# What people ask when a joint keeps hurting *Questions Answered | Regenerative Therapy Surprise* > Regenerative therapy surprise answers about worn cartilage, PRP blood care, surgery, prices, and things to try at home. ## What to ask when the ache won't settle The knee hurts when you stand. The shoulder complains when you reach. The hip keeps you from walking as far as you'd like. You want answers that apply to those limits, not a lecture. I'd keep asking one thing: what does this mean for daily life? These short answers can't replace an exam. They can help you ask about the cause, the likely gain, and the limits of care, but they won't name your joint problem. If a claim sounds certain, slow the talk down. ## Sources 1. FDA states plainly that no stem cell, exosome, stromal vascular fraction, umbilical cord blood, Wharton's jelly or amniotic-fluid product has been approved for the treatment of ANY orthopedic condition - it names osteoarthritis, tendonitis, disc disease, tennis elbow, back pain, hip pain, knee pain, neck pain and shoulder pain individually. The only FDA-approved stem cell products in the United States are cord-blood-derived blood-forming stem cells for disorders of the hematopoietic system, and there are currently no FDA-approved exosome products. US Food and Drug Administration, Center for Biologics Evaluation and Research — [Consumer Alert on Regenerative Medicine Products Including Stem Cells and Exosomes](https://www.fda.gov/vaccines-blood-biologics/consumers-biologics/consumer-alert-regenerative-medicine-products-including-stem-cells-and-exosomes). *FDA*, 2020. 2. MACI (autologous cultured chondrocytes on a porcine collagen membrane, Vericel; STN BL 125603) IS an FDA-LICENSED cell therapy - and its approved indication is narrow and specific: repair of symptomatic, single or multiple FULL-THICKNESS cartilage defects OF THE KNEE, with or without bone involvement, in adults. It is not approved for osteoarthritis. The existence of one licensed cartilage cell therapy for focal defects is the sharpest available way to show what a licensed 'regeneration' product actually looks like, and how far it is from an injection for a worn joint. US Food and Drug Administration, Center for Biologics Evaluation and Research — [MACI (autologous cultured chondrocytes on porcine collagen membrane)](https://www.fda.gov/vaccines-blood-biologics/cellular-gene-therapy-products/maci-autologous-cultured-chondrocytes-porcine-collagen-membrane). *FDA*, 2024. 3. FORWARD, the longest disease-modifying osteoarthritis drug trial reported to date, gave intra-articular sprifermin (a recombinant FGF-18) or placebo to knee OA patients and followed 378 of them for 5 years. Sprifermin produced a significant, sustained dose-response INCREASE in total femorotibial cartilage thickness versus placebo - and WOMAC pain improved about 50% from baseline in ALL groups, including placebo. It is the cleanest demonstration in the literature that adding measurable cartilage and relieving pain are two different results, and that one does not deliver the other. Eckstein F, et al. — [Long-term structural and symptomatic effects of intra-articular sprifermin in patients with knee osteoarthritis: 5-year results from the FORWARD study.](https://pubmed.ncbi.nlm.nih.gov/33962962/). *Annals of the rheumatic diseases*, 2021. DOI: 10.1136/annrheumdis-2020-219181. 4. Medicare's National Coverage Determination covers autologous platelet-rich plasma ONLY for chronic non-healing diabetic, pressure or venous WOUNDS, and only under Coverage with Evidence Development inside an approved clinical research study. There is no Medicare coverage pathway for PRP as a treatment for osteoarthritis or any other joint indication, which is why these injections are quoted as cash prices. Centers for Medicare & Medicaid Services — [Autologous Platelet-rich Plasma (Coverage with Evidence Development)](https://www.cms.gov/medicare/coverage/evidence/plasma). *CMS.gov*, 2012. 5. The AAOS clinical practice guideline summary on SURGICAL management of knee osteoarthritis - the other end of the ladder, and the honest comparator for anyone told a biologic injection will let them avoid an operation. Srivastava AK, et al. — [American Academy of Orthopaedic Surgeons Clinical Practice Guideline Summary of Surgical Management of Osteoarthritis of the Knee.](https://pubmed.ncbi.nlm.nih.gov/37883429/). *The Journal of the American Academy of Orthopaedic Surgeons*, 2023. DOI: 10.5435/JAAOS-D-23-00338. 6. The RESTORE trial - a participant-, injector- and assessor-blinded RCT of 288 adults aged 50+ with symptomatic medial knee OA (Kellgren-Lawrence 2-3) - compared three weekly intra-articular PRP injections against saline placebo, with co-primary endpoints of 12-month knee pain and medial tibial cartilage volume on MRI. PRP did not beat placebo on either. It is the single best-designed test of the specific claim that PRP changes joint structure, and it was negative. 