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Stem Cell Therapy for Osteoarthritis (OA)

Osteoarthritis is the most common form of arthritis and a chronic degenerative disease of the entire joint. Although cartilage damage is a central feature, OA can also affect the underlying bone and surrounding tissues.

Healthy cartilage provides a smooth, shock-absorbing surface between bones. As osteoarthritis progresses, pain and stiffness can restrict movement and daily function. The knees, hips, hands and spine are among the areas most commonly affected.

At ANOVA IRM in Offenbach, Germany, selected patients may be considered for two related autologous stem-cell-based approaches: Bone Marrow Concentrate (BMC) for localized treatment and cell-free Mesenchymal Stem Cell Secretome / Exosome (MSEC) therapy, which may be considered when several joints are affected or alongside BMC.

On this page, you will find more information about ANOVA’s BMC and MSEC treatments for osteoarthritis, including how the approaches differ and how patients are assessed. Both treatments remain experimental, and suitability is determined through an individual medical review.

Osteoarthritis Treatment Overview

On this page, you can jump directly to the following topics:

Medical illustration comparing a healthy knee joint with osteoarthritis, including damaged cartilage, exposed bone, an eroding meniscus and bone spurs

Joint and cartilage degeneration in osteoarthritis
ANOVA IRM - Germany

Stem Cell Therapy for Osteoarthritis at ANOVA IRM

Stem-cell-based therapy is considered alongside established osteoarthritis treatment. Depending on the joint involved and individual clinical circumstances, conventional care may include:

  • Education and self-management
  • Exercise and physiotherapy, with weight management where appropriate
  • Topical or oral medication for pain and inflammation
  • Corticosteroid injections for short-term relief
  • Supportive devices such as walking aids or braces
  • Joint replacement surgery when non-surgical care no longer provides adequate relief

These treatments can relieve symptoms and help patients remain active, but no single option is appropriate for every patient, and some have important limitations. NSAIDs may carry gastrointestinal, kidney or cardiovascular risks and must be used according to the patient’s health.

Corticosteroid injections can provide relatively rapid but temporary relief, and repeated use requires caution. Hyaluronic acid injections are also used in some healthcare settings, although evidence and clinical recommendations remain mixed.

Joint replacement may become appropriate when osteoarthritis substantially interferes with daily life despite non-surgical care. Established non-surgical treatments can manage symptoms but cannot restore an affected joint to its original condition.

This limitation has encouraged research into regenerative therapies. ANOVA IRM assesses selected patients for BMC or MSEC therapy.

Can Stem Cell Therapy Help Osteoarthritis?

Published research has reported potential benefits from stem-cell-based approaches for osteoarthritis. Some clinical studies have reported improvements in pain or function after BMC, while preclinical research suggests that MSC-derived factors may influence inflammatory and cartilage-related repair pathways.

These approaches are being investigated because OA affects the entire joint and may involve:

  • Breakdown of articular cartilage
  • Changes in the underlying bone
  • Inflammation within the joint lining
  • Altered cartilage-cell activity
  • Mechanical stress related to joint loading or instability

Although OA is not an autoimmune disease, researchers are examining whether biological signalling could influence inflammatory or repair-related activity within the joint.

The evidence base differs between the two approaches. Most clinical research involving BMC has focused on knee osteoarthritis. Some studies have reported improvements in pain or function, while others have found no clinically important advantage over comparison injections.

Research involving MSC secretome and extracellular vesicles has explored inflammatory signalling and cartilage-related repair pathways. These findings provide the scientific rationale for ANOVA’s MSEC approach, although the evidence remains predominantly laboratory and animal based.

ANOVA provides BMC and MSEC within a controlled clinical environment in Offenbach. Both products are autologous, meaning they are derived from the patient’s own biological material, and each undergoes preparation and quality-control procedures appropriate to that product.

Treatment planning begins by examining whether the proposed joint or surrounding structure is the probable source of pain. Existing records and imaging are reviewed first. When further clarification is needed, additional MRI or other imaging may be used to assess cartilage, bone, ligaments, tendons and nearby tissues.

Through its partner diagnostic clinic, ANOVA has access to on-site MRI and CT. When clinically appropriate, specialized imaging such as arthro-MRI may help distinguish structural abnormalities from findings likely to be contributing to the patient’s symptoms.

The findings help determine whether a localized BMC application, systemic MSEC treatment or a combined approach is medically reasonable. In some cases, ANOVA may instead advise the patient to continue established care, seek another specialist assessment or, in some cases, consider surgery.

What Therapeutic Outcomes Can Be Expected?

Depending on the joint involved, monitoring may include:

  • Pain and stiffness during activity or at rest
  • Range of motion and walking tolerance
  • Daily function and quality of life
  • Use of pain medication
  • Joint-specific symptom and function scores

When clinically relevant, imaging findings may be assessed alongside changes in symptoms and function.

