Marc Darrow MD,JD

We will often receive emails from people who will say “I am 59 years old, very active. I have wear and tear damage in my knee I am being told to lay off or stop weight lifting and running. I can still play golf but it now hurts on some of the swings. Can your treatments get me back to my running and weight lifting and make golf less painful for me?”

The answer is, someone who is still active, even through some pain, is usually a good candidate for treatment, but candidacy for treatment is something that would usually require a physical examination to confirm. But can stem cells offer some hope?

This is research from doctors affiliated with the South Carolina Orthopaedic Institute and the University of Miami. it was published in the prestigious, Orthopaedic journal of sports medicine.(1)

Cell-based therapies and regenerative medicine offer safe and potentially efficacious treatment for sports-related musculoskeletal injuries. Basic science and preclinical studies that support the possibility of enhanced recovery from sports injuries using cell-based therapies are accumulating; however, more clinical evidence is necessary to define the indications and parameters for their use. Accordingly, exposing patients to cell-based therapies could confer an unacceptable risk profile with minimal or no benefit. Continued clinical testing . . . to determine the relative risks and benefits as well as the indications and methodology of treatment.”

In the Journal of Knee Surgery doctors from the Department of Orthopaedic Surgery, University of Pittsburgh had this to say:

Studies assessing the utility of stem cells have shown encouraging results in the setting of osteoarthritis

  • Biologic agents (stem cells and blood platelets or PRP therapy) are gaining popularity in the management of bony and soft tissue conditions about the knee. They are becoming the mainstay of nonoperative therapy in the high-demand athletic population. . . . Studies assessing the utility of stem cells have shown encouraging results in the setting of osteoarthritis. “As the volume and quality of evidence continue to grow, biologic agents are poised to become an integral component of comprehensive patient care throughout all orthopedic specialties.”(2)

Platelet-rich plasma (PRP) and stem cells have shown promise in the treatment of various conditions. Animal and clinical studies have demonstrated improved outcomes following PRP treatment in early osteoarthritis of the knee, as well as in chronic patellar tendinopathy.

Doctors in Italy have published a new study on the excitement being created by stem cell therapy; The bullet points are:

  • The use of stem cells as a biological approach to treat cartilage lesions and osteoarthritis has widely increased  as confirmed by the growing number of clinical trials published on this topic.
  • In addition to an intensive preclinical research, the use of these procedures has recently broken down the barriers towards clinical application, with more than half of the available papers published in the last 3 years.
  • Different sources have been investigated for clinical application, especially targeting knee or ankle cartilage disease.(3)

Stem cell treatments may act as a protector against continued osteoarthritis degeneration of the knee joint

In the the American Journal of Sports Medicine, doctors at the Mayo Clinic have released a study on the effectiveness of bone marrow derived stem cells for knee osteoarthritis in the active patient. In this prospective, single-blind, placebo-controlled trial, 25 patients with pain in both knees from osteoarthritis were randomized to receive bone marrow derived stem cells into one knee and saline placebo into the other.

  • Bone marrow was aspirated from the iliac crests and concentrated in an automated centrifuge.
  • The resulting bone marrow aspirate concentrate (this is explained in the video below) was injected into the arthritic knee and was compared with a saline injection into the other knee, thereby utilizing each patient as his or her own control.

Early results show that bone marrow derived stem cell injections are a safe to use and is a reliable and viable cellular product.  Interestingly, pain scores in both knees decreased significantly from baseline at 1 week, 3 months, and 6 months. Pain relief, although dramatic, did not differ significantly between treated knees in the early stages.(4)

Recently a paper out of Augusta University in Georgia also explained stem cell therapy for osteoarthritis, specifically bone marrow stem cells. In their paper the Georgia doctors highlighted the comparisons between bone marrow derived stem cells and adipose or fat derived stem cells.

  • Bone marrow-derived stem cells have a higher chondrogenic capability (the ability to make cartilage) than fat derived stem cells.
  • Bone marrow-derived stem cells have have been more thoroughly studies than fat stem cells and findings suggest that bone marrow-derived stem cells can be safely implemented in treatment strategies for treatment-resistant osteoarthritis patients with minimal side effects.
  • Bone marrow-derived stem cells can undergo high rates of proliferation; have immunosuppressive actions,anti-inflammatory effects, and pro-regenerative properties.(5) Important to note is that the stem cells are acting as an anti-inflammatory and pro-regenerative agent at the same time.

