Stem cell rehabilitation

Bone marrow and fat tissue contain cells, often called mesenchymal stem or stromal cells, that are thought to release signals influencing inflammation and tissue repair. For a cell-based treatment, a small sample of your bone marrow or fat is taken under local anaesthetic, processed under sterile conditions and injected the same day into the joint or tendon, usually under ultrasound guidance.

The rehabilitation is not an add-on. An injection on its own does not rebuild function; the exercise programme that follows is what turns any easing of pain into better movement, strength and daily activity.

In knee osteoarthritis, a 2025 Cochrane review of 25 randomised trials found that, compared with a placebo injection, stem cell injections may slightly reduce pain and improve function for up to six months — on average by about 1.2 points on a 0–10 pain scale. The certainty of this evidence is low, none of the trials measured whether the joint changed on X-ray, and long-term safety is uncertain 1.

The American College of Rheumatology and Arthritis Foundation guideline recommends against stem cell injections in knee and hip osteoarthritis, pointing to how much the preparations vary and how little they are standardised, while strongly recommending exercise 2. This is why an injection is considered only after exercise-based rehabilitation has been tried properly.

Stem cells are being studied in stroke, spinal cord injury, cerebral palsy, multiple sclerosis, Parkinson's disease and ALS. In ischaemic stroke, a 2019 Cochrane review of seven randomised trials with 401 participants found less neurological impairment but no better function in daily life, and the evidence came mostly from small trials at high risk of bias 4.

Outside clinical trials, these treatments are experimental. The International Society for Stem Cell Research cautions against selling unproven stem cell interventions to patients and notes that patient registries are no substitute for controlled trials 3. Serious harm has been documented: a man who received stem cell infusions into the spinal fluid at clinics in several countries to treat the effects of a stroke developed a growth in his spinal cord made of cells that were not his own, and paralysis of the legs 5.

If you ask about stem cell treatment for a neurological condition, a physician will discuss it with you on those terms, within current evidence and regulation. It never replaces rehabilitation: after a stroke, recovery depends on a sustained programme delivered by a coordinated team 8.

Adults with early or moderate osteoarthritis of the knee, hip, shoulder or ankle, a focal cartilage lesion, a chronic tendon problem, or a ligament or meniscus injury — when medication, exercise and physiotherapy have not been enough. Suitability is decided by a physician after examining you and reviewing your imaging.

It is not offered with an active infection or active cancer, a blood or clotting disorder, during pregnancy or breastfeeding, with uncontrolled diabetes, while taking immunosuppressive medication, shortly after a steroid injection into the same area, or in end-stage osteoarthritis. If you take a blood thinner, tell us before your appointment.

The procedure is completed in a single day: the sample is taken, processed and injected, followed by a short period of observation.

Depending on the condition, one session may be enough or several are planned a few weeks apart. Rehabilitation begins in the following days, and the result depends on it: the injection may ease pain enough for you to load the joint or tendon properly, and the exercise programme does the rest.

Pain, swelling or bruising at the injection site for a few days is common. Your physician will tell you which painkillers to use and which to avoid in the first days. Contact us straight away if you develop a fever, spreading redness, discharge from the injection site or pain that keeps getting worse.

Any effect builds gradually over weeks rather than days. Some people notice little or no change, and that is worth knowing before you decide.

Exosomes are tiny particles released by cells, including stem cells; they are not cells themselves. Exosome products are being studied in neurological conditions and are given by intravenous, intramuscular or intrathecal injection. The US Food and Drug Administration states that there are no approved exosome products and has warned of serious adverse events in patients who received unapproved ones 7.