The extent, timing and duration of any response vary between patients.

Artificial knee and hip implants used to replace natural joints in patients with severe osteoarthritis

Knee and hip joint replacement implants
ANOVA IRM - Germany

Potency Hypothesis of Stem Cell Therapies

The research rationale for BMC and MSEC centres largely on paracrine signalling, a process through which cells and cell-derived substances communicate with surrounding tissue.

Growth factors, cytokines, proteins, microRNAs and extracellular vesicles such as exosomes are among the components studied in relation to inflammatory activity and cartilage-matrix regulation. Researchers are also examining their possible influence on the survival of cells within existing cartilage.

BMC supplies a concentrated mixture of naturally occurring bone marrow components. MSEC is a cell-free preparation of substances released by cultivated MSCs. The research rationale for both approaches centres on biological signalling rather than the direct formation of new cartilage.

BMC – Bone Marrow Concentrate – Autologous

Bone Marrow Concentrate is ANOVA IRM’s principal treatment option for a localized osteoarthritis target. It may be considered for the knee, hip or elbow. ANOVA has also treated other joints, including finger and foot joints, while every joint or nearby tendon or ligament requires individual assessment.

BMC is prepared from the patient’s own bone marrow. It is not a purified or culture-expanded stem cell product. The concentrate contains a mixture of bone marrow cells, platelets and naturally occurring bioactive factors, including a small population of mesenchymal stromal or progenitor cells.

Bone marrow is collected from the iliac crest under light sedation or suitable pain management. It is concentrated, checked and applied during the same treatment session. Depending on the location, CT or another imaging method may be used to guide the application to the selected joint or surrounding target.

Because BMC is prepared for same-day use rather than cultivated and stored, a future BMC treatment would require another medical review and bone marrow collection.

Learn more about ANOVA IRM’s Bone Marrow Concentrate therapies.

Bone marrow cell-lineage diagram showing hematopoietic adult stem cells, mesenchymal stromal cells, immune cells, erythrocytes and platelets

BMC - Bone Marrow Concentrate
ANOVA IRM - Germany

MSEC – Mesenchymal Stem Cell Secretome / Exosome Therapy – Autologous

Mesenchymal Stem Cell Secretome is a cell-free product composed of substances released by cultivated MSCs. It contains exosomes and other extracellular vesicles along with soluble signalling factors, but it should not be understood as an exclusively exosome-based product.

At ANOVA, MSEC is produced from the patient’s own adipose-derived MSCs. A small amount of abdominal fat tissue is collected through limited mini-liposuction under light sedation. The MSCs are isolated and cultivated before the substances they release are collected, enriched and quality-controlled. The completed preparation contains no living MSCs.

For osteoarthritis, MSEC may be considered when several joints are affected or as a systemic component of a plan that also includes localized BMC. MSEC is administered intravenously rather than injected separately into each osteoarthritic joint.

One mini-liposuction can provide up to 10 MSEC doses. Production takes approximately four weeks, and the completed doses can be stored for applications over a maximum period of two years. Stored doses cannot be administered after the shelf life expires.

Because OA is chronic, applications may be distributed over time rather than completed in one short course. The number of doses given during each visit and the interval between visits are determined during individualized treatment planning.

Learn more about ANOVA IRM’s Secretome / Exosome therapies.

Diagram of MSEC signalling showing mesenchymal stem cells releasing exosomes, microvesicles, cytokines, proteins and microRNAs

MSEC - Stem Cell Secretome / Exosome Therapy
ANOVA IRM - Germany

Who May Be a Candidate for Osteoarthritis Stem Cell Therapy?

Stem-cell-based treatment is not appropriate for everyone with osteoarthritis or unexplained joint pain. ANOVA assesses the probable source of symptoms, the condition of the proposed treatment target and whether established options remain more suitable.

ANOVA primarily uses MRI when assessing the proposed treatment target. Suitability is not determined by a single X-ray grade. Patients described as having early, moderate, advanced or “bone-on-bone” OA still require individual review because the same radiographic stage can have different implications for different joints and patients.

Patients Who May Be Considered Include Those With:

  • Confirmed, symptomatic osteoarthritis
  • Persistent pain or functional limitation despite appropriate care
  • Clinical and imaging findings that support a defined treatment target
  • Localized OA potentially suitable for BMC
  • Widespread or multi-joint OA potentially suitable for MSEC
  • Medical suitability for mini-liposuction, bone marrow collection or light sedation, as required
  • Willingness to continue appropriate exercise or rehabilitation
  • Realistic expectations about an experimental therapy

ANOVA IRM Does Not Treat Patients When the Following Contraindications Apply:

  • Active cancer within the last two years
  • Being under legal age
  • Pregnancy or lactation
  • Ventilator dependence or inability to breathe independently
  • Difficulty breathing while lying down
  • Severe dysphagia
  • A psychiatric condition that prevents safe treatment or informed participation
  • Active infectious disease, including hepatitis A, B or C, HIV, syphilis or another active infection

Therapy Workflow for Osteoarthritis

What to Expect From the Treatment Process

Step 1: Remote Osteoarthritis Inquiry and Consultation

Patients can begin by sending an email or submitting ANOVA’s contact form. They normally receive an initial condition-specific response outlining the practical next steps.

