as possible is becoming increasingly important. Regenerative medicine using adipose-derived stem cells (ASC) is one of those options. Of course, it is not a cure-all. In this article, we explain honestly which conditions may benefit from this approach—and which may not.
First, Check Your Knee Condition: Self-Check
| Your Condition | Surgery May Be Prioritized | Consider Regenerative Medicine |
|---|---|---|
| You have been diagnosed with a complete ligament tear | ✔ | |
| You have been told your knee is “bone-on-bone” | ✔ | |
| You have severe instability or repeated dislocations | ✔ | |
| You have joint damage accompanied by a fracture | ✔ | |
| You have been told that some cartilage remains (mild to moderate) | ✔ | |
| You have pain or swelling, but the joint structure is still preserved | ✔ | |
| You have tried rehabilitation or injections but did not achieve sufficient relief | ✔ | |
| You have been told that surgery itself carries high risk due to age or underlying conditions | ✔ | |
| You want to preserve your own joint as much as possible | ✔ |
Knee Osteoarthritis: When Is Surgery Difficult to Avoid?
Before discussing the possibilities of regenerative medicine, it is important to honestly clarify situations where surgery may be the only realistic option. Regenerative medicine is a treatment approach that aims to improve the joint environment from within the body. However, when the structure of the joint itself has already been damaged, improving the environment alone cannot solve the root problem.It is like trying to repair a building with a collapsed foundation by renovating only the interior.
Surgery and regenerative medicine are not necessarily an “either-or” choice; sometimes they are a matter of timing and sequence. Combining regenerative medicine during the recovery period after surgery may help support the restoration of the joint environment.
When Stem Cell Therapy May Help with Knee Pain and Cartilage Loss
ASC is most likely to exert its benefits when the joint still has “structural room” remaining. The key phrase is there is still room.
Orthopedic Treatment Steps: Stem Cell Therapy Is Step 5
A standard treatment pathway often follows the order below. Treatments with lower invasiveness are tried first, and if improvement is insufficient, the next step is considered.
How Adipose-Derived Stem Cells (ASC) May Work in the Knee
ASC are stem cells that can be collected from subcutaneous fat. Compared with bone marrow collection, the physical burden is considered lower, and because the patient’s own cells are used, the risk of rejection is considered low. Their most important feature is how they work.
ASC do not directly “create new cartilage to replace damaged cartilage”; rather, they help improve the overall joint environment by sending repair signals to surrounding cells (paracrine effect). Instead of acting like a fire truck arriving to extinguish a fire, they work more like strengthening the fire-prevention system of the entire city.
Gently calming chronic inflammation
They help suppress the production of substances that trigger inflammation and gently calm chronic inflammation within the joint.
Regulating immune responses
They help regulate immune responses and protect cartilage from further breakdown.
Supporting the survival of cartilage cells
They support the survival of remaining cartilage cells and help protect the joint.
Slowing the progression of degeneration
They help improve the microenvironment within the joint and slow the progression of degeneration.
Treatment is usually administered by injection into the joint. The number of treatments and intervals vary depending on the condition, but multiple administrations followed by observation are common. Mild fatigue or discomfort at the injection site may occur for several days after treatment. These symptoms are usually temporary.
How Effective Is It? The Reality of ASC Based on Clinical Data
The area with the most accumulated data at present is the application of ASC to knee osteoarthritis. One standard protocol involves administering approximately 50 million ASC to one knee, and the following results have been reported in several small-scale studies.
(Pak J et al. 2018 / Fodor PB et al. 2016)
Similar improvement trends have also been observed in daily activity scores (WOMAC), which evaluate activities such as climbing stairs, standing up, and walking.
The Limitations of ASC You Should Know Honestly
Alongside its potential, we also explain the current limitations accurately.
When the structure has already collapsed, a biological approach may not reach the underlying problem
The quality of cells that can be collected varies depending on age, degree of inflammation, and metabolic status
Large-scale comparative studies remain limited, and the evidence is still developing
Regular follow-up and lifestyle management are necessary
The idea that “regenerative medicine means surgery will never be needed” is an exaggeration.Use it at the right timing with the right expectations—that is the appropriate way to approach regenerative medicine.
Summary: Not “Surgery or Regenerative Medicine,” but “What Is Best for My Current Condition?”
- ✓ Situations where surgery is necessary and situations where regenerative medicine may be useful are clearly different
- ✓ ASC is not a therapy that “restores cartilage to a brand-new state,” but a supportive therapy that helps improve the existing joint environment
- ✓ Pain score improvements of 50–60% have been reported, but the evidence is from small-scale studies and individual results vary
- ✓ Effects may begin to appear after 1–3 months. This treatment works gradually and steadily
- ✓ The stage when it “does not hurt yet” may be when you have the widest range of options
- ✓ What matters is not choosing between two options, but selecting the treatment best suited to your current condition at the right timing
* ASC therapy is a medical practice conducted under Japan’s Act on the Safety of Regenerative Medicine. Results vary from person to person. This article is intended to provide medical information and does not guarantee any specific effect. Please consult a specialist when considering treatment.
Next Steps for Those Who Are Interested
If you are wondering, “What is really going on with my knee?” we recommend starting with these two steps.
There is no need to rush into surgery, but postponing the decision itself can also be a risk for the joint While you are thinking “I am still okay,” the remaining room in the cartilage may quietly continue to diminish.
Regenerative Medicine at Ginza YR Clinic: Adipose-Derived Stem Cell (ASC) Therapy
We provide adipose-derived stem cell (ASC) therapy for whole-body care and joint treatment.
Based on the concept of “Ageing Well,” we aim not to fight aging, but to help each person age in a healthy and natural way. By combining treatment with inflammation control, metabolic improvement, and lifestyle optimization, we aim to support the body’s remaining regenerative capacity, regardless of age.
► Learn more about adipose-derived stem cell (ASC) therapyMore Information and Consultation Booking
Tel03-6263-9219
References
- Pak J, et al. Adipose-derived stem cells and their secretome for knee osteoarthritis treatment. J Clin Med. 2018;7(12):572.
- Fodor PB, Paulseth SG. Adipose derived stromal cell (ASC) injections for pain management of osteoarthritis. Aesthetic Surgery Journal. 2016;36(2):229–236.
- Malige A, et al. Mesenchymal stem cells in orthopaedics: A systematic review. PubMed. 2024.
- Maheshwer B, et al. Regenerative Potential of MSCs for the Treatment of Knee Osteoarthritis. PubMed. 2020.
- Kim SH, et al. Intra-articular injection of MSCs for clinical outcomes in osteoarthritis of the knee. PubMed. 2019.
