# Your joint care choices begin with what the exam finds *Joint Care Options | biologic therapy mesa* > Orthobiologics and biologic injections in plain terms for biologic therapy Mesa readers comparing home care, PRP, and surgery choices. This page lays out home care, blood-based procedures, and questions about surgery. ## Start with gentle care before a clinic procedure Do less of the work that stirred up your joint. Use the joint with care and stop before a sharp jab. Short, steady walks may suit a knee or hip. A shoulder may need lighter reaching for a while. Ask your doctor which exercises are safe. I'd note which chores hurt and how long soreness stays afterward. Bring that note to the exam. It gives the visit a firm starting point. ## PRP is your blood prepared with more platelets The letters PRP stand for platelet-rich plasma. Platelets are small pieces in your blood that help form a clot. The office draws a little blood from your arm. A machine then spins the blood and gathers a part with more platelets. That prepared part becomes the shot for your sore joint. This is done in hopes of easing soreness, but results aren't certain. Concentrated PRP is prepared to hold even more platelets. Offices use different methods, so ask how yours will be made. Check the visit length and ask when you can drive or exercise. Have the complete price and expected return visits written down. PRP can't promise that worn tissue will grow back. ## Orthobiologics are joint shots using blood or several kinds of tissue The word doesn't name one clinic procedure. Blood may be used, as may marrow, fat, or tissue from a donor. A blood procedure begins with a blood draw. Marrow comes from the pelvis, while fat requires a small removal procedure. Ask what will be taken, its source, and who prepares it. Also ask which area may be sore afterward. A knee study can't predict a shoulder result. It can't replace your own exam and X-ray. Tell the examiner about blood thinners or a current infection. Don't stop a prescribed drug unless your prescriber says to stop. ## An exam can tell you whether surgery alternatives fit You might've come looking for knee or hip surgery alternatives. Ask what the exam or X-ray shows before choosing. Find out what waiting could mean for your daily life. Surgery may still deserve a talk when the joint is badly worn or simple tasks have become very hard. A choice needn't happen during one visit. Ask about the time, cost, and limits of each option. QC Kinetix may offer joint preservation and regenerative treatments, which aren't surgery and use prepared blood after a medical provider checks your joint; ask whether that provider is a doctor. ## Sources 1. The 2025 Cochrane review of stem cell injections for knee osteoarthritis pooled 25 randomised trials (1,341 participants) and found that, compared with placebo injection, stem cell injection MAY slightly improve pain (1.2 points better on a 0-10 scale, 7 studies, 445 participants) and function (14.2 points better on a 0-100 scale, 7 studies, 432 participants) up to six months - both rated LOW-certainty evidence, downgraded for indirectness (cell source, preparation and dose varied across studies) and suspected publication bias, since up to three larger RCTs were conducted and withdrawn before reporting results. Radiographic progression was not assessed in any included study. Whittle SL, et al. — [Stem cell injections for osteoarthritis of the knee.](https://pubmed.ncbi.nlm.nih.gov/40169165/). *Cochrane Database of Systematic Reviews*, 2025. DOI: 10.1002/14651858.CD013342.pub2. 2. The largest head-to-head trial of cell-based orthobiologics to date randomised 480 patients with KL II-IV knee OA across four arms: autologous bone marrow aspirate concentrate, autologous adipose stromal vascular fraction, allogeneic umbilical cord tissue-derived MSCs, and a corticosteroid injection control. At 12 months NONE of the three orthobiologic injections was superior to another or to the corticosteroid control on either co-primary endpoint (VAS pain, KOOS pain), and none of the four groups showed a significant change in MRI osteoarthritis score from baseline. No procedure-related serious adverse events were reported. Mautner K, et al. — [Cell-based versus corticosteroid injections for knee pain in osteoarthritis: a randomized phase 3 trial.](https://pubmed.ncbi.nlm.nih.gov/37919438/). *Nature Medicine*, 2023. DOI: 10.1038/s41591-023-02632-w. 3. A network meta-analysis of 43 trials (5,554 patients) reached the OPPOSITE ranking to the more recent orthobiologic-favourable reviews: steroids ranked most likely to be effective for pain and function, with adipose MSC and multiple PRP ranked LEAST likely; single PRP, multiple PRP and adipose MSC did not produce a relevant reduction in pain or improvement in function versus placebo. The authors noted treatment-effect differences were small and potentially not clinically meaningful either way. Han SB, et al. — [Intra-Articular Injections of Hyaluronic Acid or Steroids Associated With Better Outcomes Than Platelet-Rich Plasma, Adipose Mesenchymal Stromal Cells, or Placebo in Knee Osteoarthritis: A Network Meta-analysis.](https://pubmed.ncbi.nlm.nih.gov/32305424/). *Arthroscopy*, 2021. DOI: 10.1016/j.arthro.2020.03.041. 