Medically reviewed by the Celva medical team · June 2026
Small joints,
big consequence.
For thumb basal joint arthritis, finger OA, and refractory wrist tendinopathy, MSC therapy is a precision-delivered, image-guided alternative to fusion, arthroplasty, or repeated cortisone. Ultrasound is the workhorse here, the small joint space demands it.
Thumb basal joint arthritis is the dominant hand indication. Disabling pinch, weak grip, and a surgical recommendation in hand.
When most hand patients first notice change. Peak around 8–12 weeks. Function returns ahead of pain.
You've been told
fusion or replacement.
For thumb CMC and small finger joints, the standard surgical answer is fusion, ligament reconstruction with tendon interposition (LRTI), or a small-joint implant. All work in the right hands. None are reversible. Patients with preserved joint structure and a clear inflammatory driver are often worth evaluating first. Thumb CMC arthritis is largely driven by the supporting ligaments going lax, so we treat the joint and the structures around it, not only the cartilage.
Hand and wrist joints are small. The therapeutic window is narrow and the delivery has to be precise. We use high-resolution ultrasound guidance every time, no blind injection, no palpation-only technique.
If your hand surgeon has recommended fusion or arthroplasty but the joint still has real structure, an evaluation is a reasonable next step. You don't need to bring imaging: we assess the joint live on ultrasound, read any films you do have, and tell you plainly.
Thumb CMC arthritis, Eaton stage I–III
Preserved joint space, no significant subluxation, pinch is painful but possible. The best response profile on the hand.
Finger / IP joint OA & wrist conditions
Finger and IP joint osteoarthritis with inflammatory hand pain. Wrist osteoarthritis with preserved structure, De Quervain's, ECU, and FCR tendinopathy, and early-stage trigger finger, refractory to splinting, PT, and cortisone.
End-stage CMC (Eaton IV), nerve-driven pain
Bone-on-bone with pantrapezial involvement, unstable thumb column, carpal tunnel or cubital tunnel pain, surgery or release is the correct tool.
Hand & wrist
we evaluate.
Every evaluation starts with a physician, your history, and the joint assessed live on ultrasound (prior imaging helps but isn't required). Not every diagnosis qualifies. Candidacy is decided on staging, structure, and your specific case.
CMC (basal joint) arthritis
The most common hand indication. Painful pinch, weak grip, a surgical recommendation in hand. Best response in Eaton I–III.
- Eaton stage I–III
- US-guided intra-articular
- Pinch & grip strength tracked
Finger & IP joint osteoarthritis
Distal and proximal interphalangeal (IP) joint OA, Heberden's and Bouchard's nodes, with inflammatory hand pain. Painful grip, morning stiffness, deformity not yet severe.
- DIP / PIP (IP joint) OA
- Inflammatory hand pain
- Often paired with systemic IV
Wrist OA & tendon
Wrist osteoarthritis with preserved structure. De Quervain's, ECU, and FCR tendinopathy, triangular fibrocartilage complex (TFCC) injury, and early-stage trigger finger (stenosing tenosynovitis). Where splinting, PT, and cortisone have stopped holding.
- Wrist osteoarthritis, preserved structure
- De Quervain's / ECU / FCR · TFCC
- Trigger finger, early-stage
How a hand session
actually runs.
Small joints demand precision. Cells are delivered under high-resolution ultrasound, in-plane, with needle position confirmed before release. The dose is calibrated to the joint volume, not the body. We treat the whole joint: the cartilage and the supporting ligaments and tendons around it that drive much of the pain, which for the thumb CMC is often the larger problem.
Joint cases like yours use bone-marrow and umbilical-cord MSCs, often in combination and sometimes with chondrocytes for cartilage support. The exact recipe, which cells, what doses, which routes, is decided by Celva's medical team after assessing the joint, by exam and ultrasound, and reviewing any imaging you have. Matched to your case, not pulled off a shelf. Why we use multiple cell types →
The entire procedure is physician-supervised at Hospital Angeles, Tijuana. Concierge transport from San Diego in the morning, discharge the same afternoon. The hand is fully functional within 24–48 hours.
Exam & candidacy
Your history and any films you have, reviewed by the attending. Prior imaging isn't required: we confirm Eaton or KL grade, joint space, and instability on live ultrasound at your visit. You'll hear either way.
Dose & targets
Cell dose calibrated to joint volume, number of joints, and whether a same-day systemic IV is indicated.
Ultrasound-guided injection
High-resolution US, in-plane technique. Each target confirmed before release. Local anesthetic and twilight sedation (no general): a still, comfortable patient lets the physician place each target precisely.
Systemic IV
A second MSC dose IV in the infusion suite. Circulating cells are drawn toward inflammation and migrate toward the joints we just injected, reinforcing the local repair while calming inflammation across the hand and body-wide.
Scoring & check-ins
We score QuickDASH and VAS at baseline, then at 4, 8, and 12 months (by phone or online form), with a lighter pain check around six weeks. Pinch and grip strength are measured in person on visit days. Repeat ultrasound on return for re-treatment.
What to expect.
And what we won't promise.
No outcome guarantees. What you get is a thorough evaluation, a realistic conversation, and treatment delivered to pharmaceutical-grade standards. Here is what our clinical follow-up generally shows for hand candidates.
Inflammation down
Morning stiffness shorter, less throbbing at rest. Pinch pain may still be present on loading.
Function returns
Pinch and grip dynamometry improve for most qualifying candidates. Patients open jars, turn keys, write longer.
Peak window
Some patients report near-complete relief. Others see partial improvement. A subset benefit from a booster at this point.
Durability window
Many hand patients hold meaningful results for one to three years, and often longer. Heavy mechanical demand shortens that window.
Hand patients often report function returning ahead of pain. The ability to pinch a key or grip a coffee cup comes back before resting pain drops to zero.
We measure progress on standardized scales: QuickDASH for function and VAS for pain, scored remotely at baseline and again at 4, 8, and 12 months, with pinch and grip strength measured in person on visit days.
Eaton IV with pantrapezial involvement, severe instability, or pain that's nerve-driven rather than joint-driven is generally not a strong MSC case. We'll tell you directly, and explain why surgery or release may be the right answer.
Hand-specific
questions.
Q.01 Can MSC therapy replace thumb CMC surgery?
Q.02 How long before I notice improvement?
Q.03 Can multiple finger joints be treated in one session?
Q.04 Does the injection hurt?
Q.05 What about carpal tunnel or trigger finger?
Other joint regions
we treat.
Start with an
honest read.
A consult is a physician reviewing your history, goals, and any imaging you have, then telling you plainly whether MSC therapy is a realistic option for your hand. If it isn't, we'll say so.