Historically, we have offered our patients with arthritis physical therapy, activity modification and limitations, nonsteroidal medications, steroid injections, and hyaluronic acid injections with moderate success. But where do we go from here? How do we help our patients avoid the risks of major surgery when they are given the ominous report, “You have bone-on-bone arthritis in your hip or knee”?
Orthobiologic therapies are proving to be very successful in harnessing the power of your own body’s repair processes to relieve arthritic pain, slow the degenerative changes, and improve a patient’s mobility. With a growing body of scientific evidence, these therapies may be the ultimate solution to this growing problem. It is reported that the number of total knee replacements in the U.S. is expected to increase from 1 million per year in 2025 to 3 million per year in 2030.
Unfortunately, approximately 90,000 people (three percent of the U.S. population) will require revision within two years or less. That is a lot of unhappy patients!
I have spoken before about the power of platelet-rich plasma, which provides up to twelve months of relief to seventy percent of patients suffering from the condition. However, we can also stack this treatment with hyaluronic acid or a concentrated protein in your plasma, called A2M, to prolong the results to eighteen months.
What’s New and Exciting on the Horizon
What is exciting for Florida in the newly passed legislation, Florida House Bill 1617, in July 2025? This now permits the use of umbilical cord and amniotic tissue to harvest stem cells and exosomes, which can be applied to treat orthopedic conditions, manage pain, and promote wound healing.
We know that stem cells derived from these sources are more powerful in their regenerative capabilities, and they can produce these powerhouses in much greater numbers. Additionally, the patient does not have to undergo the process of harvesting from the bone marrow or fat, which is associated with discomfort and risks.
What Are These Stem Cells and Exosomes We’re Hearing About?
Stem cells are very specialized cells located throughout your body along every blood vessel and within the bone marrow. These cells are activated by injury and mobilize to the site of injury, coordinating a complex process of repair and regeneration. They also recruit stem cell mobilization from the bone marrow to “go to work” in these processes.
When we inject these cells into a degenerative joint, they immediately go to work amplifying the reparative processes, decreasing inflammation for the surrounding joint structure. There is also scientific evidence of partial cartilage repair and restoration, leading to decreased pain and improved mobility.
How Do Exosomes Work in This Process?
Exosomes are extremely small extracellular vesicles produced by stem cells and platelets, which are released from the cell as small packages carrying a concentrated cargo of proteins, growth factors, enzymes, and mRNA. They travel, protected by a fatty layer throughout the body, in circulation to target injury or disease and enter their target cells to direct cellular activities, including protein production, regeneration, and anti-inflammatory functions. These exosomes are released from your platelets during a PRP injection as part of the repair process. However, when these are harvested from the umbilical cord or amniotic fluid, ten times as many exosomes are available for clinical use, targeting degenerative tissue and joints. The latest research suggests these tiny powerhouse packages provide a more targeted and safer approach without the concern for immune response to a “foreign cell.
All these latest orthobiologics, stem cells, and exosomes are collected at the time of a routine C-section delivery. All donors are screened, and the samples are processed in an FDA-regulated laboratory. A complete certificate of analysis is provided with each sample for tracking. These are some of the most exciting and cutting-edge therapies currently being made available to the public.
At Body Restore of Naples, we aim to make these options available to those who have been diagnosed with bone-on-bone arthritis and require a joint replacement procedure. Come see us for a consultation today, and let’s see if you are a good candidate for these exciting nonsurgical solutions.
Dr. Steven Case, MD, is a board-certified orthopedic surgeon with over twenty years of experience in sports medicine and joint replacement surgeries. He is the only orthopedic surgeon in South Florida with a practice solely focused on avoiding surgery using these cell-based therapies. Body Restore of Naples is located at 4760 Tamiami Trail N, Ste. 24, Naples.
To learn more, visit: bodyrestorenaples.com, call 239.241.2869, or email: bodyrestorenaples@gmail.com