What is actually known about cell therapy for joints: which products exist, what the research shows and what results can realistically be expected.

Cell products used in orthopaedics

  • Bone marrow aspirate concentrate (BMAC) — obtained by aspiration from the iliac crest.
  • Microfragmented adipose tissue (MFAT) — mini-liposuction and mechanical processing.
  • Stromal vascular fraction (SVF) — cells are isolated with enzymes; in the EU this is regulated as a medicinal product.
  • The share of true mesenchymal cells in all these products is small; the main effect appears to come from anti-inflammatory signalling rather than cells turning into cartilage.

What the research says

Reviews of randomised trials in knee osteoarthritis show that cell products reduce pain and improve function compared with baseline in some patients. But the trials are small, the certainty of evidence is low to moderate, follow-up is short, and in placebo-controlled studies the difference from control is often small. There is no evidence that injections grow new cartilage.

Why injection accuracy matters

An injection under ultrasound or X-ray guidance is more accurate than a “blind” one, especially into deep joints. This increases the chance that the product reaches the joint, but does not guarantee a result.

Realistic expectations

  • The best results are seen in early and moderate osteoarthritis.
  • Any effect is assessed after 6–12 weeks; its duration varies.
  • In severe osteoarthritis injections give at best temporary relief; the reliable option is joint replacement.
  • Cell therapy does not replace exercise and weight loss.

Warning signs of a dubious clinic

Promises of a cure, “new cartilage” or guaranteed results; intravenous infusions “for everything”; donor or embryonic cells outside clinical trials; no written plan and price. More on the methods on the cell therapy page.

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Who it is not suitable for and possible risks

Contraindications

  • Active infection — at the injection site or systemic, with fever.
  • Active cancer or ongoing chemotherapy.
  • Blood clotting disorders or a low platelet count. Anticoagulants are discussed with the physician.
  • Pregnancy and breastfeeding — the procedure is usually postponed.
  • A corticosteroid injection into the same area in recent weeks.
  • Severe stage IV osteoarthritis with axial deformity and joint destruction — joint replacement is usually discussed instead.

Possible risks

  • Pain and swelling at the injection site for 1–3 days.
  • Bruising where blood or fat tissue is taken.
  • Rarely, infection. The procedure is therefore performed under sterile conditions with ultrasound or X-ray guidance.
  • The effect may be absent or smaller than expected.

If any of these apply to you, mention it in your request. The coordinator will check with the clinic physician whether treatment is possible. Contact a coordinator.

Scientific evidence

Studies of regenerative methods show mixed results. Clinic physicians rely on research including the following:

  1. Pas HI et al. Stem cell injections in knee osteoarthritis: a systematic review of the literature. Br J Sports Med, 2017.
  2. Pak J et al. Cartilage Regeneration in Humans with Adipose Tissue-Derived Stem Cells and Adipose Stromal Vascular Fraction Cells: Updated Status. Int J Mol Sci, 2018.

Next steps: Treatment methods · Treatment cost · How treatment in Germany is organised

Clinic and method matching — free of charge

Describe your case and attach your MRI report. We will identify clinics that use the relevant methods and forward your request to them. No obligation; we reply within 24 hours.

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Frequently asked questions

Do stem cells help osteoarthritis?

Some patients have less pain and better function, but the studies are small and the cells do not grow new cartilage. The result depends on the stage of osteoarthritis and cannot be predicted in advance.

What are the dangers of dubious stem cell clinics?

Intravenous “courses for every disease”, cells of unknown origin and promises of “new cartilage”. In Germany, laboratory-grown cells are allowed only as a medicinal product (ATMP).

How long does a stem cell procedure take?

Fat or bone marrow harvesting and injection take place on the same day as an outpatient procedure under local anaesthesia. Patients usually go home the same day.

How does RegenPAS help organise treatment?

RegenPAS is a patient service centre in Munich, not a clinic. We review your images and symptoms and send a request to several partner clinics at once. Clinics that can accept you send their own conditions and price; prices differ between clinics, and you choose the option that suits you. The coordinator replies within 24 hours, and a clinic physician’s preliminary opinion follows in 1–3 business days. We then arrange the appointment, visa invitation, interpreter, transfers and accommodation. Treatment decisions are made by the clinic physician. Contact a coordinator.

How much does treatment cost and how long do I need to stay in Munich?

The cost depends on the method, the diagnostics needed and the clinic itself: prices differ between clinics. We request offers from several clinics and send you their conditions and quotes so you can compare. Price guidance is on the treatment cost page. For an outpatient procedure, 2–3 days in Munich are usually enough: examination, procedure and follow-up visit.