When a patient comes in for a consultation, we perform a physical examination to help us determine which is the best course of treatment options. We then discuss our recommendations with the patient.

A realistic healing program


In June of 2018, our research team published the paper Short-Term Outcomes in Treatment of Knee Osteoarthritis With 4 Bone Marrow Concentrate Injections. This research appeared in the medical journal: Clinical medicine insights. Arthritis and musculoskeletal disorders.

In this research we were able to conclude that following treatment, short-term outcomes demonstrated that patients experienced less pain and were able to perform daily activities with less difficulty after the first Bone Marrow Concentrate (stem cell) injection and reported additional benefit with each subsequent treatment.

Other research that we will soon publish on the subject of knee osteoarthritis include: Treatment of Chronic Knee Pain with Platelet-Rich Plasma Injections


In August 2018, our research team published the paper Short-Term Outcomes of Treatment of Hip Osteoarthritis With 4 Bone Marrow Concentrate Injections: A Case Series. This research appeared in the medical journal: Clinical medicine insights. Case reports.

In this study, we were able to document that the patients in this case series experienced decreased pain and improved functionality compared with baseline. On average, patients experienced successive decreases in resting and active pain after each treatment. Patients also experienced a mean increase in total overall improvement percentage and functionality score after subsequent treatments. Prior to Bone Marrow Concentrate (stem cell) treatment, 2 of the 4 patients had been advised to undergo total hip replacement. Following treatment, neither patient considered surgery.

Other research that we will soon publish on the subject of hip osteoarthritis include:

  • Comparing Outcomes of Spun and Whole Bone Marrow Concentrate injections in Hip and Shoulder Pain Patients
  • Treatment of Chronic Hip Pain with Platelet-Rich Plasma Injections.

You can learn more about this treatment at my article: Treatment of Hip Osteoarthritis with Platelet-Rich Plasma Injections

Do you have questions? Ask Dr. Darrow

A leading provider of stem cell therapy, platelet rich plasma and prolotherapy

PHONE: (800) 300-9300 or 310-231-7000

Stem cell and PRP injections for musculoskeletal conditions are not FDA approved. We do not treat disease. We do not offer IV treatments. There are no guarantees that this treatment will help you. Prior to our treatment, seek advice from your medical physician. Neither Dr. Darrow, nor any associate, offer medical advice from this transmission. This information is offered for educational purposes only. The transmission of this information does not create a physician-patient relationship between you and Dr. Darrow or any associate. We do not guarantee the accuracy, completeness, usefulness or adequacy of any resource, information, product, or process available from this transmission. We cannot be responsible for the receipt of your email since spam filters and servers often block their receipt. If you have a medical issue, please call our office. If you have a medical emergency, please call 911.


1 Ajibade DA, Vance DD, Hare JM, Kaplan LD, Lesniak BP. Emerging applications of stem cell and regenerative medicine to sports injuries. Orthopaedic journal of sports medicine. 2014;2(2):2325967113519935.

2 Kopka M, Bradley JP. The Use of Biologic Agents in Athletes with Knee Injuries. J Knee Surg. 2016 May 20. [Epub ahead of print]

3 Filardo G, Perdisa F, Roffi A, Marcacci M, Kon E. Stem cells in articular cartilage regeneration. Journal of Orthopaedic Surgery and Research. 2016;11:42. doi:10.1186/s13018-016-0378-x.

4 Shapiro SA, Kazmerchak SE, Heckman MG, Zubair AC, O’Connor MI, A Prospective, Single-Blind, Placebo-Controlled Trial of Bone Marrow Aspirate Concentrate for Knee Osteoarthritis. Am J Sports Med. 2017 Jan;45(1):82-90. doi: 10.1177/0363546516662455. Epub 2016 Sep 30.

5 Burke J, Hunter M, Kolhe R, Isales C, Hamrick M, Fulzele S. Therapeutic potential of mesenchymal stem cell based therapy for osteoarthritis. Clinical and Translational Medicine. 2016;5:27. doi:10.1186/s40169-016-0112-7. 2