Condition · Joints
Knee, hip & shoulder pain: regenerative and non-surgical care in Orlando
Before anyone talks about PRP or stem cells, you should know what is actually hurting. Dr. Chantasi, board-certified in Physical Medicine & Rehabilitation and Pain Medicine, examines the joint himself, uses ultrasound when it helps, and tells you plainly which options — including surgery or no procedure at all — make sense.
Scheduling opens securely in Prospyr · in-office or telemedicine evaluation
The honest summary
Can stem cells or PRP help a painful knee, hip or shoulder?
Short answer
Some patients improve after PRP, and cell-based injections are being studied, but the largest trials in knee osteoarthritis show mixed results and no stem cell or exosome product is FDA-approved for joint pain. Exercise-based rehabilitation and weight management remain first-line care. A procedure is worth discussing only once the painful structure has been identified.
Joint pain rarely comes from one tidy source. Arthritis, a degenerative meniscus or labrum, an irritated tendon or bursa, an unstable ligament, or pain referred from the spine can all feel like “my knee” or “my shoulder” — and often more than one is involved. An X-ray or MRI is useful, but a finding on a report is not proof that the finding is what hurts.
Common presentations
What each joint usually turns out to be
The same complaint can have several causes. These are the patterns Dr. Chantasi sorts through most often.
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01
Knee pain & osteoarthritis
The most common reason patients ask about stem cell therapy for knee pain. Typical stories: pain on stairs or rising from a chair, morning stiffness that eases within half an hour, swelling after activity, or aching along the inside of the knee.
Beyond osteoarthritis (inner, outer or kneecap compartment), the evaluation looks for a degenerative meniscus, pes anserine bursitis, patellar or quadriceps tendinopathy, kneecap tracking problems and pain referred from the hip. Mild-to-moderate arthritis and end-stage “bone-on-bone” disease are managed very differently.
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02
Hip pain
Where the pain sits matters. Groin pain with stiffness putting on socks points toward the hip joint itself — osteoarthritis or a labral problem. Pain on the outside of the hip, worse lying on that side, is more often gluteal tendinopathy (greater trochanteric pain syndrome) than arthritis. Buttock pain that travels down the leg frequently starts in the lower back.
Because the hip is deep, many hip-joint injections are performed with image guidance, and the evidence for biologic injections is thinner here than for the knee.
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03
Shoulder pain
Most persistent shoulder pain involves the rotator cuff: tendinopathy, bursitis or a partial-thickness tear, typically aching over the outer arm and worse reaching overhead or at night. Other causes include frozen shoulder (adhesive capsulitis), arthritis of the ball-and-socket or AC joint, and pain referred from the neck.
Weakness after a fall or a sudden inability to lift the arm can mean a full-thickness tear, which deserves a prompt surgical opinion rather than a series of injections.
Physician evaluation & diagnosis
How the painful structure is identified
Part of the PrimeCell Candidacy Assessment. You see the physician — not a sales coordinator — and there is no predetermined package.
- History
- Where it hurts, what provokes it, how long it has lasted, what has and has not helped, other medical conditions and medications, and what you want to get back to.
- Examination
- Range of motion, strength, stability, gait, and special tests for the meniscus, labrum and rotator cuff — plus a check of the spine and neighboring joints for referred pain.
- Ultrasound
- Diagnostic musculoskeletal ultrasound when it answers a real question: fluid, tendon thickening or tearing, bursitis. It also allows real-time needle guidance if a procedure is chosen.
- Imaging review
- Your existing X-rays or MRI are reviewed against the examination. New imaging is ordered only when it would change the plan.
- When to refer
- Mechanical locking, a full-thickness tear, major instability, severe structural arthritis or signs of infection are routed to the appropriate surgeon or specialist without delay.
Care categories
Options, in the order they are usually considered
Conventional care first. Biologic injections when there is a specific target and a reason to try them. Cell-based products only after written informed consent.