4. The 2012 Annals of Internal Medicine meta-analysis of 89 viscosupplementation trials (12,667 adults) is the classic demonstration of publication bias in this field: the pooled effect across 71 trials was -0.37, but five UNPUBLISHED trials showed an effect size of -0.03, and 18 large trials with blinded outcome assessment showed a clinically irrelevant -0.11. Fourteen trials showed an increased risk of serious adverse events (RR 1.41). Rutjes AW, et al. — [Viscosupplementation for osteoarthritis of the knee: a systematic review and meta-analysis.](https://pubmed.ncbi.nlm.nih.gov/22868835/). *Annals of Internal Medicine*, 2012. DOI: 10.7326/0003-4819-157-3-201208070-00473. 5. In a within-patient placebo-controlled trial, 25 people with BILATERAL knee osteoarthritis received bone marrow aspirate concentrate in one knee and saline in the other, acting as their own controls. Pain scores fell significantly from baseline in BOTH knees at 1 week, 3 months and 6 months, and the relief - described by the authors as dramatic - did not differ significantly between the BMAC knee and the saline knee. Shapiro SA, et al. — [A Prospective, Single-Blind, Placebo-Controlled Trial of Bone Marrow Aspirate Concentrate for Knee Osteoarthritis.](https://pubmed.ncbi.nlm.nih.gov/27566242/). *American Journal of Sports Medicine*, 2017. DOI: 10.1177/0363546516662455. 6. A phase III double-blind placebo-controlled trial of a SINGLE injection of culture-expanded autologous adipose-derived MSCs in 261 patients with KL grade 3 knee OA found significantly better VAS pain (25.2 vs 15.5 mm improvement; P=.004) and total WOMAC (21.7 vs 14.3; P=.002) at 6 months versus placebo, with no serious treatment-related adverse events - but MRI showed NO significant difference in cartilage-defect change between groups. Culture-expanded cells of this kind are a drug in the United States and are not available outside a trial. Kim KI, et al. — [Clinical Efficacy and Safety of the Intra-articular Injection of Autologous Adipose-Derived Mesenchymal Stem Cells for Knee Osteoarthritis: A Phase III, Randomized, Double-Blind, Placebo-Controlled Trial.](https://pubmed.ncbi.nlm.nih.gov/37345256/). *American Journal of Sports Medicine*, 2023. DOI: 10.1177/03635465231179223. 7. FDA states verbatim of stem cell products, stromal vascular fraction (adipose-derived cells), umbilical cord blood, Wharton's jelly, amniotic fluid and exosome products: 'None of these products have been approved for the treatment of any orthopedic condition, such as osteoarthritis, tendonitis, disc disease, tennis elbow, back pain, hip pain, knee pain, neck pain, or shoulder pain.' The only FDA-approved stem cell products in the United States are blood-forming (hematopoietic progenitor) cells derived from umbilical cord blood, approved only for disorders of blood production, and there are currently NO FDA-approved exosome products. U.S. Food and Drug Administration — [Consumer Alert on Regenerative Medicine Products Including Stem Cells and Exosomes](https://www.fda.gov/vaccines-blood-biologics/consumers-biologics/consumer-alert-regenerative-medicine-products-including-stem-cells-and-exosomes). *FDA (Center for Biologics Evaluation and Research)*, 2020. ## A first visit can sort out your next step Tell them when the ache first appeared, which motion starts it, and what it keeps you from doing. Ask about the exam, full price, recovery time, and who takes later calls. Mesa residents can use Dobson Road or Loop 202 toward Chandler. Call (602) 837-PAIN before leaving. A visit can help you weigh choices, but your outcome can't be promised. Book a free consultation: --- Clear help for a sore joint. Plain help with a sore joint, care at home, office visits, and choices besides surgery. Plain Mesa help for aching joints, care at home, and office visits. This site is operated by the owners of the QC Kinetix Phoenix-area clinics, including the Chandler and Scottsdale locations described in this guide, and those owners benefit when a reader books a consultation. © 2026 Mesa Biologic Field Guide. General health education only; a clinician who examines you should guide decisions about your own joint.