If the patient remains interested after reviewing this information, they can reply to request further details. A patient care manager then provides the relevant forms, identifies any records or imaging needed for review and helps arrange a video consultation. Detailed paperwork is therefore part of the continuing assessment rather than a requirement for receiving the initial information.

The consultation with an ANOVA physician allows the patient’s symptoms, diagnosis, previous treatment and expectations to be discussed before travel is planned. The process can usually be coordinated by email, so an initial telephone call is not required.

Step 2: Diagnostic Work-Up and On-Site Medical Confirmation

Before the patient travels, ANOVA recommends preliminary blood testing in the home country. This can identify infectious-disease exclusions or procedural concerns early and reduce the risk of travelling to Germany only to learn that treatment cannot proceed.

Required bloodwork is performed again in Offenbach in accordance with German medical requirements. ANOVA cannot treat patients whose testing identifies HIV, hepatitis A, B or C, syphilis or another active infection. Other medical findings may also make treatment inappropriate.

The diagnostic work-up is directed at treatment planning. Existing scans are considered first, but the treating physician may recommend MRI or other imaging when it could clarify whether pain arises from cartilage, underlying bone, a ligament, a tendon or another structure. The on-site findings may show that the proposed procedure is not appropriate or that another treatment should take priority.

Step 3: Osteoarthritis Treatment Planning

ANOVA develops the treatment plan from the diagnostic findings, number of affected joints, procedural suitability and practical travel considerations.

The principal pathways are:

  • Localized BMC treatment: Bone marrow is collected, concentrated and applied to a defined joint or surrounding treatment target.
  • MSEC treatment: Adipose tissue is collected once to produce up to 10 stored doses for later intravenous applications.
  • Combined BMC and MSEC treatment: Local BMC is used for a selected target while MSEC forms the systemic component of the plan.

When 10 doses are available, ANOVA’s Balanced-Boost MSEC example divides them across four treatment visits, generally as three doses at the first visit, three at about six months, two at about 12 months and two at about 18 months.

This is an example rather than a fixed prescription. Patients who live closer to Germany may be able to attend more frequently, while doses for long-distance patients may be grouped to reduce travel. The treating physician determines the final pattern according to the patient’s condition and travel requirements. Stored doses cannot be administered after the two-year shelf life.

Before the patient commits to treatment, ANOVA explains the proposed products, application routes, expected visits and individualized cost estimate.

Step 4: Bone Marrow or Adipose Tissue Collection

For BMC, bone marrow is collected from the iliac crest under light sedation or appropriate pain management. It is processed and applied to the selected target during the same session.

For MSEC, abdominal adipose tissue is obtained through limited mini-liposuction. The patient’s MSCs are then isolated and cultivated to produce the cell-free secretome. Production and quality control take approximately four weeks, so MSEC applications begin during a later visit.

When a plan includes both products, ANOVA coordinates the same-day BMC procedure and the longer MSEC production process within an individual schedule.

Step 5: Treatment Applications and Follow-Up

BMC is applied locally, with imaging guidance used when appropriate to the target. Rehabilitation and activity recommendations are discussed in relation to the joint treated and the procedure performed.

MSEC is administered intravenously during scheduled visits to Offenbach. The number of doses provided during each visit and the interval between visits follow the individualized schedule developed during treatment planning.

Treatment Timeline and Travel Requirements

Initial information exchange and physician consultation can begin remotely. This stage may take approximately two weeks or extend over several months, depending on scheduling and how quickly the required information is assembled.

For planning purposes:

  • Diagnostic work-up and BMC: Final review, required bloodwork, bone marrow collection and local application are generally organized during the Offenbach visit. The exact length of the visit is confirmed individually.
  • MSEC tissue collection: The initial trip includes on-site confirmation and mini-liposuction, commonly requiring approximately two consecutive days.
  • MSEC production: Secretome production and quality control take about four weeks. The patient does not need to remain in Germany during this period.
  • MSEC applications: The patient returns to Offenbach according to the individualized treatment schedule. Repeated travel is required when more than one application visit is planned.

When BMC and MSEC are included in the same plan, their timing is coordinated individually.

Cost of Stem Cell Treatment for Osteoarthritis

MSEC treatment generally costs approximately €20,000 to €36,000, depending on the total number of doses used.