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Standard care · FDA-approved
Conventional care
- Exercise therapy, weight management and activity changes — first-line for knee and hip osteoarthritis in the American College of Rheumatology guideline3
- Topical or oral anti-inflammatory medication, when safe for your kidneys, stomach and heart
- Corticosteroid injection: short-term relief for arthritis, bursitis and some shoulder problems; repeated use has trade-offs
- Hyaluronic acid (knee): FDA-approved devices with modest trial benefit; the ACR conditionally recommends against
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Off-label
Orthobiologics
- Platelet-rich plasma (PRP): your own blood, concentrated with an FDA-cleared device. Mixed trial results for knee arthritis; less evidence for hip and shoulder
- A PRP gel preparation: a thicker, gel-consistency form of your own PRP, with more limited published evidence
- Platelet-rich fibrin (PRF): a related preparation with a different composition
- Prolotherapy and other orthobiologic injections: limited, lower-quality evidence
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Not FDA-approved · investigational
Cell-based & exosome products
- Umbilical-cord-tissue-derived stem cell injections and perinatal (birth-tissue) allograft injections: offered only to selected patients under Florida law, with written consent naming the product’s source and status
- Exosome products: offered in selected cases after evaluation and written consent. No exosome product is FDA-approved, the FDA has warned consumers about unapproved exosome products,5 and the evidence in people is early
Performed at PrimeCell
Diagnostic musculoskeletal ultrasound and ultrasound-guided injections, small and intermediate joint injections, trigger-point injections, peripheral nerve blocks, prolotherapy, PRP (including a PRP gel preparation), PRF and, for selected patients, stem cell, perinatal allograft or exosome injections. Dr. Chantasi performs them himself.
Coordinated or referred
Physical therapy, radiofrequency ablation (for example of the nerves around the knee), EMG and nerve-conduction studies when pain may come from a nerve, and surgical opinions. Repair, arthroscopy or joint replacement is the right answer for some tears and for advanced arthritis, and PrimeCell will say so directly rather than delay a referral you need.
Candidacy
Who is — and is not — a reasonable candidate for a biologic joint injection
Often worth evaluating
- Pain for three months or more despite a genuine course of rehabilitation
- Mild-to-moderate knee or hip arthritis, or a rotator cuff tendinopathy or partial tear
- A clearly identified pain source on examination and imaging
- Wanting to explore non-surgical options before, or instead of, a surgical consultation
- Expecting gradual, possibly partial improvement — and willing to keep doing the exercises
Usually not a candidate
- End-stage arthritis with collapse or deformity, where joint replacement is the realistic option
- A full-thickness tendon tear, locked knee or major instability that needs surgical repair
- Active infection, uncontrolled diabetes, certain blood disorders, or blood thinners that cannot be adjusted safely
- Active cancer or recent cancer treatment (for cell-based products), or pregnancy
- Looking for a guaranteed or single-visit cure
Evidence & limitations
What the largest knee trials actually found
Short answer
Large, well-designed trials have not shown PRP or cell-based injections to beat placebo or a steroid injection for knee osteoarthritis at one year. Smaller studies and meta-analyses are more favorable, which is why the answer for an individual patient depends on the diagnosis — and why no one should promise cartilage regrowth.
In the RESTORE trial, 288 adults with knee osteoarthritis received either PRP or a saline placebo; at 12 months there was no meaningful difference in pain or in cartilage volume on MRI.1 A 480-patient randomized trial comparing bone-marrow, fat-derived and umbilical-cord cell injections with a corticosteroid injection found no product outperformed the steroid at one year.2 The American College of Rheumatology recommends against PRP and stem cell injections for knee and hip osteoarthritis, citing heterogeneous preparations and uncertain benefit.3
Pooled analyses paint a less uniform picture. A 2024 meta-analysis of randomized trials in the American Journal of Sports Medicine compared PRP with other injectable options for knee arthritis and examined how fragile the statistically significant findings were — a useful reminder that many “positive” results rest on small numbers of patients.4 Evidence for the hip and shoulder is smaller still and mostly limited to individual trials.
That is the context for every recommendation made here. Completed assessments join PrimeCell’s Outcomes Follow-Up program, which tracks pain and function with standardized measures; it has no published results yet.
Read the full evidence review: do stem cell injections work?
What to expect
From first visit to follow-up
Most patients leave the first visit with a diagnosis and a written plan, not a procedure.
Consultation
History, examination and ultrasound when useful. Bring prior imaging reports and a list of treatments you have tried.
Plan & estimate
Options compared with their evidence, risks and alternatives. A written estimate before anything is scheduled.
