When to go in and when not to wait

When to book a regular visit

Book a regular visit when the ache repeatedly limits sleep, walking, stairs, or dressing. Go in as well when your usual home care isn't enough.

The clinician will check tender areas, movement, swelling, and strength. An X-ray may help explain how the joint has changed.

Ask whether the bone, cartilage, tendon, or nearby muscle seems sore. Then ask how the exam supports any office care being offered.

No procedure choice is required at the first meeting. Take enough time to understand what would happen to your body.

When to get care quickly

Seek care that day if a fever appears along with fresh heat and swelling around a joint. Go promptly if an injury suddenly leaves you unable to put weight on it.

A joint that suddenly looks out of shape also needs quick care. New bladder or bowel trouble with weakness or numbness can be an emergency.

For those warning signs, seek urgent help instead of making an appointment for planned joint care. After a procedure, call promptly for fever, drainage, spreading redness, or pain that keeps rising.

What information to bring for safety

Write down every medicine you take and mark any blood thinner. Tell the clinician about allergies, illness, bleeding trouble, and past joint care.

Don't stop a prescribed medicine because a handout tells you to stop. Ask the person who prescribed it and the clinician doing the procedure.

Before leaving, ask which soreness can happen afterward and which signs require a call. Keep the clinic number where your family can find it.

Sources

1. The ESSKA-ORBIT European consensus on blood-derived orthobiologics graded 28 question-statement sets; only 9 of 28 had high-level scientific support. Three statements reached grade A: that there is enough preclinical and clinical evidence to support PRP use in knee OA; that clinical evidence shows effectiveness in MILD TO MODERATE knee OA (KL grade 3 or lower); and that PRP provides a longer effect than the short-term effect of corticosteroid with a safer profile. The panel regarded PRP as a valid and possible first-line injectable option for KL grades 1-3.

   Laver L, et al. — The use of injectable orthobiologics for knee osteoarthritis: A European ESSKA-ORBIT consensus. Part 1-Blood-derived products (platelet-rich plasma).. Knee Surgery, Sports Traumatology, Arthroscopy, 2024. DOI: 10.1002/ksa.12077.

2. 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.. Cochrane Database of Systematic Reviews, 2025. DOI: 10.1002/14651858.CD013342.pub2.

3. RESTORE, the largest and most rigorously blinded placebo-controlled PRP trial in knee OA (n=288, participant-, injector- and assessor-blinded), gave three weekly injections of a commercial leukocyte-poor PRP or saline. At 12 months the change in knee pain was -2.1 vs -1.8 points (difference -0.4; 95% CI -0.9 to 0.2; P=.17) and the change in medial tibial cartilage volume was -1.4% vs -1.2% (difference -0.2%; P=.81). Twenty-nine of 31 prespecified secondary outcomes showed no between-group difference. The authors concluded the findings do not support the use of PRP for knee OA.

   Bennell KL, et al. — Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial.. JAMA, 2021. DOI: 10.1001/jama.2021.19415.

4. 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. FDA (Center for Biologics Evaluation and Research), 2020.

5. The AAOS patient-education FAQ on orthobiologics states that because orthobiologics are relatively new the evidence supporting their use is LIMITED, that rigorous testing of effectiveness in most orthopedic conditions is lacking, and that preliminary results are encouraging but hard to evaluate. It names tendinopathies such as tennis elbow, pain from early knee osteoarthritis, adjunct healing after rotator cuff repair, and avascular necrosis as the settings where biologic therapies have shown promise, and notes that stem cell treatments not derived from the patient's own body and further manipulated in a laboratory can only be offered inside an FDA-approved clinical trial.

   American Academy of Orthopaedic Surgeons — Orthobiologics (Regenerative Medicine) FAQ. OrthoInfo (AAOS), 2024.