Non-Surgical Options for Managing Knee Osteoarthritis

The knee is a joint, and it is the largest one in the body. It is the point where the thigh bone (femur) connects with the shin bones (tibia and fibula). The ends of these bones are covered with a smooth, slippery tissue called cartilage, which may help reduce friction within the joint. This surface allows the bones to move against one another more easily and may help protect the joint from stress. The knee also contains two crescent-shaped pieces of fibrous cartilage called the meniscus. These structures contribute to joint stability and help distribute weight more evenly.

Over time, the knee joint is subjected to significant stress during weight-bearing activities. Like all joints, it goes through natural cycles of wear and repair, which can include cartilage thinning, the development of bone spurs, and other structural changes. In some cases, the body’s repair response can alter the joint’s shape or alignment. When this occurs, the bones may not remain properly aligned or adequately lubricated. Over time, this may lead to inflammation, pain, swelling, and stiffness, which are often associated with a condition called osteoarthritis. Contributing factors may include excess body weight, the natural aging process, or previous injury to the joint.

Arthritis is a general term used to describe inflammation of the joints. There are two primary types of arthritis:

1. Osteoarthritis (OA) – also referred to as degenerative joint disease- is the most common form of arthritis. It occurs when the cartilage within a joint gradually wears away, commonly affecting the hips, knees, and spine.⁶
2. Rheumatoid arthritis (RA) – is an autoimmune condition in which the immune system mistakenly targets the lining of the joints (synovium), resulting in inflammation and joint damage.⁷

Yes. An analysis of our data indicates that individuals with less advanced arthritis experienced similar outcomes to those with bone-on-bone arthritis. This observation is also supported by findings published by other researchers.⁸

Both X-rays and magnetic resonance imaging (MRI) can reveal changes in the joints associated with degenerative arthritis. However, symptoms of osteoarthritis may appear before visible damage is detectable on standard X-rays. For this reason, physicians often rely on MRI, which is more sensitive for identifying early signs of osteoarthritis. Additionally, MRI provides three-dimensional imaging, offering more detailed views compared to traditional X-rays.

Although cartilage plays a key role in joint function, its loss is not typically the direct source of pain. The MRI finding most consistently linked with pain is swelling within the bone, known as bone marrow edema (BME) or a bone marrow lesion (BML). Recent research on knee pain related to arthritis has shifted focus from cartilage deterioration to the presence of bone marrow swelling.

No, they will not regenerate large areas of cartilage; however, they may help:

• Replenish diminished cellular reserves. The body’s natural supply of cells involved in repair and maintenance tends to decline with age and the progression of arthritis.
• Support cellular recovery. Research suggests that mesenchymal stem cells may transfer healthy mitochondria to neighboring cells with damaged mitochondria, potentially restoring function in those cells.
• Address bone lesions. Emerging evidence indicates that microfractures, rather than cartilage loss, are a primary contributor to pain.
• Modulate the joint environment. Arthritic joints often contain a mix of inflammatory and catabolic substances, and cellular therapies may help shift the environment toward one that is more supportive of tissue maintenance.