Procedure day
If you choose one, the injection is performed by Dr. Chantasi, usually with ultrasound guidance. Expect soreness for several days afterward.
Rehabilitation
A structured return to loading, with follow-up visits. Any change tends to develop over weeks to months, and some patients do not improve.
Cost & process
Self-pay, with a written estimate first
PrimeCell is a self-pay practice and does not bill insurance; regenerative joint procedures are generally not covered by insurance anyway. The total depends on the joint, the diagnosis, image guidance, the preparation used and the number of visits. You receive the figure in writing before you decide, and qualifying patients can use Cherry payment plans. No referral is needed.
Who examines your joint
Kenny Chantasi, DO
Board-certified in Physical Medicine & Rehabilitation and in Pain Medicine, and a former Assistant Professor of Rehabilitation and Regenerative Medicine at Columbia University Irving Medical Center. Musculoskeletal diagnosis and rehabilitation are the core of his specialty — which is why the plan starts with function, not a product. He performs PrimeCell’s evaluations and procedures himself.
Can a stem cell or PRP injection regrow knee cartilage?
Current evidence does not support that promise. In the largest placebo-controlled PRP trial, cartilage volume did not differ from placebo at 12 months. The realistic goal is less pain and better function for some patients, and a better ability to take part in rehabilitation.
Is there a real alternative to knee replacement?
For mild-to-moderate arthritis, yes: exercise therapy, weight management, bracing, medication and injections can keep many people active for years. For advanced arthritis with deformity, joint replacement is often the most reliable option, and Dr. Chantasi will tell you if that is where you are.
Are the results permanent?
No procedure can responsibly be promised as permanent. Osteoarthritis can continue to progress, and results are affected by alignment, body weight, muscle strength and activity.
Will I still need physical therapy?
Usually, yes. A procedure does not replace strengthening, mobility work and load management; it may make them easier to do.
Is stem cell therapy FDA-approved for arthritis?
No. No stem cell or exosome product is FDA-approved to treat osteoarthritis or joint pain. Florida law allows physicians to use certain non-approved stem cell therapies for orthopedic conditions and pain under specific conditions, which does not make them FDA-approved. FDA status and Florida law, explained.
Does insurance cover regenerative joint injections?
Generally not. PrimeCell is self-pay and gives you a written estimate before any procedure is scheduled.
Find out what is actually hurting — then decide.
A physician evaluation of your knee, hip or shoulder, with ultrasound when useful and a written plan that includes the option of no procedure at all.
$97Initial physician consultation · offer valid through October 31, 2026
THE PATIENT AND ANY OTHER PERSON RESPONSIBLE FOR PAYMENT HAS A RIGHT TO REFUSE TO PAY, CANCEL PAYMENT, OR BE REIMBURSED FOR PAYMENT FOR ANY OTHER SERVICE, EXAMINATION, OR TREATMENT THAT IS PERFORMED AS A RESULT OF AND WITHIN 72 HOURS OF RESPONDING TO THE ADVERTISEMENT FOR THE FREE, DISCOUNTED FEE, OR REDUCED FEE SERVICE, EXAMINATION, OR TREATMENT.
References
- Bennell KL, Paterson KL, Metcalf BR, 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. JAMA. 2021;326(20):2021-2030. doi:10.1001/jama.2021.19415
- Mautner K, Gottschalk M, Boden SD, et al. Cell-based versus corticosteroid injections for knee pain in osteoarthritis: a randomized phase 3 trial. Nat Med. 2023;29:3120-3126. doi:10.1038/s41591-023-02632-w
- Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Care Res. 2020;72(2):149-162. doi:10.1002/acr.24131
- Oeding JF, Varady NH, Fearington FW, et al. Platelet-rich plasma versus alternative injections for osteoarthritis of the knee: a systematic review and statistical fragility index-based meta-analysis of randomized controlled trials. Am J Sports Med. 2024;52(12):3147-3160. doi:10.1177/03635465231224463
- U.S. Food and Drug Administration. Consumer alert on regenerative medicine products including stem cells and exosomes. fda.gov
Medically reviewed by Kenny Chantasi, DO, on September 23, 2026. General education only; not medical advice. Candidacy is determined at an individual evaluation. Individual results vary and are not guaranteed.