What to ask about an arthritis treatment

What to ask before choosing PRP

PRP begins with a small amount of your own blood. The clinic spins it and collects a portion with more platelets, the tiny blood parts involved in normal repair. That prepared blood portion is then used in the sore joint.

Concentrated PRP has still more platelets in the portion being used. Human studies disagree about how much PRP helps joint soreness, so results can't be promised. Ask what change would count as success for you, such as easier stairs or fewer wakeful nights.

What to expect when a visit is useful

Consider a visit when home care no longer gives enough relief. QC Kinetix calls its non-surgical procedures using material from your own body regenerative treatments and natural pain treatments. Its medical providers, the clinicians who examine you and perform care, first review your joint, health, medicines, and daily limits.

Bring old reports or X-rays and wear clothing that leaves the joint easy to examine. You'll explain which tasks hurt and what relief you hope to notice. The clinician should say whether the expected change is less soreness, easier movement, or better sleep.

What to settle before you schedule

Get the full cost and expected visit count in writing. Before scheduling, ask how long the visit takes, whether you can drive home, which medicines to take, and how much walking or work is sensible during the first day afterward. Medicare coverage for joint PRP is limited, so don't assume your plan will pay.

Ask what happens when the procedure gives little or no relief. Exercise, medicine, or a well-fitted aid may still help some soreness. Severe joint damage may call for a surgical opinion, and the clinician should say so plainly.

Sources

1. FDA states verbatim that stem cell products, stromal vascular fraction (adipose-derived), umbilical cord blood, Wharton's jelly, amniotic fluid and exosome products have NOT 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. FDA (Center for Biologics Evaluation and Research), 2020.

2. Federal district court orders announced 8 January 2025 permanently ban the co-founders of the Stem Cell Institute of America and several related companies from marketing stem cell therapy, and require payment of $5,155,146 in civil penalties and consumer refunds. On summary judgment in March 2024 the court found the defendants created and published false and misleading advertisements about the efficacy and approval of stem cell injection treatments for conditions including osteoarthritis and joint pain. The clinic charged up to $5,000 per injection and its customers were almost exclusively elderly and disabled people.

   Federal Trade Commission — Stem Cell Institute Co-Founders and Companies Banned from Marketing Stem Cell Treatments and Ordered to Pay More Than $5.1 Million for Refunds and Civil Penalties. FTC press release, 2025.

3. A prospective cross-sectional study contacted 273 of 317 US direct-to-consumer stem-cell centres posing as a 57-year-old man with knee osteoarthritis. The mean advertised price of a unilateral same-day stem-cell knee injection was $5,156 (SD $2,446; 95% CI $4,550-5,762, n=65), and the mean claimed clinical efficacy was 82% (SD 9.6%, n=36) - a figure the authors describe as a gap between the published literature and marketing claims.

   Piuzzi NS, et al. — The Stem-Cell Market for the Treatment of Knee Osteoarthritis: A Patient Perspective.. J Knee Surg, 2018. DOI: 10.1055/s-0037-1604443.

4. A Bone & Joint Journal annotation on 'rogue stem cell clinics' documents a growing number of clinics worldwide making unwarranted claims or performing risky biological procedures, recommending, prescribing or delivering so-called 'stem cell' preparations without sufficient data to support their true content or efficacy.

   Murray IR, et al. — Rogue stem cell clinics.. Bone Joint J, 2020. DOI: 10.1302/0301-620X.102B2.BJJ-2019-1104.R1.

5. A cross-sectional analysis of the top 50 results from Google, Bing and Yahoo for 'stem cells osteoarthritis' (82 websites) found mean readability at grade level 13.6 - far above the grade 6-8 recommended by the NIH - and mean DISCERN quality of 49.5/80, with physician-clinic websites scoring significantly lower than academic ones (38.1 vs 64.6, P<.001).

   Ng MK, et al. — Analysis of Readability, Quality, and Content of Online Information Available for "Stem Cell" Injections for Knee Osteoarthritis.. J Arthroplasty, 2020. DOI: 10.1016/j.arth.2019.10.013.

6. CMS covers autologous platelet-rich plasma ONLY for patients with chronic non-healing diabetic, pressure and/or venous wounds, and only when the patient is enrolled in an approved clinical research study under the coverage-with-evidence-development National Coverage Determination. There is no national Medicare coverage for PRP in osteoarthritis of any joint.

   Centers for Medicare & Medicaid Services — Autologous Platelet-rich Plasma (Coverage with Evidence Development). CMS Coverage with Evidence Development, 2014.

7. A triple-blind randomized within-patient trial injected placental mesenchymal stromal cell-derived extracellular vesicles into one knee and saline into the other in 29 patients with bilateral grade 2-3 knee OA. NO statistically significant difference was detected between the treated and control knees on VAS, WOMAC or Lequesne scores at 2 or 6 months.

   Bolandnazar NS, et al. — Safety and efficacy of placental mesenchymal stromal cells-derived extracellular vesicles in knee osteoarthritis: a randomized, triple-blind, placebo-controlled clinical trial.. BMC Musculoskelet Disord, 2024. DOI: 10.1186/s12891-024-07979-w.

8. A systematic review and meta-analysis of 25 randomized trials (1,048 participants) found mesenchymal stromal cell therapy for knee OA lowered 12-month pain VAS by 1.91 points versus viscosupplementation and by only 0.99 points versus placebo - and rated the certainty of evidence VERY UNCERTAIN by GRADE for both comparisons. Excluding high-risk-of-bias studies left a similar effect at moderate certainty versus viscosupplementation.

   Tabet CG, et al. — Advanced therapy with mesenchymal stromal cells for knee osteoarthritis: Systematic review and meta-analysis of randomized controlled trials.. J Orthop Translat, 2024. DOI: 10.1016/j.jot.2024.07.012.