Stem Cell Therapy and PRP for the Knee

Biological treatment of knee cartilage is part of this practice. Dr Gobinder Singh’s clinical interest includes cartilage treatment, and both platelet-rich plasma and cell-based injection are discussed in consultation alongside the alternatives.²

What is offered

Two different things, often confused with each other.

Platelet-rich plasma. Your own blood is drawn and spun in a centrifuge to concentrate the platelets and the growth factors they release. The concentrate is injected into the knee. It contains no stem cells. For most patients this is an outpatient procedure in clinic under local anaesthetic after cleaning the skin, and more than one session is commonly proposed.

Cell-based treatment. Cells, most often mesenchymal cells from bone marrow or adipose tissue, are obtained, prepared and injected.¹

They are different treatments, with different evidence, different costs and a different regulatory position. Worth asking which one is being proposed for you, how the material would be obtained, and what the total cost is.⁴

Who it suits

Orthopaedic surgeons grade arthritis on X-ray using the Kellgren-Lawrence scale, from grade 1 through grade 4. It describes how much joint space has been lost and what changes have appeared in the bone.³

• Grade 1, and some grade 2. Early change. Strengthening, load management and weight reduction where relevant are better supported by evidence than anything injectable, so they come first.
• Grade 2 to grade 3. Where the question arises. There is cartilage left, symptoms are limiting, and a joint replacement is not yet the proportionate answer. If biological treatment has a place, it is here.
• Grade 4. The joint surface is worn through, and injection is unlikely to change its course. Postponing a replacement the knee needs costs conditioning and can allow deformity to progress, which makes eventual surgery harder.

Selection is the whole conversation. It is decided on your weight-bearing imaging and your examination, not on a package.

What else helps, and comes first

For knee osteoarthritis the interventions with the strongest evidence are unglamorous, and they are the ones to exhaust first:

• Strengthening. Quadriceps and hip muscles, progressively loaded. The best return available.
• Weight reduction, where relevant. The load through the knee in walking is a multiple of body weight, so the mechanical effect is substantial.
• Activity modification. Cycling, swimming, walking on the flat. Not rest.
• Simple analgesia, used sensibly and reviewed.
• Corticosteroid injection for a flare. Short-term relief, not a strategy.
• Joint replacement when the joint is worn out and quality of life is the issue. One of the more reliable operations in medicine.

Biological injection is not a replacement for any of these. Where it is considered, it sits alongside them.

Questions worth asking

1. What precisely would be injected, and how is it prepared?
2. What Kellgren-Lawrence grade is my knee, on weight-bearing films?
3. How many sessions, and what is the total cost in writing?
4. What are the alternatives in my case?
5. If it does not help, does it complicate anything I might need later?

Common questions

Is cell therapy for the knee available at this clinic?

Cell-based and platelet-rich plasma injections for knee osteoarthritis are part of the practice, and Dr Gobinder Singh's clinical interest includes biological treatment of cartilage. Whether either is appropriate for you depends on how worn the joint is on weight-bearing imaging, what you have already tried, and what you want the knee to do. It is discussed in consultation alongside the alternatives, not offered as a package.

What is the difference between PRP and cell therapy?

Platelet-rich plasma is prepared by spinning your own blood to concentrate platelets and the growth factors they carry. It contains no stem cells. Cell-based therapy involves harvesting and preparing cells, most often mesenchymal cells from bone marrow or fat. They are different treatments with different evidence, different costs and a materially different regulatory position in Malaysia.

Who is considered for it?

Broadly, knees with mild to moderate change rather than an end-stage joint. Orthopaedic surgeons grade arthritis on X-ray using the Kellgren-Lawrence scale, and it is the middle of that scale, grade 2 to grade 3, where the question of biological treatment genuinely arises. A knee where the joint surface is worn through is a different conversation, and injections are unlikely to change its course.

Does it regrow cartilage?

No trial in the 2025 Cochrane review assessed whether joint structure changed on imaging, so cartilage regeneration has not been demonstrated. The evidence position is set out in the notes at the foot of this page and in the evidence review.

What does the procedure involve?

For PRP and for some cell preparations it is an outpatient procedure performed in clinic under local anaesthetic after cleaning the skin, rather than an operation in theatre. More than one session is often proposed. What is involved in your case, including how the cells would be obtained and prepared, should be explained to you specifically before you agree to anything.

Will insurance cover it?

Generally no. These treatments are usually self-funded in Malaysia, and a treatment whose regulatory status is not settled is unlikely to be covered by a medical card. Ask your insurer in writing rather than assuming, and ask the clinic for a written quotation including any repeat sessions.

References

1. Cochrane Review CD013342: stem cell injections for knee osteoarthritis, April 2025
2. The Conversation: costly stem cell injections for knee osteoarthritis, and what is not known
3. Azmi & Associates: the regulatory framework of stem cell research and therapy in Malaysia
4. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Annals of the Rheumatic Diseases 1957;16(4):494-502

Related reading

Do Stem Cell Injections Work for Knee Arthritis?

What the evidence and Malaysian regulations actually say about stem cell and PRP injections for knee osteoarthritis, and how to read the claims you are shown.

Knee Osteoarthritis

What knee osteoarthritis is, how it is assessed and graded, what actually helps at each stage, and when a joint replacement becomes the sensible option.

Total Knee Replacement

What a total knee replacement involves, who it suits, what recovery asks of you, and the risks and alternatives worth understanding before deciding.