A careful knee visit starts with an exam

A proper exam comes before choosing treatment

A doctor or another trained health professional first asks about your health and then examines the knee. The exam can check your steps, knee motion, strength, swelling, and tender spots. Earlier X-rays can help, so take old reports if you have them. Mention any fall, catching, or times the knee has buckled. If another test is needed, ask what it could show.

The findings decide which choices make sense.

Written answers protect your time and money

Before agreeing, find out what goes into the treatment, who gives it, how many return visits you'll make, and whether those visits are included in the price. Ask what relief is likely, what can go wrong, and what happens when it doesn't help. Request a written total. Then you aren't left trying to remember a quick number given across a desk. An impressive medical name isn't an answer to any of those questions.

Read the price before paying.

The right choice must fit your daily goal

Name one task you miss, such as walking a course or rising from your chair. After the exam, choices may include home care, guided exercise, a brace, a shot, or surgery. If weak legs are adding strain, strength work may come first. If the joint is badly worn, asking a surgeon may spare months of cost and trouble. You won't know until someone examines the knee.

A useful visit may end without a shot.

Sources

1. FDA's guidance on the 21 CFR 1271.10(a) criteria of MINIMAL MANIPULATION and HOMOLOGOUS USE is the rule that decides whether a cell or tissue product may be offered as a lightly-regulated 'section 361' HCT/P or requires full drug approval as a 'section 351' biologic. Docket FDA-2017-D-6146; the revised July 2020 version extended the agency's period of enforcement discretion through 31 May 2021 - which has now expired, so products outside 361 need an approved application or an active IND.

   US Food and Drug Administration, CBER and CDRH — Regulatory Considerations for Human Cells, Tissues, and Cellular and Tissue-Based Products: Minimal Manipulation and Homologous Use. FDA, 2020.

2. On 25 June 2019 US District Judge Ursula Ungaro of the Southern District of Florida permanently enjoined US Stem Cell Clinic LLC, US Stem Cell Inc. and their chief scientific officer from manufacturing or distributing stromal vascular fraction products until they comply with the law. The Department of Justice had filed in May 2018; on 3 June 2019 the court granted summary judgment, concluding the defendants had ADULTERATED AND MISBRANDED cellular products made from patients' own adipose tissue. Autologous origin is not a regulatory exemption.

   Sharpless NE (Acting Commissioner of Food and Drugs) — Statement on stem cell clinic permanent injunction and FDA's ongoing efforts to protect patients from risks of unapproved products. FDA Press Announcements, 2019.

3. In January 2025 the Federal Trade Commission banned the co-founders of a stem cell institute and their companies from marketing stem cell treatments and ordered them to pay more than $5.1 million in refunds and civil penalties. Deceptive EFFICACY ADVERTISING, not merely unapproved manufacturing, is independently actionable - the FTC polices what a clinic promises as well as what it injects.

   US Federal Trade Commission — Stem Cell Institute Co-Founders and Companies Banned from Marketing Stem Cell Treatments and Ordered to Pay More Than $5.1 Million for Refunds and Civil Penalties. FTC Press Release, 2025.

4. FDA's public list of licensed cellular and gene therapy products is the checkable answer to 'is this FDA-approved?'. A product not on that list, and not being administered under an active IND, is not an approved therapy however it is described in a brochure. For orthopedics the list is short and its cartilage entry is MACI, indicated for focal full-thickness knee defects.

   US Food and Drug Administration, Center for Biologics Evaluation and Research — Approved Cellular and Gene Therapy Products. FDA, 2026.

5. 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. FDA, 2020.

6. 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). CMS.gov, 2012.