Introduction: Addressing a Growing Challenge

Knee osteoarthritis is a common and often debilitating problem that affects millions of people worldwide. This condition occurs when the cartilage—the smooth tissue that cushions your knee joint—gradually wears down. As a result, people experience pain, stiffness, swelling, and difficulty moving, making everyday activities harder. With more people living longer and staying active into older age, knee osteoarthritis is becoming even more widespread, placing a heavy burden on both individuals and healthcare systems. According to Knežević et al. (2022), osteoarthritis is now the leading cause of disability among the elderly.

Traditional treatments mainly focus on relieving pain and improving mobility, but they don’t repair the underlying cartilage damage. Recently, a newer group of treatments called orthobiologics has gained attention. These therapies use natural substances from your own body to help your knee heal itself. As described by Bishop and Rizzolo (2024), orthobiologics involve harnessing naturally-derived materials to treat musculoskeletal conditions like knee osteoarthritis. In this article, we’ll explore how orthobiologics are changing the landscape of knee osteoarthritis care and what practical factors patients and doctors need to consider.

Understanding Knee Osteoarthritis and Conventional Care

Knee osteoarthritis develops when the protective cartilage that cushions the knee joint begins to break down. Without this smooth layer, the bones rub together, causing pain, swelling, and stiffness—and making it tough to move your joint comfortably.

This condition also brings significant healthcare costs, since many people require ongoing medication, physical therapy, and sometimes eventual knee replacement surgery.

Usually, treatment begins conservatively with pain relievers, anti-inflammatory medications, exercise, lifestyle modifications, and sometimes steroid injections to control inflammation. Key strategies include educating patients, encouraging weight loss for those who are overweight, and building strength around the knee through exercise (Knežević et al., 2022). Although these approaches can help control pain and swelling, they don’t repair cartilage or prevent further joint damage. That’s why researchers are searching for treatments that support actual healing of the knee.

Orthobiologics: How They Work and Why They Matter

Orthobiologics are therapies that use natural, biologically-derived substances to encourage the healing environment inside the body. The two most commonly used for knee osteoarthritis are mesenchymal stem cells and platelet-rich plasma (PRP).

Mesenchymal stem cells have the ability to develop into various tissues, including cartilage. These cells are typically harvested from a person’s bone marrow or fat. PRP, on the other hand, is created by concentrating platelets from a small sample of your blood—platelets that release growth factors critical for tissue healing.

Both PRP and stem cells are injected directly into the knee joint. Unlike traditional treatments that simply address symptoms, orthobiologics aim to help the knee repair itself—boosting healing and reducing inflammation over time.

There’s also a growing interest in other orthobiologic options, such as amniotic suspension allografts. Early studies are investigating their ability to reduce inflammation and support cartilage repair. For example, one study found that a single injection of amniotic suspension allograft was safe and potentially helpful for people with knee osteoarthritis (Vines et al., 2015).

What Does the Research Show? Promises and Limitations

Recent research is encouraging. Clinical trials show that PRP injections can lead to longer-lasting pain relief and better knee function when compared to steroid injections. Early studies on stem cell treatments indicate these therapies may help repair cartilage, although we still need more long-term data.

Initial results with amniotic suspension allografts are also promising, with patient-reported improvements lasting up to a year (Vines et al., 2015).

The main advantages of orthobiologics are that they’re minimally invasive—no surgery required—and may reduce a person’s dependency on medication. Most importantly, they aim to address the underlying joint damage, not just the symptoms. However, these treatments can be expensive, their preparation and administration can vary widely between clinics, and more research is needed on their long-term safety and effectiveness. The regulatory environment is also still catching up, meaning not every therapy is covered by insurance or widely available.

Despite these limitations, orthobiologics represent a significant step forward in non-surgical care for knee osteoarthritis. However, not every doctor includes these treatments in their discussions of available options, and current guidelines often differ on how—or whether—to use them. That’s why it’s so important to individualize treatment plans, weighing the potential risks and benefits for each person (Knežević et al., 2022).

Practical Considerations and What’s Next

Orthobiologic therapies are generally most effective in people with mild to moderate knee osteoarthritis—those looking to delay or avoid surgery. Careful patient selection is crucial, as people with more severe joint damage may not see as much benefit.

Most patients begin to notice improvements in pain and mobility gradually, over weeks or months, and the recovery time is typically much shorter than for surgical options.

For orthobiologics to become mainstream, we need standardized methods for preparing and administering them, as well as more large-scale, high-quality research. Ongoing studies are also looking at how best to combine orthobiologics with other therapies, such as physical rehabilitation, and figuring out which patients are most likely to benefit.

As the research grows and more treatment data becomes available, it’s likely that orthobiologics will become a more standard feature of osteoarthritis care—providing patients additional ways to manage their condition without resorting to surgery any sooner than necessary.

Conclusion: Looking Forward with Cautious Optimism

Orthobiologics offer an exciting, non-surgical option for people with knee osteoarthritis, focusing on the goal of healing damaged cartilage and reducing pain. While early studies are promising, we need more evidence and clear guidelines to fully unlock their potential and ensure they’re used safely and effectively.

As this field develops, orthobiologic therapies could transform knee osteoarthritis care—offering millions the hope of pain relief and better joint function. Staying informed about these advances can empower patients and healthcare providers to make the best treatment choices together for a healthier, more active future.