The cost of BMC alone or a combined BMC and MSEC treatment plan is determined individually. The number of treatment targets, required diagnostics, sedation and application schedule can affect the total.

ANOVA provides an individualized written estimate before treatment. Travel, accommodation and other personal expenses are separate.

Does Health Insurance Cover the Therapy Costs?

BMC and MSEC for osteoarthritis are generally not reimbursed by statutory or private health insurance.

Patients should plan to pay privately unless their insurer provides explicit confirmation of coverage.

Why Choose ANOVA IRM for Osteoarthritis Treatment?

  • Two related autologous approaches: ANOVA can assess localized BMC and cell-free MSEC separately or as components of one treatment plan.
  • Treatment-focused diagnostic work-up: The proposed source of pain is examined before a joint or nearby structure is selected for treatment.
  • Radiology-led planning: Existing imaging is reviewed, with further MRI or other scans used when they could change the treatment decision.
  • Image-guided local application: BMC can be directed to a selected joint or surrounding target with imaging support where appropriate.
  • Controlled preparation and storage: Each product follows its own preparation and quality-control process, while MSEC doses can be stored for repeated use.
  • Planning for international patients: Remote consultation and grouped MSEC applications can reduce unnecessary travel where medically appropriate.

Request a Medical Evaluation

Find out whether BMC or MSEC may be medically appropriate for your osteoarthritis.

ANOVA can begin with condition-specific information and a remote physician consultation before you arrange travel. If you decide to continue, the patient care team will explain the required records, preliminary bloodwork and next steps.

Contact ANOVA IRM to begin the inquiry process.

Frequently Asked Questions About Stem Cell Therapy for Osteoarthritis

Is Stem Cell Therapy for Osteoarthritis Available at ANOVA IRM?

Yes. ANOVA offers autologous BMC and MSEC therapy for selected patients in Offenbach, Germany. The appropriate approach depends on the source and distribution of symptoms, imaging findings and individual medical assessment.

Can Stem Cell Therapy Help With Osteoarthritis Pain?

Some knee OA studies have reported pain or functional improvement after BMC, although results have varied. Research into MSC secretome and extracellular vesicles has identified effects on inflammatory and cartilage-related repair pathways that provide the scientific rationale for ANOVA’s MSEC approach.

Can Stem Cell Therapy Delay or Prevent Joint Replacement?

Treatment might delay joint replacement in some cases. If BMC produces a satisfactory and sustained improvement in pain and function, a patient may be able to continue without joint replacement for longer. Whether surgery remains necessary depends on the patient’s individual condition and response.

What Is the Difference Between BMC and MSEC Therapy?

BMC is a concentrate of the patient’s bone marrow and is applied locally during the same session in which it is collected. MSEC is produced from substances released by the patient’s cultivated adipose-derived MSCs. It contains no living MSCs and is administered intravenously.

Which Joints Can ANOVA Treat With BMC?

ANOVA principally applies BMC to the knee, hip and elbow, but other joints have also been targeted, including finger and foot joints. Any proposed joint, tendon or ligament requires individual review and imaging when appropriate.

Can Patients With Advanced or Bone-on-Bone Osteoarthritis Be Treated?

Radiographic stage alone does not decide suitability. Advanced structural damage can limit what an injection-based treatment could reasonably achieve, and joint replacement may offer a more appropriate pathway for some patients.

How Many MSEC Doses Are Produced and How Are They Scheduled?

One mini-liposuction can provide up to 10 MSEC doses. The physician individualizes how the doses are grouped and spaced according to the patient’s condition and travel requirements. Stored doses cannot be administered after the two-year shelf life.

Does Treatment Replace Exercise, Physiotherapy or Medication?

Exercise and physiotherapy may remain important components of osteoarthritis care. In some cases, satisfactory improvement may allow pain medication to be reduced or discontinued under medical supervision.

ANOVA generally advises against repeated intra-articular corticosteroid injections because of concerns about their potential long-term effects on cartilage.

Can International Patients Apply for Treatment?

Yes. International patients can begin by email or contact form and complete the initial consultation remotely. Travel to Offenbach is required for the on-site diagnostic work-up, tissue collection, treatment and any later MSEC applications.

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Contraindications

Our stem cell treatments are experimental, but we only treat patients for whom we believe the risk/benefit ratio indicates treatment based on the state of the art, i.e., medical, scientific evidence.

Please understand that we therefore do not treat patients for whom the following points apply:

  • Active cancer in the last two years
  • Not yet of legal age
  • Existing pregnancy or lactation period
  • Unable to breathe on own, ventilator
  • Difficulty breathing in supine position
  • Dysphagia (extreme difficulty swallowing)
  • Psychiatric disorder
  • Active infectious disease (Hepatitis A, B, C, HIV, Syphilis, or other)