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.](https://pubmed.ncbi.nlm.nih.gov/34812863/). *JAMA*, 2021. DOI: 10.1001/jama.2021.19415. 7. A four-arm, multicentre, single-blind phase 2/3 randomized trial of 480 knee OA patients (KL II-IV) compared autologous bone marrow aspirate concentrate, autologous adipose stromal vascular fraction and allogeneic umbilical-cord-tissue mesenchymal stromal cells against a corticosteroid injection control. At 12 months NONE of the three orthobiologic injections was superior to another, or to the corticosteroid control, and none of the four groups showed a significant change in MRI osteoarthritis score from baseline. No procedure-related serious adverse events occurred. Mautner K, et al. — [Cell-based versus corticosteroid injections for knee pain in osteoarthritis: a randomized phase 3 trial.](https://pubmed.ncbi.nlm.nih.gov/37919438/). *Nature medicine*, 2023. DOI: 10.1038/s41591-023-02632-w. 8. A randomized trial in the New England Journal of Medicine compared physical therapy against intra-articular glucocorticoid injection for knee osteoarthritis and found physical therapy produced better WOMAC outcomes at one year. When a clinic offers an injection, the comparator that matters is not 'nothing' - it is a course of supervised exercise. Deyle GD, et al. — [Physical Therapy versus Glucocorticoid Injection for Osteoarthritis of the Knee.](https://pubmed.ncbi.nlm.nih.gov/32268027/). *The New England journal of medicine*, 2020. DOI: 10.1056/NEJMoa1905877. ## Can worn knee cartilage grow back? A worn knee hasn't been shown to grow its smooth covering back through exercise or a supplement. Exercise can still settle soreness and make daily tasks easier. That's useful even when the X-ray doesn't change. One small damaged spot is different and may need a surgery talk. ## What does bone on bone mean for me? It means the X-ray shows that the usual gap between the bones has become very narrow. It doesn't tell the doctor how much you hurt. Rest pain, poor sleep, a bent joint, or repeated giving way are reasons to ask whether surgery now makes more sense. ## What can I do for a worn joint at home? Try steady strength work and change the activity that keeps starting the soreness. Shorter walks, fewer golf days in a row, or a brace may help. Your doctor can check whether medicine is safe for you. These steps won't rebuild the joint, but they may help you do more. ## What is PRP, and might it help my ankle? PRP means platelet-rich plasma, a fluid made by spinning blood until platelets, the tiny clotting parts, gather in less liquid. That fluid is put into the ankle so the joint may feel or move better. Results for ankles aren't as clear as results for knees, so ask what supports its use in your ankle. ## When is it time to ask about joint replacement? Ask when soreness at rest, poor sleep, a joint bent out of shape, or hard walking keeps limiting life after other care. Replacement is a major operation, and recovery takes time. Still, months spent on uncertain care can also mean months with the same limits. ## How much does this care cost in Arizona? There isn't one Arizona-wide price listed here. Ask for the full written cost and what later visits include. Don't let a vague price rush you. At QC Kinetix in Peoria, medical providers—the people who check the sore joint—can discuss regenerative treatment, the name for non-surgical care using body material, including PRP, a shot made by spinning blood until its clotting parts collect in less fluid. ## Take the scan and the questions that matter Note the sore spot, the motion that starts the ache, and what you've tried. Bring an X-ray or MRI report if you have one. Ask what care might change, what it can't do, how much it costs, and when surgery deserves a talk. The nearest office for most Surprise residents is in Peoria near Thunderbird Road and Loop 101. Call (602) 837-PAIN or choose a time online. Book a free consultation: --- Start with the sore joint. Then talk through the choices. Clear answers for a joint that aches, gentle things to try, urgent trouble, and care offered near Surprise. Simple facts about aches, safe self-care, urgent trouble, and the nearby office. This site is operated by the owners of the QC Kinetix Phoenix-area clinics, including the Peoria location recommended to most Surprise readers, and the business may benefit when a reader books a consultation. Copyright 2026 Surprise Joint Signal. General joint-health education, not individual medical advice; urgent symptoms need prompt in-person assessment.